England Scotland Northern Ireland Wales

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Regulatory systems for healthcare quality

Each nation within the United Kingdom is placing increasing emphasis on healthcare quality and the need to ensure that standards are both maintained and improved.

To monitor, inspect and encourage improvement of healthcare quality, each nation has its own individual regulatory system, often involving a range of bodies with frequently overlapping responsibilities.

Table 1 briefly sets out the regulators for the core health and social care areas in each nation:

 Sector/Nation  England  Northern Ireland
 Scotland Wales
Hospitals and acute care
Care Quality Commission and NHS Improvement
Regulation and Quality Improvement Authority
Healthcare Improvement Scotland
Healthcare Inspectorate Wales
GP practices
Care Quality Commission
Health and Social Care Board
Healthcare Improvement Scotland and RCGP Scotland
Healthcare Inspectorate Wales
Mental health services
Care Quality Commission and NHS Improvement Regulation and Quality Improvement Authority Mental Welfare Commission for Scotland and Healthcare Improvement Scotland
Healthcare Inspectorate Wales
Social care
Care Quality Commission Regulation and Quality Improvement Authority
The Care Inspectorate and Healthcare Improvement Scotland
Care and Social Services Inspectorate Wales


The BMA has produced a briefing on the regulatory systems for healthcare quality across the United Kingdom in order to clarify how these systems work and to identify the ways in which they are changing.

Full briefing paper


Regulations of healthcare quality by nation

  • England

    The regulation of healthcare quality in England has recently undergone significant change, following the creation of NHSI (NHS Improvement) as the combined regulator of NHS foundation trusts, NHS trusts and independent providers of NHS-funded care.

    Find out more


  • Northern Ireland

    The quality of healthcare services in Northern Ireland is regulated principally by the RQIA (Regulation and Quality Improvement Authority), the independent health and social care regulator.

    The HSCB (Health and Social Care Board) are responsible for the monitoring and appraisal of HSC (Health and Social Care) GP services.

    The quality standards for health and social care are used by the RQIA in its inspections and as a guide for health and social care providers to improve services.

    Quality regulation in Northern Ireland is also linked to Quality 2020, the 10 year quality improvement strategy launched by the Department of Health in 2011.

    Find out more


  • Scotland

    The quality and improvement of health services in Scotland is principally regulated by HIS (Healthcare Improvement Scotland), the national healthcare improvement organisation.

    HIS works alongside MWCS (Mental Welfare Commission for Scotland), which regulates mental health services.

    The Care Inspectorate is the social care and social services regulator in Scotland.

    The Scottish Government sets the general direction of quality improvement with its national health policies, namely its 2020 Vision and the Quality Strategy for NHS Scotland.

    It also monitors the performance of Scottish NHS services using a small set of targets and standards, which are currently under review.

    Find out more


  • Wales

    The quality of NHS and independently provided healthcare in Wales is regulated by the HIW (Healthcare Inspectorate Wales).

    Healthcare providers are expected to meet the Health and Care Standards set by the Department for Health and Social Services.

    The WAO (Wales Audit Office) also contributes to healthcare quality regulation, working with HIW to provide financial regulation as the external auditor of the Welsh NHS.

    CHCs (Community Health Councils) act as a form of independent ‘watchdog’ of health services in Wales, representing and promoting the views of patients and the public.

    Additionally, the CSSIW (Care and Social Services Inspectorate Wales) regulates social care and social services throughout Wales.

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