How does the OHSC grade a practice and issue a certificate of compliance?

Every measure is rated non-negotiable, vital or essential, and a practice is graded Excellent, Good, Satisfactory or Unsatisfactory on the lower of its vital and essential scores. It is certified compliant only with 100% on non-negotiable measures and a grade of Satisfactory or better, and the certificate lasts four years.

The grading model

Each measure carries a risk rating based on the severity, impact and likelihood of the risk, and the grade comes from the percentage scored on vital and essential measures.¹ Excellent needs vital measures at 80% or more and essential at 70% or more, and the final grade is the lowest obtained across the two.¹

How to move from Satisfactory to Excellent

1. Clear every non-negotiable. A single miss on a non-negotiable measure makes the practice non-compliant, whatever its grade, so check these first.
2. Find the weaker score. The grade is the lower of the vital and essential results, so the weaker set decides it.
3. Fix the vital record measures. The clinical assessment and plan in the record is a vital measure, scored on three records per measure.
4. Close the document gaps. Each missing procedure, register or training record costs a point, and many are essential measures.
5. Rehearse with the tool. Score the practice against the published GP tool a month before, and again a week before.

1. Date ______ Scored by ______
2. Non-negotiable measures met ______ of ______
3. Vital measures ______ % Essential measures ______ %
4. Projected grade ______
5. Lowest scoring area ______ Fix ______ Owner ______ Due ______

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Certification, notices and enforcement

A compliant establishment receives a certificate of compliance, valid for four years, and a non-compliant one receives a compliance notice and a re-inspection.¹ The OHSC's Certification and Enforcement unit issues certificates, publishes them and the enforcement actions taken, and convenes hearing tribunals.³ Enforcement runs from a warning to a fine or referral to the National Prosecuting Authority, and a certificate can be revoked for serious breaches.¹ Under section 39(2)(b) of the NHI Act, proof of OHSC certification is a condition of accreditation by the NHI Fund.⁴

Questions

What is a non-negotiable measure?

A measure where failure is highly likely to cause severe harm or death, such as a stocked emergency trolley. An establishment must meet every one to be certified.

How long is a certificate of compliance valid?

Four years. Recertification comes through a routine inspection after that.

How many establishments pass?

In 2024/25, 733 of the 812 establishments inspected were compliant, 90%, and the cumulative rate since 2020/21 is 58%.

Sources

1. 1Office of Health Standards Compliance, 2026Annual Inspection Report 2024/25Read source
2. 2Office of Health Standards Compliance, 2025Annual Inspection Strategy 2025/26Read source
3. 3Office of Health Standards Compliance, 2026Certification and EnforcementRead source
4. 4Office of Health Standards Compliance, 2026Role of the OHSC in National Health InsuranceRead source
5. 5Office of Health Standards Compliance, 2026Compliance InspectorateRead source

Written by the wai team from Health Professions Council of South Africa and Office of Health Standards Compliance guidance, checked on 16 October 2026. This is guidance, not legal advice. Neither the OHSC nor the HPCSA endorses wai or any software.