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New research starts on quality and safety in NHS and independent hospitals

AMBS and the University of York have joined forces to launch new research into the quality and safety of patient care in NHS and independent hospitals.

Set to culminate in 2025, the project marks the first time the substantial changes to the way the NHS and independent sector work together have been studied since the COVID-19 pandemic.

The research, funded by the National Institute for Health Research, will build on reforms led by both NHS Digital and the Private Healthcare Information Network (PHIN), which will create a single dataset for all admitted patient care across all acute hospitals. 

Good clinical governance

Research lead Kieran Walshe, Professor of Health Policy and Management at AMBS, said: “The research will explore the changes which have followed reports such as the Paterson inquiry – an independent inquiry set up following the conviction of surgeon Ian Paterson – which highlight the need for good clinical governance across the interface between NHS and independent hospitals. This is a complex area where good evidence of what works is much needed.”

The research team plans to use existing routine data to explore patterns of care provision and patient flows, to examine the scope of practice of doctors working across both sectors, and any differences in quality of care. 

Through national surveys of hospital leaders and on-site qualitative fieldwork, the team will explore how reforms to clinical governance are working and how information is used in practice to support quality improvement. Qualitative research will also examine patients’ experiences of care across the NHS and independent sectors. 

Important research

Dr Andrew Vallance-Owen, chair of the project advisory group and former chief medical officer of BUPA, said: “This is important research considering safety and quality in both NHS and independent hospitals in one project. 

“Hospitals in both sectors now collect enough relevant data for quantitative analysis and useful comparisons to be made. These, in addition to in-depth qualitative analysis, will provide evidence to enable the two sectors to learn from each other, strengthen practical clinical governance and bring opportunities for clinical quality improvement.”

Dr Howard Freeman, medical director of the Independent Healthcare Providers Network, added: “Patient safety is the top priority for all independent healthcare providers, with almost nine in ten independent sector hospitals currently rated good or outstanding by the CQC.

“With the sector playing an increasingly important role in meeting the rising demand for both NHS and privately-funded treatments, this research will help ensure that all parts of the healthcare system work together as effectively as possible so that patients get the best possible care, regardless of where they are treated.”


The development of the research has had close involvement and support from a range of stakeholder organisations, including the Independent Healthcare Provider Network, the Care Quality Commission, NHS Digital, the Private Healthcare Information Network, the General Medical Council and NHS England, and from AMBS’ patient and public involvement forum.

Dr Jon Fistein, PHIN’s Chief Medical Officer, said: “We are delighted to be part of this project, as it will provide important insights into how healthcare is delivered and governed in both the NHS and private sectors.”

Professor Karen Bloor from the University of York added: “This project will be the first major study to make use of data about inpatient care from both NHS and independent hospitals to look at the whole scope of medical practice and to explore differences and variations within and across hospitals. It is an exciting step forward in understanding the quality of care.”