How do you respond to RQIA areas for improvement and the quality improvement plan?

Answer each area for improvement in the quality improvement plan with the action you have taken against the regulation or standard it cites, and keep the evidence, because RQIA assesses each one as met or not met at the next inspection. An area not met is stated again, and RQIA may take enforcement action where it finds non-compliance with regulations or standards.¹²

How an area for improvement is written

Each area for improvement sits under one of two headings, action required to ensure compliance with the Independent Health Care Regulations (Northern Ireland) 2005, or action required to ensure compliance with the Minimum Care Standards for Independent Healthcare Establishments (July 2014). Each has a number, a reference to the regulation or standard, a line saying how many times it has been stated, and the action required.¹³

In a January 2025 report, for example, an area for improvement from the previous year on client feedback under Regulation 17, which had asked for a summary report to be sent to RQIA with the plan, was assessed as met.³ Plans and reports are downloaded and returned through RQIA's web portal.⁴

1. Read the reference first. Open the regulation or standard each area cites, so the action meets the requirement rather than the symptom.
2. Write what you have done. Describe the action taken or planned, with dates, in terms an inspector can check.
3. Name who is responsible. The registered person or manager who will make sure the change holds.
4. Keep the evidence. Revised policies, audit results, training records or record samples, dated, ready for the next inspection.
5. Send anything RQIA asked for. Where the action asks for a document or confirmation by a date, send it through the portal by that date.
6. Check it held before the next visit. An area found not met will be stated a second time.

1. Area for improvement number ______
2. Ref, regulation or standard ______ Stated ______
3. Action taken or planned ______
4. Responsible person ______ Completed by ______
5. Evidence held ______
6. Checked again on ______ Met or not met ______

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When RQIA takes enforcement action

RQIA says it may take enforcement action where it identifies concerns about a service, including non-compliance with regulations or standards. Its published enforcement activity lists failure to comply notices, improvement notices and conditions on registration, each with a date by which compliance is required.² For the four domains in full, see the RQIA hub, and for laser services, the guide to the records RQIA checks at a cosmetic laser service.

Questions

What does 'Stated, Second time' mean?

That RQIA raised the same area for improvement at a previous inspection and found it not met, so it has been stated again.

Is every area for improvement a breach of the law?

No. Some cite the 2005 Regulations and some cite the Minimum Care Standards. Both are taken into account, and compliance with the regulations is mandatory.

What if there are no areas for improvement?

The report says the inspection resulted in no areas for improvement being identified, and there is no quality improvement plan to complete.

Sources

1. 1RQIA, 2024Inspection Report, Hillsborough Private Clinic, 6 June 2024Read source
2. 2RQIA, 2026Enforcement ActivityRead source
3. 3RQIA, 2025Inspection Report, Elise Clinic, 28 January 2025Read source
4. 4RQIA, 2026Web Portal GuidanceRead source
5. 5RQIA, 2026Inspection Report, Rossconnor Clinic Derry, 23 February 2026Read source

Written by the wai team from Regulation and Quality Improvement Authority guidance, checked on 15 October 2026. This is guidance, not legal advice. RQIA does not endorse wai or any software.