Proposed changes to the risk assessment framework for independent healthcare providers

Revised risk assessment to consider the financial sustainability of independent providers of NHS services

17 February 2020

The NHS has called for reform to the regulatory and oversight regime for independent healthcare providers in a consultation document released [last] week. The consultation calls for updates to the current risk assessment framework for independent providers of NHS Services (IPRAF) which was first published back in April 2014.

Under the current regulatory regime, independent providers of essential healthcare services are subject to financial oversight by NHS Improvement with the aim of reducing the likelihood and impact of a provider getting into financial difficulty. The current risk assessment framework, however, has not been updated since it was first published back in 2014 and, according to the NHS, no longer reflects contemporary understanding of financial risk.

Summary of proposed changes

The proposed changes aim to streamline and improve the current process by:

  • widening the range of factors to be taken into account as part of the overall risk assessment
  • making changes to the financial metrics used to calculate each provider's risk rating so that the NHS is able to understand and respond to situations of concern in a more timely and effective manner
  • refocussing monitoring by reducing the number of future years taken into account when calculating risk
  • introducing standardised quarterly monitoring for low risk providers
  • introducing greater flexibility for regulators to monitor higher risk providers on either a monthly or quarterly basis depending on the nature of the risk presented.

Benefits to providers

According to the consultation paper, the proposed changes will not only benefit the regulator but also providers. By focussing information requirements where they are required most, the new approach should, theoretically, provide a more efficient process and one which is less likely to clash with external audit activities.

Next steps

The consultation will close at midnight on 28 February 2020 after which the aim is to publish an updated IPRAF in March 2020 in time for implementation from 1 April 2020.

If you have any questions in relation to this article, please contact Patrick Parkin or your usual Burges Salmon contact.

This article was written with the assistance of Alex Fallon, Trainee Solicitor.

Key contact

Patrick Parkin

Patrick Parkin Partner

  • Healthcare
  • Procurement and State Aid
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