Healthcare Improvement Scotland software, built to help you achieve Exceptional.
wai is Healthcare Improvement Scotland compliance software that runs booking, clinical notes, consent, patient messaging, payments and records for independent clinics and hospitals in Scotland, and keeps each one as evidence an HIS inspector can read. Built to help you achieve Exceptional, the top grade HIS gives each of its 3 key focus areas.
02Implementation and deliveryHow well does the service engage with its stakeholders and manage/improve its performance? Domains 3, 4 and 5.13 quality indicators
The sources HIS uses before, during and after an inspection.2
01
Self-evaluation
The provider's own account against the Quality Assurance Framework, sent through the HIS portal when asked.
02
Annual return
The service's composition, activities, incidents and accidents, and staffing, for the calendar year.
03
Notifications
The events a provider must report to HIS, each within its own timescale.
04
Complaints
Complaints made to the service and to HIS, and how they were handled.
05
Enforcement activity
Any condition, notice or other action already taken against the service.
06
Other professional bodies
Intelligence shared by other regulators and professional bodies.
07
Patients and staff
The views of those receiving care and those delivering it, gathered at inspection.
08
Care and treatment
Outcomes for patients first, then the processes that keep care safe.
How does HIS grade a service?
One grade for each key focus area, on a four point scale.3
ExceptionalContinuous, self-directed improvement, benchmarked externally, with stakeholders involved
GoodSystems working, positive outcomes and self-directed improvement
SatisfactorySystems developed and implemented, with evidence of impact
UnsatisfactoryNo evidence of appropriate systems being developed or implemented
3
grades in every inspection report, one each for Direction, Implementation and delivery, and Results.3
8 weeks
after an inspection, the report and the provider's improvement action plan are published on HIS's website.3
5 days
working days to return the factual accuracy form on a draft report, before HIS may finalise it.3
Each key focus area is graded on its own evidence, so a service can be Exceptional in one and Good in another.
A follow-up inspection can raise a grade to no higher than Satisfactory, because it looks only at what was asked of the service last time.
Exceptional also asks for evidence of external assurance or benchmarking, and of stakeholders helping to improve the service.
Grades may change after a report, for example after enforcement action or an upheld complaint.
What is changing for independent healthcare in Scotland?
The Quality Assurance Framework is unchanged in 2026. A new Act adds rules for non-surgical procedures.
In force today are the Quality Assurance Framework of September 2022 and the inspection methodology of July 2024. HIS says it is updating its guidance for providers.
The Non-surgical Procedures and Functions of Medical Reviewers (Scotland) Act 2026 received Royal Assent on 12 May 2026. It bans the procedures it covers for anyone under 18, and outside specified premises, which include registered independent clinics.4
As of 15 October 2026 the premises offence is not in force, and the Act says it cannot start before 6 September 2027. A registered clinic run by a doctor, a dentist or an independent prescriber is already among the permitted premises.
Who has to register with Healthcare Improvement Scotland?
HIS registers five kinds of independent healthcare service, and running one unregistered is an offence.
Providing an unregistered independent healthcare service is an offence under section 10Z9 of the 1978 Act, and a service may not trade until HIS grants registration. HIS says a complete application now takes a minimum of six months.5
Registering an independent clinic costs £3,996 in 2026/27, and £5,708 for an independent hospital, with an annual continuation fee after that. The fee is not refunded if an application fails. The fees for 2026/27.
Service
What it covers
Independent clinics
A clinic outside a hospital where a doctor, dentist, nurse, midwife, pharmacist, pharmacy technician or dental care professional provides consultations, investigations or treatments. A private GP and a nurse led cosmetic clinic are both examples, and so are wholly private dental practices. The definition and exemptions.
Independent hospitals
Hospitals outside the NHS, as section 10F of the National Health Service (Scotland) Act 1978 defines them.
Private psychiatric hospitals
A hospital treating one or more patients under an order or direction of the Mental Health (Care and Treatment) (Scotland) Act 2003 or the Criminal Procedure (Scotland) Act 1995.
Independent hospices
Voluntary hospices, regulated by HIS as independent hospitals.
Independent medical agencies
Services with no premises for patients to visit, such as an online GP based in Scotland. Regulated since 2025.
What does HIS ask for between inspections?
Self-evaluations, annual returns and notifications feed the risk score that sets the next inspection.
Self-evaluation. Sent through the HIS portal when HIS asks, against the Quality Assurance Framework. What the service does well, what could improve, and how it will.6
Notifications. 31 categories, each with its own timescale. A complication of dermal filler is notified within 24 hours, a controlled drug incident within 2 working days. The notifications guidance.
Variations. A change to the conditions of registration, such as adding laser or IPL treatments, is requested at least 28 days before it happens.
Service Risk Assessment. HIS scores every service on five indicators. The score sets the next inspection, from a follow-up within 3 to 6 months to a full inspection within 5 years.
What happens when a service falls short?
HIS makes requirements first, then uses graduated legal notices under the 1978 Act.7
Step
What it does
Requirement
What the provider must do to comply with the 1978 Act, regulations or a condition of registration. Enforceable.
Recommendation
What the service should do to align with relevant standards and guidance.
Condition notice
Varies, removes or adds a condition of registration, under section 10U.
Improvement notice
Sets out HIS's intention to cancel registration unless significant improvement is shown within a set time, under section 10R.
Cancellation
Cancels registration when an improvement notice's timescale passes without compliance, under section 10S.
Emergency action
An emergency condition notice, or an application to the sheriff to cancel registration, where there is serious risk to life, health or wellbeing.
What should Healthcare Improvement Scotland compliance software actually run?
Booking, notes, consent, messaging, payments, access and reports, each mapped to the key focus areas it evidences.
01
Appointments and booking
Online booking from your own website, every clinician's diary read from their calendar, reminders, rebooking after a missed visit and waitlist offers when a slot opens.
Online booking at any hour, with a reminder before the visit.
For the business
Fewer missed appointments, and cancelled slots offered to the waitlist.
On the record
Every booking, reminder and change, with a time and a name.
02
Billing and payments
Card payments into your own Stripe account, the cancellation policy shown at booking, invoices, statements and reconciliation, with an export for your accountant.
A clear price and policy before they commit, and an invoice in their app.
For the business
Payments reconciled against visits, with an export for your accountant.
On the record
What was charged, when, against which visit, and the price and policy the patient saw before booking.
03
AI scribe and clinical notes
The note, letters and referrals written from the consultation, cited to guidelines such as NICE, with the transcript beside the note, for the clinician to read, edit and sign.
The clinician's attention stays on them during the consultation.
For the business
Less time spent writing notes after clinic.
On the record
A contemporaneous note, signed, with the time, the signature and the source it cites.
04
Follow-ups and patient messaging
WhatsApp, email and calls in one thread per patient, replies drafted in the patient's own language for your team to approve, a response clock on every new enquiry, and recalls a clinician approves.
A reply in the language they wrote in, approved by your team.
For the business
More enquiries answered within the hour, when they are most likely to book.
On the record
The whole conversation on one record, with response times.
05
Referrals, consent and audit trails
Recording consent taken at booking, referrals written from the visit, patient flags for controlled drugs and safeguarding notes, and every read of a record logged against a named account.
For each key focus area, the records wai keeps, how you produce them, and what changes for patients and the business.
Direction
Weekly reports on takings, the front desk and response times, for the people who lead the service.
Takings, front desk, response and website reports, as key performance indicators
Named accounts and role-based access, enforced in the database
The signing clinician named on every note and letter
A clinic in Scotland has its records hosted in the United Kingdom
On request. Asked how you know the service is meeting its aims, show the reports you already read on Monday.
For patients
Aims, values and service standards they can read before they book.
For the business
Weekly figures for leaders to review at governance meetings.
Implementation and delivery
Feedback, complaints and response times recorded on one thread per patient.
Every message, review request and complaint on one thread per patient
A response clock on every new enquiry, and response targets in the reports
Prices and the cancellation policy shown before booking, and what was charged
The audit trail behind every record, for your audits and risk reviews
On request. Show what patients told you this quarter, how fast you answered, and what changed because of it.
For patients
Answered quickly, in their own language, and told what happens next.
For the business
More enquiries converted to bookings, and more patients returning for follow-up.
Results
Signed, timed patient care records, with consent and an access log on each.
Notes written from the consultation, signed and timed by the named clinician
Recording consent taken at booking, and the consent discussion in the note
Patient flags for controlled drugs and restricted safeguarding notes
Every read and change of a record, logged against a named account
On request. Pull any five patient care records. Note, consent, signature and time appear together.
For patients
Flags, consent and history on the record at every visit.
For the business
Adverse events reviewed from the record, in minutes.
What do patients and the business gain?
Published figures on response times, clinician workload after hours and attendance.
7x
An enquiry answered within the hour is nearly seven times as likely to become a real conversation.8
30%
Clinicians using an ambient scribe did 30% less work after hours.9
23%
Patients sent a notification before their visit were 23% more likely to attend.10
How does wai surface HIS evidence on request?
Where each item an inspector asks for is kept, and how it is produced.
Asked forWhere it livesHow it is produced
Patient care recordsThe patient record, beside the transcriptEach consultation and its outcome, signed and timed by the named clinician.
ConsentThe booking and the noteThe recording notice the patient saw at booking, and the consent discussion in the signed note.
Audit trailsEvery recordWho read or changed it, under which account, to the minute.
Adverse eventsThe record and its historyThe exact sequence of events, from the audit trail, for your review and your notification to HIS.
Prices and policiesBooking and paymentsThe price and cancellation policy a patient saw before they booked, and what they paid.
Staff accessAccounts and rolesWho holds which role, and every action taken under it.
Feedback and complaintsThe patient's threadEvery message, review request and complaint, with response times.
Self-evaluation and annual returnReportsFront desk, response and takings reports to draw on when HIS writes.
How do you prepare for an HIS inspection?
A readiness checklist, by key focus area.
01Before HIS writes
Check your certificate of registration matches what you offer, and that every variation was approved.
Close every requirement and recommendation from registration, your last inspection and any complaint investigation.
Keep your self-evaluation current, with three priorities and an action plan for each.
Keep the records HIS lists inside the service, unless HIS has agreed otherwise in writing.
02Direction
Aims, objectives and values that patients and staff can see.
Key performance indicators that include patient safety, reviewed at governance meetings.
Minutes of management and clinical governance meetings, with actions and owners.
Practising privileges agreements that say who is accountable for what.
03Implementation and delivery
Patient feedback gathered in one structured way, with what changed because of it.
A complaints procedure on your website that names HIS and says patients can contact HIS at any time.
A risk register reviewed by senior staff who did not write it.
An annual duty of candour report, published.
04Results
Five patient care records a reviewer could read cold, complete, signed and dated.
Consent recorded for every treatment, with risks and aftercare.
Staff files with two references, PVG membership, training and appraisal.
Lessons learned from complaints and adverse events, and what changed.
What will an HIS inspector ask you?
Common inspection questions, what to show, and where the answer is kept.
01Show me five patient care records.
What to show
Records completed, signed and dated, with consent, treatment and aftercare.
Where wai has it ready
Notes are written during the visit and signed with a time, and an amended note is signed again.
02How do patients consent, and where is it recorded?
What to show
What the patient was told, when they agreed, and where it is written.
Where wai has it ready
Recording consent is taken at booking, and the consent discussion is in the signed note.
03How do you know what patients think of the service?
What to show
Feedback gathered in one place, with what changed because of it.
Where wai has it ready
Every message, review request and complaint sits on one thread per patient, with response times.
04How are complaints handled?
What to show
A log, an investigation, and a reply within 20 working days.
Where wai has it ready
The complaint and every reply sit on the patient's thread, timed, for your complaints log.
05Walk me through your last adverse event.
What to show
The sequence of events, the review, the notification and what changed.
Where wai has it ready
The audit trail gives the exact sequence, to the minute, from the record itself.
06Are prices clear before a patient commits?
What to show
The price and policy a patient sees before booking.
Where wai has it ready
The cancellation policy is shown at booking, and every charge is tied to its visit.
07Who can see patient records, and how would you know?
What to show
Roles, access controls and an access log.
Where wai has it ready
Role-based access enforced in the database, and every read logged against a named account.
08How do leaders know how the service is performing?
What to show
Key performance indicators, read at governance, with actions that close.
Where wai has it ready
Front desk, response, takings and website reports, read by leaders every week.
What does an HIS grade cost to lose, and what does registration cost?
Every HIS inspection report is published with its grades, and registering a service takes months and a fee that is not refunded.
Public
Every inspection report, with its three grades and the provider's improvement action plan, is published on HIS's website about 8 weeks after the inspection, where patients can read it.3
£3,996
is HIS's 2026/27 fee to register an independent clinic, £5,708 for an independent hospital, with an annual continuation fee of up to £3,928 for a clinic after that.11
6 months
is the minimum HIS now takes to process a complete registration application, and a service may not trade until it is granted.12
What is the best software for a Healthcare Improvement Scotland inspection?
The system your service already runs on, so the evidence is recorded as the work is done. Look for one record behind booking, notes, consent, messaging, payments and access, with signed, timed notes and a full audit trail. wai is built that way, to help you achieve Exceptional.
Is there HIS approved software?
Healthcare Improvement Scotland registers, inspects and grades independent healthcare services. It does not approve, certify or endorse software, wai included, and software cannot earn a grade on a provider's behalf. wai keeps the records your team uses to show HIS how care is delivered, and HIS decides the grade.
Does my clinic need to register with HIS?
If a doctor, dentist, nurse, midwife, pharmacist, pharmacy technician or dental care professional provides consultations, investigations or treatments from premises outside the NHS, it usually does. Aesthetic clinics and wholly private dental practices included. HIS lists the exemptions and worked scenarios, such as room rental, on its site.
How does HIS grade a service?
Each of the 3 key focus areas, Direction, Implementation and delivery, and Results, is graded Exceptional, Good, Satisfactory or Unsatisfactory. Exceptional needs continuous, self-directed improvement, external assurance or benchmarking, and stakeholders involved in improving the service.
What is the difference between a requirement and a recommendation?
A requirement sets out what a provider must do to comply with the National Health Service (Scotland) Act 1978, regulations or a condition of registration, and it is enforceable. A recommendation sets out what a service should do to align with relevant standards and guidance.
How often does HIS inspect?
It depends on the Service Risk Assessment score. A service scored very high gets a follow-up within 3 to 6 months. A very low score means a full inspection within 5 years. A new service is usually first inspected 18 to 24 months after registration.
Does wai work for aesthetic clinics and hospitals?
Yes. A single-handed aesthetic clinic and a multi-site hospital group run on the same record, inbox and reports. Larger organisations usually start with one pathway, prove it on their own data, and widen it from there.
Where does wai keep our records?
A clinic in Scotland has its records hosted in the United Kingdom, encrypted, with a full audit log. We set this up with you before go-live.
See how wai runs an independent clinic in Scotland.
Fifteen minutes on video, on your own diary, notes and inbox. Built to help you achieve Exceptional. A clinic in Scotland has its records hosted in the United Kingdom.
