In this edition, we focus on primary care, including:
- Key findings from our inspections of GP practices across Wales, where in some cases immediate action was required to reduce risks to patient safety.
- Reflections and emerging themes from our latest dental inspections, highlighting areas of concern and good practice. We also feature new application requirements for HIW-registered private dental practices.
- A selection of resources to support improvement in primary care, including national guidelines and toolkits.
Other highlights include:
- The publication of our Annual Report 2024-2025 - offering a clear and independent assessment of healthcare services across Wales.
- The consultation on the HIW Strategy for 2026–2030 - we invite your views to help shape our future priorities.
- Insights from the May Healthcare Summit, covering challenges in mental health, maternity care, digital inclusion, and workforce sustainability.
- Updates on our inspection activity across NHS and independent healthcare providers.
- New developments, including the pilot of a new methodology for dispensing practices, our CCTV policy statement, and strengthened partnerships through Memoranda of Understanding.
We hope you find this bulletin informative and useful. Your feedback helps us improve how we communicate and share key messages - please take a moment to complete our short survey.
Thank you.
Learning and Insight
Insights from our Inspections: Key Themes in GP Practices
Following our assurance work in 2024-25, we inspected 30 GP practices and reported on a number of issues across Wales. In some circumstances we have needed to ask the practices to take immediate action to reduce risks to patient safety.
🔎 What GP inspections are telling us
Insights from our Inspections: What we found in Dental Practices
Following our inspection activity in 2024–25, we reviewed a number of dental practices across Wales and identified several recurring themes that require attention.
While most practices deliver safe and effective clinical care, our findings highlight common issues in non-clinical areas that impact patient safety, compliance, and the overall patient experience.
Business Update
Annual Report 2024-2025
We have published our Annual Report for 2024-2025, offering a clear and independent assessment of healthcare services across Wales. The report draws attention to a system under sustained pressure, where dedicated staff continue to deliver good care in difficult conditions, but where risks to patient safety persist, and improvement is not always sustained.
Help Shape HIW’s Strategy 2026-2030 - Consultation Now Open
We are now developing our Strategy for 2026-2030. This strategy outlines our ambitions and priorities for the next four years and how we will continue to deliver our responsibilities as the independent inspectorate and regulator of healthcare in Wales.
We are inviting healthcare professionals, organisations, and the public across Wales to take part in the consultation and help shape the final version of the strategy.
The consultation opened on the 8 September 2025 and closes on 1 December 2025
How to Take Part
Complete the online survey.
Download a paper copy or complete the survey by phone: 0300 062 8163
Please take a few minutes to share your views and thoughts - tell us what matters to you.
For more information, please visit our dedicated webpage.
Key Themes from the Healthcare Summit
Healthcare Summit meetings take place bi-annually, to share intelligence on the quality and safety of healthcare services provided by NHS Wales.
HIW coordinates and administers the Healthcare Summit, on behalf of the participating organisations - this includes Audit Wales, NHS Wales Executive and Llais.
The key themes that were identified as areas of concern from the May Summit are:
- Mental health services across Wales continue to face significant challenge – including gaps in discharge planning, poor documentation and low compliance with mandatory training.
- Neurodevelopmental and CAMHS assessments – long waits for assessments, with some families resorting to private options that are not recognised by the NHS.
- Cultural challenges in some Health Boards – this includes whistleblowing concerns where staff do not feel heard when raising issues.
- Ongoing concerns regarding the lack of sustainable models for planned care improvement – including inconsistent discharge planning.
- Despite significant investment there are ongoing concerns relating to the ageing estates infrastructure – concerns were raised regarding the backlog of maintenance work.
- High staff sickness rates and rota gaps in some maternity services – also concerns where some women and families have felt unheard and have received inconsistent care.
- Digital first approaches are unintentionally creating barriers for vulnerable groups – this includes some older people or neurodivergent individuals who may struggle with digital check in systems and remote consultations.
- Inconsistent application of duty of candour and Regulation 28 learning – a view that stronger governance frameworks are needed to embed learning and drive improvement.
- Workforce fragility is a significant ongoing concern – in particular paediatrics, radiology and emergency medicine staffing.
- Cross border and cross sector integration remains a challenge – including fragmented pathways for some conditions, and poor communication between NHS and social care at the point of discharge.
Activity Updates
Assurance and Inspection Activity
We inspect NHS services and regulate independent healthcare providers against a range of standards, policies, guidance, and regulations to highlight areas requiring improvement. Following our inspection and assurance work we will publish a report outlining our findings and recommendations. Watch and find out how we check healthcare services across Wales by watching this short video.
The latest inspection reports include:
Dispensing Practice Methodology Pilot
During Autumn 2025, we will be piloting a new methodology for Dispensing Practices. This will include completion of a booklet in advance of the inspection and a discussion with a GP Peer Reviewer during the inspection. If your practice is selected to take part in the pilot or the early adoption of this new methodology, we’d be grateful for your feedback on how you found the process. Please send your feedback to HIW@gov.wales with ‘GP Dispensing Methodology Feedback’ in the subject.
Balancing Safety and Privacy: CCTV in Mental Health Settings
We have published a policy statement outlining our position on the use of CCTV in mental health and learning disability hospitals. While CCTV can support incident investigations and safeguard both patients and staff, HIW emphasises the need for providers to carefully consider privacy, dignity, and ethical implications. The policy encourages providers to explore less intrusive alternatives and ensure any use of CCTV is justified, proportionate, and risk-assessed on a patient-specific basis.
🎥 Read the full policy statement
Working Together for Safer Care: HIW’s Memoranda of Understanding
We have formalised our collaborative approach through a series of Memoranda of Understanding (MoUs) with key partners including Llais, the Royal College of Physicians, Health Education and Improvement Wales (HEIW), and the Children’s Commissioner for Wales. These agreements outline shared priorities, principles of cooperation, and frameworks for joint working to strengthen the regulation and improvement of healthcare services across Wales.
Join Us - Vacancies Now Open
We are currently recruiting for several key roles, including Second Opinion Appointed Doctors (SOAD) and Practice Nurse Peer Reviewers. These positions offer a unique opportunity to contribute to the regulation and improvement of healthcare services across Wales.
Resource Library
We have curated a small number of resources, based upon recent common areas of the concern that we have identified during our GP inspections
Practices should continue to review new guidelines, professional requirements, patient safety notices, and any internal learning when reviewing existing policies, processes and practices.
Clinical Governance Practice Self-Assessment Toolkit (CGPSAT)
For each of the below topics, including Infection Prevention and Control (IPC), we advise practices to refer to their latest Clinical Governance Practice Self-Assessment Toolkit (CGPSAT) for further guidance. Practices can access the CGPSAT website here and all relevant chapters here: CGPSAT - Primary Care One.
Emergency kit and Resus UK standards for primary care
UK Gov guidance on the eligibility of the Disclosure and Barring Services (DBS) for healthcare roles. We generally expect practices to demonstrate that all clinical staff are in receipt of an enhanced check. It is for practices to risk assess and have a clear policy and rationale in place for when DBS checks are renewed and when they are required for non-clinical staff, based on their roles and responsibilities (e.g. if they have direct and unsupervised access to patients).
UK Gov guidance on the immunisation of staff, including Hepatitis B:
Mandatory training
We expect practices to identify substantive training requirements for both clinical and non-clinical staff, considering national and professional guidelines, individual roles and responsibilities, and the needs of the local population. This includes establishing the appropriate level of training and the frequency with which it should be undertaken. Once these requirements have been determined, staff should be made aware of what is expected of them, and mechanisms should be in place to monitor compliance and ensure completion.
As a starting point, practices may wish to refer to:
- Training resource for GP practice staff
- Training statutory and mandatory | Advice guides | Royal College of Nursing
- Home | RCGP Learning
Safeguarding
Chaperones
Have Your Say
We want your views! Head over to our website where we have a range of patient surveys now open, and we welcome your views.
All open surveys can now be found on our surveys page.
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