CQC Independent Healthcare Training Gap Index 2026: Staff Training in Independent Hospitals and Clinics

We read what CQC inspectors wrote about staff training in the latest reports for 679 independent hospitals, clinics and other independent healthcare services in England. At 2 in 5 (286), inspectors recorded a staff training gap. Safeguarding was the subject named most often, and in non-specialist independent acute hospitals 1 in 5 had a gap in life support training.

Key findings

• Inspectors recorded a staff training gap at 42.1% of independent healthcare locations (286 of 679), about 2 in 5.
• In non-specialist independent acute hospitals, the figure was 53% (59 of 112), and 20% (22 of 112) had a gap in life support training such as BLS or ILS.
• Safeguarding was the subject named most often, at 135 locations: 47% of those with a gap. Then life support (57), the Mental Capacity Act and DoLS (52) and infection prevention and control (47).
• 37% of locations rated Good overall had a staff training gap recorded (194 of 526), against 73% of those rated Requires improvement or Inadequate (77 of 105).
• Including locations where inspectors said the systems for tracking training weren't working, the figure is 43.2% (293).
• 85 locations had gaps in three or more named subjects at once.

What training was missing

Safeguarding was named at 47% of locations with a gap. Life support came next (20%), then the Mental Capacity Act and DoLS (18%), infection prevention and control (16%), and learning disability and autism, including the Oliver McGowan training (12%). At 34% of locations with a gap, inspectors recorded that mandatory training wasn't complete without naming a subject.

Example wording from CQC reports (no service named):

• "At the time of the inspection only 49% of staff that required training in immediate life support had received it."
• "Sixty percent of staff had completed Paediatric Immediate Life Support (PILS) training, which was below the mandatory training target."
• "The safeguarding lead had not completed level 4 safeguarding training."

More on safeguarding adults training, Mental Capacity Act training and infection control training.

Life support in independent hospitals

Across all 679 locations, inspectors recorded a life support training gap at 57 (8%). It was concentrated in hospitals: 22 of the 112 non-specialist independent acute hospitals (20%) and 9 of the 104 specialist ones (9%). Most of these gaps were compliance figures below the hospital's own target for basic or immediate life support, often for theatre, ward or radiology staff. A few involved paediatric life support for staff treating children, or anaphylaxis training.

More on basic life support training and immediate life support training.

Mental health services

Inspectors recorded a staff training gap at 49% of independent mental health services (78 of 158). Among those 78, safeguarding was named at 24, restrictive practice and restraint training at 21, the Mental Capacity Act and DoLS at 20, the Mental Health Act at 17 and learning disability and autism at 12. Most of the restraint findings were compliance rates below 90% or below target for courses such as breakaway, physical intervention or reducing restrictive interventions. At one service, some agency staff had been trained in a different restraint model from the one in the provider's policy. Outside mental health, 6 independent ambulance services had a restraint training gap, including 2 where the training didn't meet, or couldn't be shown to meet, the Restraint Reduction Network standards.

Locations rated Good

A Good rating doesn't mean inspectors found nothing. Among the 526 locations rated Good overall, inspectors recorded a staff training gap at 194 (37%). Among the 105 rated Requires improvement or Inadequate, it was 77 (73%). Of the 42 rated Outstanding, 10 had a gap recorded. Independent healthcare reports often give training compliance as a percentage against the provider's own target, so a figure just below target counts here even at a service that is otherwise rated well.

By region

Share of independent healthcare locations with a staff training gap recorded by inspectors:

• East of England: 62% of 66 locations
• North West: 45% of 110
• Yorkshire and the Humber: 42% of 66
• West Midlands: 42% of 83
• South East: 42% of 88
• London: 42% of 106
• South West: 37% of 67
• North East: 35% of 40
• East Midlands: 25% of 53

The numbers in each region are small, and some of the difference may come from how different inspection teams write their reports, so treat these as a guide rather than a ranking. Confidence intervals are in the download below.

What registered managers can do

Built from what inspectors wrote, not from Kasorb's courses:

• A training matrix that covers every staff group: bank and agency staff, consultants and other doctors with practising privileges, and volunteers, with completion and expiry dates for each person.
• Evidence of training for doctors with practising privileges checked and kept on file, rather than accepted on self-declaration.
• Life support at the level each role needs, including immediate life support for staff who need it and paediatric life support where children are treated, with expiry dates flagged before they lapse.
• Safeguarding training at the level the intercollegiate guidance sets for each role, including the safeguarding lead.
• Where staff use restraint, training that meets the Restraint Reduction Network standards and matches your own policy, including for agency staff.
• Learning disability and autism training at the right tier for each role, required for staff at CQC-registered services since July 2022.
• Agency and new staff inducted, with the induction recorded, before they work a shift.
• Certificates and compliance reports easy to find on the day.

How we did it

1. Took the 752 independent healthcare locations in CQC's ratings data (October 2026) with an overall rating published between December 2023 and September 2026. These are independent acute hospitals, independent mental health services, consulting doctors and clinics, ambulance services, hospices, substance misuse services and a few others. 73 had no report under CQC's current assessment approach that we could read, leaving 679 locations.
2. Read the overall, Safe, Effective and Well-led pages of each location's latest report on cqc.org.uk, and the same pages for each service within it (up to 8 services, such as surgery or diagnostic imaging). We pulled every sentence mentioning training, competence, induction, refreshers, mandatory training, life support, resuscitation, sepsis, restraint, learning disability, autism or chaperones. A location counts as having a gap if any of its services did.
3. Coded each location: a staff training gap recorded by inspectors (training missing, out of date, overdue or not evidenced, competency sign-off missing, induction not done or not recorded, or a compliance figure below the provider's own target, or below 90% where no target was given); weak oversight of training (systems or records for tracking training not working); and training done but not applied or understood. Where a report said only "most" of the staff had done the training, we counted it as a gap. Lapsed training counts even if the staff were booked onto a course. Gaps fixed after inspectors raised them count. Gaps fixed before the assessment, suggestions, training not required for the role, and concerns raised only by patients, relatives or staff don't.
4. Every location was coded twice, independently, using AI-assisted text analysis against the same written guide. The two codings agreed on 99.1% of locations for a training gap (kappa 0.98), 98.5% for weak oversight (kappa 0.93) and 99.4% for a life support gap (kappa 0.96). The 19 disagreements were reviewed against the guide, with a reason recorded for each, and the same rules were then applied to every location.

Limits. CQC doesn't inspect every location each year, so these figures describe locations with a recent rating, not all independent healthcare. Reports cover what inspectors chose to write about, so no training finding doesn't prove training was complete. Because a figure just below the provider's own target counts as a gap, some gaps are narrow: without the locations that rest only on "most staff" wording, the figure is 39%. A training gap doesn't mean a service is unsafe, and the data shows where gaps were recorded, not that they caused a rating. England only.

Data and credits

• Download the data (CSV): figures by measure, service type, rating, subject and region, with confidence intervals. No service is named.
• Cite as: Kasorb (2026), CQC Independent Healthcare Training Gap Index 2026, kasorb.com/blog/cqc-independent-healthcare-training-gap-index. Reports read 26 October 2026.
• Contains CQC data and report text, © Care Quality Commission, used under the Open Government Licence v3.0.
• Author: Steve van de Worp, Head of Learning, Kasorb.
• See also: CQC Training Gap Index 2026 for care homes, CQC Home Care Training Gap Index 2026, CQC GP Training Gap Index 2026 and CQC Dental Training Gap Index 2026.

FAQs

How many independent hospitals and clinics have a staff training gap?

286 of 679 independent healthcare locations with a recent CQC rating (42.1%), about 2 in 5, had a staff training gap recorded by inspectors.

What is the most common staff training gap CQC finds in independent healthcare?

Safeguarding: the subject named most often, at 135 of the 286 locations with a gap (47%). Life support was next, at 57.

How often do independent hospitals have life support training gaps?

Inspectors recorded a life support training gap at 22 of 112 non-specialist independent acute hospitals (20%) and 9 of 104 specialist ones (9%).

Does a training gap mean a service is unsafe?

No. It means inspectors recorded a shortfall in staff training, competency sign-off, induction or training records at that assessment.

Will this be updated?

Yes, every year, at the same address.