13 Accepted in Part

Independent sector provider responsibility

Paterson Inquiry · Report of the Independent Inquiry into the Issues raised by Paterson · Issued 4 February 2020 · Addressed to: Department of Health and Social Care

Source — verbatim from the inquiry

Inquiry recommendation

We recommend that the government addresses, as a matter of urgency, this gap in responsibility and liability.

Paterson Inquiry, Report of the Independent Inquiry into the Issues raised by Paterson · 4 Feb 2020 Source PDF →

Published evidence summary

Publicly available evidence relating to this recommendation:

- The Independent Healthcare Providers Network (IHPN) refreshed the Medical Practitioners Assurance Framework (MPAF) to clarify that independent providers are responsible for the quality of care in their facilities (DHSC and NHS England implementation update provided to the Thirlwall Inquiry, April 2025).
- The CQC stated it assesses independent sector providers on their governance mechanisms, taking the MPAF into account during inspections (DHSC and NHS England implementation update provided to the Thirlwall Inquiry, April 2025).
How was this evidence gathered?
Evidence searched by Gemini (Google) on 30 Jun 2026
Checked data held on this site (government responses, progress updates, independent evidence)
External sources searched: www.gov.uk, www.legislation.gov.uk, hansard.parliament.uk

Response — verbatim from government

Department of Health and Social Care

Accepted in principle. Government acknowledges gap in legal responsibility when consultants work under practising privileges. CQC strengthened requirements for independent providers to have robust governance over consultants. Consideration being given to whether legislative change needed. Government working with Independent Healthcare Providers Network on voluntary improvements. (Source: Government Response, December 2021)

Department of Health and Social Care · 16 Dec 2021

Evidence trail — what's actually happened since

  • 1 Apr 2025 DHSC and NHS England implementation update provided to the Thirlwall Inquiry (April 2025). This is the government's own account of progress, submitted to the inquiry. Reviewed extent of implementation: Partially implemented – Ongoing. The Independent Healthcare Providers Network has refreshed the Medical Practitioners Assurance Framework (MPAF) for clinical governance in the independent sector. This framework makes clear that independent sector providers must take responsibility for the quality of care provided in their facilities. CQC assesses all providers, including independent sector providers, on their mechanisms for ensuring high standards of care, taking into account frameworks such as MPAF as appropriate. See recommendation 7 in relation to work on clinical indemnity issues. Source →

Each entry above links to a primary source — gov.uk written statement, consultation response document, or inspection report. The Index does not characterise government intent; it tracks what has been published.

How this page is built

Source and Response are verbatim from primary documents. The Evidence trail records published activity since — written statements, consultation outcomes, inspection findings, parliamentary references. The Index does not paraphrase or characterise intent; it tracks what has been published. Where the evidence is the absence of action (a missed deadline, a slipped timetable), that absence is documented from primary sources rather than inferred.

This recommendation's data is verified periodically against primary sources. The Index is monitored for staleness weekly.