Q3 2026 in review: the regulatory changes independent providers need to know…

Regulatory Updates

9 Oct

July to September brought a new Prime Minister, a new Health Secretary, a Health Bill through the Commons and a CQC that finally hit its inspection target. What it didn't bring was the new assessment framework. For independent providers, that leaves a clear message for Q4: you are still being judged under the Single Assessment Framework, and the regulator is inspecting at pace.

Here's what happened, what it means for the independent sector, and what's on the horizon.

A new Prime Minister and a third Health Secretary in a year

What happened. Andy Burnham became Prime Minister in July and appointed Yvette Cooper as Secretary of State for Health and Social Care on 20 July. She replaced James Murray, who had held the post for about two months after Wes Streeting resigned in May. Cooper has named her early priorities as maternity services, social care reform and support for the NHS.

What it means for the independent sector. Three Health Secretaries in one year means policy priorities can move quickly. The 10-Year Health Plan is still the backbone, but watch for social care reform to move up the list. If you provide adult social care or community services, expect more political attention on quality, workforce and cost.

One detail worth noting: as Greater Manchester mayor, the new Prime Minister publicly opposed abolishing Healthwatch. That position matters for the Health Bill, below.

The Health Bill clears the Commons, with a Healthwatch rethink

What happened. The Health Bill 2026–27 finished its Commons stages on 8 September after Public Bill Committee (which ended on 16 July) and two days of Report Stage. The core of the Bill is unchanged. It abolishes NHS England, moves the Health Services Safety Investigations Body (HSSIB) into the CQC, and abolishes Healthwatch England and local Healthwatch.

The Healthwatch piece is now in play. On the last day of Report Stage, health minister Karin Smyth committed to review the abolition provisions, and ministers have signalled amendments in the Lords to keep an independent local voice for patients and people using care. The detail hasn't been decided.

What it means for the independent sector. HSSIB moving into the CQC is the change to watch. The government says the "safe space" for safety investigations will be preserved behind an internal wall. Critics, including the CQC itself in May, have warned about a conflict between investigating and regulating in the same body. For independent providers, this sharpens a question you should already be answering: if a safety investigator and your regulator share a building, how confident are you in your own PSIRF learning responses, candour records and board oversight of incidents?

If Healthwatch survives in a new form, Enter and View-style scrutiny of care services may survive with it. Plan as though independent patient-voice scrutiny will continue.

CQC: target beaten, framework delayed

What happened. The CQC set itself a target of 9,000 assessments between April 2025 and the end of September 2026. Its August update reported 9,646, a month early. For context, at the end of March it had completed 6,382, against 3,825 the year before.

The new assessment frameworks are running behind. The CQC's own plan was to publish final sector-specific frameworks in summer 2026 and implement from the end of the year. Instead, the summer pilots (the general practice pilot runs June to October) have been followed by an autumn programme of further sector-specific engagement, with the pilot evaluation due in November. A January 2027 launch now looks optimistic.

The CQC's instruction to providers hasn't changed: until the new approach is implemented, keep working to the current published guidance.

What it means for the independent sector. Two things. First, every one of those 9,646 assessments used the Single Assessment Framework, and that will carry on until the CQC says otherwise. Your evidence still needs to map to the 34 quality statements. Second, the CQC now has capacity. If your rating is more than two years old, the chance of an assessment in the coming months is higher than it has been for years.

The drafts still give you a head start. All four replace quality statements with key lines of enquiry (24 in the adult social care draft) and bring back rating characteristics instead of numerical scoring, with more weight on learning culture and outcomes. Build evidence that works under both.

AI scribes: the regulators draw a line

What happened. On 29 July the MHRA published guidance on ambient voice technology (AVT), better known as AI scribes. NHS England updated its own ambient scribing guidance to version 3 at the same time and withdrew its earlier position that any summarising scribe had to be a registered medical device. The MHRA's view: a tool that only transcribes, summarises, drafts letters or suggests codes for a clinician to check is not a medical device. A tool that supports diagnosis or treatment, or acts without clinician review, is. Clinicians stay responsible for checking what the AI produces. HSSIB has also opened an investigation into AVT.

What it means for the independent sector. Many independent clinics adopted scribes quickly. The new guidance is welcome clarity, but it moves the governance burden onto you. Your board should be able to show what each tool is for, a completed DPIA, how clinicians verify outputs, and how patients are told. Healthwatch England found that 81% of people want explicit consent when AI scribes are used, so consent is a good place to start.

Employment Rights Act: the October wave

What happened. The second big tranche of the Employment Rights Act 2025 lands this month. The main changes:

• The time limit for most employment tribunal claims doubles from three months to six.

• Employers must take "all reasonable steps" to prevent sexual harassment of staff, up from "reasonable steps".

• Employers become liable for harassment of staff by third parties, such as patients, relatives and visitors.

• Trade unions gain stronger rights of access and recognition.

What it means for the independent sector. Healthcare is a patient-facing sector, so third-party harassment is a live exposure every day. Check that your harassment policy covers patients and visitors, that staff know how to report it, and that your risk register reflects it. Longer tribunal time limits also mean HR records need to be complete and kept for longer. This is a workforce issue, but it is also a well-led issue: boards should see it.

Assisted dying bill falls

What happened. The reintroduced Terminally Ill Adults (End of Life) Bill was defeated at Second Reading on 11 September, by 286 votes to 270. It makes no further progress in its current form.

What it means for the independent sector. Nothing changes in practice for now. Hospices and palliative care providers should still expect the issue to return, whether through another Private Member's Bill or government legislation. The debate kept attention on access to palliative care, which may well shape funding and policy before any law on assisted dying does.

On the horizon

Health Bill Lords stages - Amendments on Healthwatch; scrutiny of the HSSIB safe space inside CQC

CQC sector-specific engagement events - Last chance to shape the frameworks for your sector

CQC pilot evaluation - The clearest signal yet on when new frameworks go live

To be confirmed

New CQC Chair

Sir Mike Richards is stepping down once a successor is in post; a permanent Chief Executive appointment follows

2027

Medical device regulation overhaul

The MHRA published draft amending regulations in May; relevant to any clinic using software or AI tools

January 2027

Unfair dismissal reforms

The next major Employment Rights Act change

What to do this quarter

🌊 Keep evidence mapped to the current 34 quality statements, and start a parallel map to the draft key lines of enquiry for your sector.

🌊 If your rating is over two years old, run a mock assessment now.

🌊 Take your incident, PSIRF and duty of candour records to the board, assuming an investigator could read them.

🌊 List every AI tool in clinical use, its intended purpose, DPIA status and how outputs are verified.

🌊 Update harassment policies to cover patients and visitors before the end of October.

Regulatory updates and horizon scanning to keep you on course as the rules shift: that's what the Harbour Governance team is here for. If any of this lands on your board agenda, we can help you make sense of it.