Growing private services creating ‘regulatory gap’ , claims watchdog

There is a growing “regulatory gap” around several NHS services where private provision has grown rapidly, the Parliamentary watchdog has told HSJ.

Paula Sussex, who became the Parliamentary and Health Service Ombudsman in August, said she received a large number of concerns about ADHD and autism  services, and provision of wheelchairs.

In relation to neurodiversity diagnosis, there has been rapid growth in NHS-funded and self-funded independent sector provision responding to growing demand, alongside an absence of agreed standards, qualifications, and training.

As a result, Ms Sussex often receives complaints that other services are refusing to recognise and act on the diagnoses, she said.

Wheelchair services, meanwhile, are often privately provided through block contracts and subject to regular concerns about long waits for equipment and repairs.  These services are not registered with the Care Quality Commission as they are not counted as a healthcare service.

Ms Sussex said private provision – which was patchy, sometimes poor quality and not properly regulated – was “driving more costs into the system”.

She suggested the Department of Health and Social Care should examine “who is going to pick up” these “regulatory gaps”.

She added: “That would give more clarity to [integrated care boards] and providers to say: ‘Is it okay to accept this diagnosis?’ or for them to know there is a body overseeing private sector provision.”

Read full story (paywalled)

Source: HSJ, 22 May 2026