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Certification programme
Most hospital rankings and "best surgeon" lists are paid placements. This one is decided by a random sample of the hospital's own recent surgical patients, answering questions about the things that actually determine whether surgery was safe and honest. A hospital needs 90% or above to be certified. Below that, it receives its report and nothing else — no badge, no partial recognition, no listing.
The measure
Six domains, all of them things a patient can answer from their own experience and none of them a matter of opinion about clinical skill.
What we ask Whether the alternatives to surgery, including waiting, were explained; whether the patient was told what would happen if they did nothing; whether they felt able to ask questions.
Why it matters This is the single domain most often missing when an operation turns out to have been avoidable.
What we ask When the form was signed and where; whether it was blank; whether the specific operation was named; whether the patient signed for themselves; whether they were given a copy.
Why it matters A signature taken on a trolley is not consent, and it is measurable.
What we ask Whether a written estimate was given before admission; whether exclusions were explained; how far the final bill differed; whether an itemised bill was provided on request; whether implant invoices were given.
Why it matters Estimate-to-bill gap is the most objective integrity measure available to us.
What we ask Whether reports, operation notes, histopathology and discharge summary were provided, and within what time.
Why it matters The Charter of Patients' Rights sets timelines. Compliance is a yes-or-no fact.
What we ask Whether warning signs were explained; whether wound and medicine instructions were in writing; whether an after-hours contact number was given; whether it was reachable when used.
Why it matters Most surgical infections appear after discharge. What the patient was told determines whether they are caught.
What we ask Only of patients who had one: whether they were examined promptly, told plainly what had happened, and whether they were charged afresh for treating it.
Why it matters How an institution behaves when something goes wrong is the most revealing thing about it.
The process
The fee covers the cost of running the survey and is identical for every applicant of a given size. It buys the survey, not the outcome, and it is not refundable if the hospital fails.
Including that we may publish the fact that it applied, and that it will not contact surveyed patients about the survey.
The hospital supplies the full list for that period. It does not get to choose which patients we approach, and the list is checked against its own admission numbering for gaps.
If a hospital cannot supply a complete list, the application ends there.
No individual answer, and nothing that could identify a respondent, is ever shared with the hospital or published. Participation is voluntary and refusal is recorded as a non-response, not as a negative.
Immediately, without refund, and we publish that the application was voided.
Below 90%, the hospital receives its detailed report and nothing else. There is no bronze, no silver, no "working towards" badge, and no partial mark to display.
Blank consent forms, records refused, a body or discharge withheld over a bill, or implant charges above a notified ceiling price. A hospital cannot average its way past these.
Certified hospitals appear on this site with their score band and the year. Failures are not named, because our purpose is to raise the floor, not to run a blacklist.
Certification can be withdrawn mid-cycle, and withdrawal is published.
Integrity rules
Published, identical for all applicants of the same size, and non-refundable on failure. Paying more changes nothing.
Sampling is ours, from a complete consecutive list, checked for gaps.
Not to the hospital, not publicly, not in any report. Only aggregate scores.
And the voiding is published. This is the rule with the sharpest teeth.
We do not sell advertising to hospitals, and a certified hospital cannot buy visibility on this site.
There is no partial award to market. This is what makes the mark mean something.
For patients
It tells you that a random sample of that hospital's own recent surgical patients reported being properly informed, properly consented, honestly billed, given their records, and safely discharged. That is a meaningful thing to know, and almost nowhere published.
It does not rank surgeons, measure surgical skill, or promise you a good outcome. No survey can. Use it as one input alongside the questions on our condition pages and an independent second opinion.
Read the condition pages firstFor hospitals
Read the rules above in full first. Write to us from an official hospital address with your annual surgical volume and the name of the person accountable for the application. We will send the complete method document and the fee schedule. We do not negotiate the threshold, the sampling, or the confidentiality rules with applicants.
