Prepare under the three themes HIW reports on, quality of the patient experience, delivery of safe and effective care, and quality of management and leadership. Expect a sample of patient records to be read, patients and staff to be asked about their experience, and your policies, audits and training records to be reviewed.1
How HIW inspects
HIW inspections may be announced or unannounced. HIW prefers unannounced visits, and gives up to 12 weeks' notice when it announces one, usually where it needs information in advance or certain staff present. The team includes at least one HIW inspector and usually an external clinical peer reviewer. Most inspections last one to three days.1
HIW aims to inspect each independent service at least once every three years, and more often where more complex procedures are carried out. It decides when to inspect using previous findings, the vulnerability of patients, concerns from patients and staff, and information from partner organisations.1 For a medical agency without premises, HIW has used a self-assessment form and reviewed documents with the registered manager.2
What HIW reads, by theme
| Theme | Standards it covers | How HIW checks |
|---|---|---|
| Quality of the patient experience | Dignity and respect, patient information and consent, communicating effectively, care planning, equality, feedback | Patient discussions and questionnaires, patient information, a sample of medical records |
| Delivery of safe and effective care | Environment, risk, infection control, medicines, safeguarding, devices, clinical care, information management, records | Observation, policies, audits, risk assessments, medical records, staff training records |
| Quality of management and leadership | Governance, concerns and incidents, workforce planning, recruitment | Interviews with senior managers, staff questionnaires, rotas, training and recruitment records |
- Check your registration matches reality. Your statement of purpose, patients' guide and conditions of registration should describe the services you actually provide.
- Read five patient records cold. Choose them at random. Each should show assessment, consent, the care given, medicines and follow up, signed and dated at the time.
- Test patient information. Make sure what patients are given explains treatments and costs in plain language, and that other languages and formats are available.
- Gather the documents HIW reviews. Policies and procedures, audits, risk assessments, rotas, training and recruitment records, each current and indexed.
- Prepare your team. Staff should be able to say how they raise a concern, how incidents are reported, and what changed after the last one.
- Name who answers for each theme. One person per theme who can explain the evidence and produce it without searching.
- Theme ______ Owner ______
- Standards that apply to our service ______
- Records an inspector will sample ______
- Documents to show ______ Last reviewed ______
- What patients told us this year ______
- What we changed as a result ______
At the end of the visit
HIW gives verbal feedback on its key findings on the last day. If it has immediate concerns about patient safety it writes to the service within 2 days. A draft report follows for factual accuracy, the improvement plan is completed where one is needed, and the final report is published in English and Welsh.1 A report with no areas for improvement says so, and the clinic is not required to complete an improvement plan.2 If HIW does find something, the guide to HIW improvement plans explains how to answer it.
Questions
Will HIW tell me before it inspects?
Not always, because HIW prefers unannounced inspections. When it announces one, it can give up to 12 weeks' notice by letter or email.
Who is on the inspection team?
At least one HIW inspector, and usually at least one external clinical peer reviewer with expertise in your type of service.
Does HIW talk to my patients?
Yes. It speaks to patients and those close to them, and invites them to complete an HIW questionnaire. Their comments appear in the published report.
Sources
- 1HIW, 2025How does HIW inspect independent services?Read source
- 2HIW, 2026Independent Healthcare Inspection Report (Announced), Clinig Byw'n Iach, The Lifestyle Clinic, 21 April 2026Read source
- 3Welsh Government, 2011National Minimum Standards for Independent Health Care Services in Wales, full textRead source
Written by the wai team from Healthcare Inspectorate Wales guidance, checked on 15 October 2026. This is guidance, not legal advice. HIW does not endorse wai or any software.