Consultation on the draft updated risk assessment framework and reporting manual for independent sector providers of NHS services

Closed 22 Feb 2023

Opened 25 Jan 2023


Separate to this consultation NHS England is currently preparing a response to a consultation on proposed updates to the NHS provider licence. Those proposals include:

  • adding specific quality governance related criteria to the continuity of services (CoS) licence conditions and
  • establishing a category of ‘hard to replace’ independent providers of NHS services, as designated by NHS England, to whom some of the CoS conditions will also apply.  

Those proposals would require us to make some changes to how we oversee independent providers of NHS-funded services. Hence we are consulting on an updated version of our Independent Provider Risk Assessment Framework (IPRAF), which incorporates the proposed approach by which NHS England, working with other bodies including the Care Quality Commission (CQC), will identify and respond to issues of poor quality governance at those independent sector providers that are subject to the CoS conditions of the license.

The updated IPRAF also reflects NHS England’s assumption of Monitor’s regulatory role over licensed independent providers of NHS services since the abolition of Monitor.

This consultation is therefore mainly aimed at independent providers that are subject to the CoS conditions of the licence, but also contains information for all other licensed independent providers, including NHS-controlled providers that have been told they will be regulated under the IPRAF. The proposed updates have no implications for our oversight of NHS trusts or foundation trusts.

Why your views are important

Your feedback will be used to shape the updated version of the IPRAF that will include NHS England’s approach to the oversight of quality governance at providers subject to the CoS conditions. We welcome comments on each of the proposed changes as set out in the consultation document.

The consultation will close at midnight on 22 February 2023.

Note on the application licence changes

We expect to issue updated licences to all existing and new licence holders once the licence is finalised post consultation, with an effective date based on when all licences will have been issued. The estimated timeline will be communicated as part of the publication of the consultation response. Existing arrangements will be maintained until such time as the new licences take effect.


  • All interested stakeholders


  • Any Interest