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Healthcare Inspectorate

Healthcare Inspectorate Wales (HIW) is the independent inspectorate and regulator of healthcare in Wales.  Their role is to regulate and inspect NHS services and independent healthcare providers in Wales against a range of standards, policies, guidance and regulations to highlight areas requiring improvement. Their purpose is to check that people in Wales receive good quality healthcare.

They do this by undertaking a range of activities;

  1. HIW inspect NHS and independent healthcare services in Wales to check people are receiving good care. Some inspections are announced so that health services know when HIW are going visit. Other inspections including ward visits are unannounced, so that services are inspected without anyone having prior notice that HIW are going to visit. In this way HIW can get a clearer picture of how services are operating.
  2. Following an inspection the service is given general verbal feedback on the day and they discuss what they found the service did well and what they found the service could improve on. They will then follow this up with a written report, and if the service need to make improvements, then they must develop a plan of how they will do this, called an improvement plan. However if they think something needs immediate attention they will issue an immediate assurance, -this means the service must rectify the issue as soon as possible within a given timeframe by HIW.


All HIW reports are published on their website where you can search for them by name or health board.

How we learn and improve from inspection

Learning from HIW feedback is really important, and it’s really critical that as a health board we make sure that the learning is not just focused in one area but across the whole organisation. To support the sharing of learning and the spread of good practice we have developed a self -assessment that ward sisters are asked to complete. Following an inspection in one area of the UHB we create a simple checklist of both the improvements required and areas of good practice that were identified by HIW during the inspection. The checklist is sent out to all ward sisters so that they can self- assess if their ward has the required standards in place. It also helps to share the things that teams are doing well. An example of the checklist can be viewed here.

HIW also carry out other activities:

  • Thematic reviews- HIW are currently carrying out a National Review of Maternity Services which the health board is participating in.
  • Investigations-HIW carry out reviews of healthcare organisations or services in response to concerns arising from a particular incident or incidents, dependent upon seriousness and/or frequency of occurrence.
  • Homicide Reviews- If a person known to mental health services commits a homicide against another person HIW may be commissioned by Welsh Government to undertake an independent external review.
  • Death in custody reviews- HIW contribute to death in custody investigations by undertaking a clinical review.
  • Deprivation of Liberty Safeguards (DoLS)- HIW work with Care and Social Services Inspectorate Wales (CSSIW) to monitor the implementation of the Safeguards by the NHS and registered independent hospitals.
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