How do you prepare for a Healthcare Improvement Scotland inspection?

To prepare for a Healthcare Improvement Scotland inspection, close every open requirement, keep the records HIS lists inside the service, and be ready to show all 3 key focus areas working. Independent clinics usually get 4 weeks' written notice, while hospitals and hospices are usually inspected unannounced.

Which inspection you will get

HIS has legal powers to enter and inspect a registered service at any time. Inspections of inpatient services are generally unannounced. Inspections of independent clinics are generally announced, with 4 weeks' written notice, though HIS may arrive unannounced at a clinic that performs poorly or where it has intelligence to verify.¹

How often HIS comes depends on the Service Risk Assessment. It scores five indicators, the clinical risk of what you do, your annual return, complaints and notifications, your inspection outcomes, and any significant concern. A very high score brings a follow-up within 3 to 6 months. A very low score, a full inspection within 5 years.¹²

What inspectors do on the day

Before the visit HIS checks your self-evaluation, annual return, conditions of registration, notifications, complaints and previous requirements. On the day it checks your registration certificate and conditions, checks those requirements, assesses compliance with legislation, evaluates how you apply the Quality Assurance Framework, and seeks feedback from patients and staff. It gives feedback to the service manager before it leaves.¹ Inspections focus mainly on outcomes for patients, then on the processes that keep care safe.³

1. Check your certificate and conditions. Make sure every treatment you offer is covered by your conditions of registration, and that any change, such as adding laser treatments or treating under-18s, was approved as a variation.
2. Close every open requirement. Inspectors check the requirements and recommendations from registration, previous inspections and recent complaint investigations. Have the evidence for each one ready.
3. Refresh the self-evaluation. Bring it up to date against the 7 domains, with three priorities and the action plan behind them.
4. Keep the records in the building. HIS expects its listed records to be kept within the service unless it has agreed otherwise in writing. Staff files, complaints, maintenance, meetings and patient records all count.
5. Audit five patient care records. Check that each is complete, signed and dated, with consent, treatment, medicines and aftercare. Where a field is often missing, change how records are made.
6. Gather patient and staff views. Inspectors ask patients and staff directly. Know what they will say, and what you changed after they last told you something.
7. Name who answers. One person for each key focus area, and the manager to receive feedback at the end of the day.

The records HIS lists

HIS publishes the records every registered service must keep. For patients, the full name, address and date of birth, next of kin, GP, a record of consent to treatment, and the dates care began and ended. For staff, qualifications, references, professional registration number, Disclosure Scotland or PVG details, indemnity insurance, training and supervision. Then complaints with their investigation and outcome, medicines records, equipment maintenance, actions on MHRA alerts, and minutes of staff meetings.⁴

Regulation 4 of the 2011 regulations adds the shape of the patient care record itself. The date and time of every consultation and the clinician's name, its outcome, every treatment with place, date, time and the responsible clinician, and every medicine, recorded as closely as possible to the time.⁵

1. Certificate of registration and conditions, checked on ______
2. Open requirements and recommendations, with evidence for each ______
3. Self-evaluation, last submitted on ______
4. Five patient care records audited on ______ by ______
5. Staff files checked for references, PVG, registration and training on ______
6. Complaints log and duty of candour report, current to ______
7. Lead for Direction ______ Implementation and delivery ______ Results ______

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After the visit

About 5 weeks after the inspection you receive a draft report. You return the factual accuracy form and an improvement action plan for any requirements and recommendations, and if the form is not back within 5 working days HIS may finalise the report. At 8 weeks the final report and your action plan are published on HIS's website, and the plan comes down at 16 weeks.¹ The guide to responding to HIS requirements and recommendations covers that plan. England's equivalent process is on the CQC hub.

Questions

How much notice does HIS give?

For an announced inspection, normally 4 weeks in writing, though HIS may give less. Clinics are usually announced. Hospitals, hospices and psychiatric services are usually unannounced, and can be inspected during the day, the evening or at the weekend.

Can records be kept at head office?

Only by agreement. HIS expects records to be kept within the registered service unless it has agreed otherwise in writing, for example for centrally held personnel files.

What does a follow-up inspection look at?

Only the requirements and recommendations from the last inspection or a complaint investigation. Any improved grade from a follow-up is capped at Satisfactory.

Sources

1. 1Healthcare Improvement Scotland, 2024Independent healthcare regulation, inspection methodology, July 2024Read source
2. 2Healthcare Improvement Scotland, 2024Independent healthcare regulation, provider handbook, July 2024Read source
3. 3Healthcare Improvement Scotland, 2026How we inspect independent healthcare servicesRead source
4. 4Healthcare Improvement Scotland, 2019Guidance on records to be kept by registered independent healthcare servicesRead source
5. 5legislation.gov.uk, 2011The Healthcare Improvement Scotland (Requirements as to Independent Health Care Services) Regulations 2011, regulation 4Read source

Written by the wai team from Healthcare Improvement Scotland guidance, checked on 15 October 2026. This is guidance, not legal advice. HIS does not endorse wai or any software.