Is HKZ mandatory? A quality mark, sometimes a procurement requirement

HKZ (Harmonisatie Kwaliteitsbeoordeling in de Zorgsector, Dutch harmonised quality assessment for healthcare) is a voluntary quality mark. We found no law that requires an HKZ certificate. HKZ.nl describes external audits as a tool that a care organisation uses itself. HKZ.nl does state that clients can use certification as a selection criterion in tenders. The step-by-step plan and the overview per sector show what the process involves. So whether HKZ is mandatory for you depends on the contracts you want to sign, not on the law.

What is and is not mandatory

A table makes the difference easiest to see. It is about what a buyer can ask for, not what the law requires.

Situation	HKZ mandatory?	Explanation
Care office (zorgkantoor) under the Long-Term Care Act (Wet langdurige zorg), or health insurer under the Health Insurance Act (Zorgverzekeringswet)	Sometimes	It can appear in the purchasing terms. Read the contract requirements of the specific care office or insurer.
Municipality under the Social Support Act (Wmo: Wet maatschappelijke ondersteuning) or the Youth Act (Jeugdwet), when tendering	Sometimes	Certification can be a requirement or an award criterion.
Private client or service user	No	Service users may prefer the quality mark, but they cannot enforce it.
Self-employed freelancer (zzp’er) who wants a contract	Sometimes	This is set in the client’s terms. See also HKZ for freelancers.

What it means for your sector is explained on who is HKZ for?. If you do not need a contract that mentions HKZ, certification is a choice.

A requirement in a tender is a contract term. Assess it separately from whether the law requires something. Check with the supervisory body whether HKZ plays a role in your licence or registration. This page does not cover that.

How do you check whether HKZ is mandatory for your client?

You do not need to guess. The answer is in one of three places.

The tender documents. Search the selection guide or the programme of requirements for “keurmerk” (quality mark), “certificaat” (certificate) or “HKZ”. If it is listed as a requirement with the word “must”, it is a hard requirement. If it appears under “desirable” or “advantage”, it is a bonus point.
The purchasing terms or framework contract. At care offices and insurers, the requirement is often in an annex on quality. Ask the purchasing contact in writing for the exact passage.
The conversation with the buyer. Ask one clear question and keep the answer.

Example email to the buyer

Use this as a basis. Fill in the brackets and send it as it is.


Subject: Question about quality requirement in [tender name / framework contract]

Dear [name],

[document, date] contains a requirement about a quality mark.
Can you confirm whether HKZ (and which scheme) is a hard requirement, or whether
another recognised quality mark is also acceptable? Then I can align my bid
with that.

Kind regards,
[name, job title, organisation]

The answer determines whether you need the HKZ process. If another quality mark or ISO 9001 is enough, the difference between HKZ and ISO 9001 is the next question to answer.

Common mistakes

Assuming it is required everywhere. A tender from one municipality says nothing about the one next door.
Only checking the client’s website. The actual criterion is usually in the tender documents.
Getting a certificate without knowing the requirement. You then pay for a scheme the buyer does not ask for. Check the schemes per sector first.
Mixing up HKZ and information security. If the client asks for protection of patient data, that is usually a different requirement. See HKZ and NEN 7510.

What if HKZ is mandatory?

Then follow the step-by-step plan. Choose the right scheme first. Then plan the external audit and work out the costs and timeline. The process takes months, so start well before the submission deadline.

What if you do not have HKZ?

The practical consequence is simple: you are not eligible for contracts that require HKZ. If a tender also accepts ISO 9001 or another quality mark, that is an alternative. The tender text will say so.

A quality mark is also a way to show trust to service users, referrers and partners. That applies without a procurement requirement too. But it is a choice, not an obligation. Weigh the costs against what you gain. The overview of those costs is on what HKZ certification costs.

If you are unsure between HKZ and another quality mark, use the comparison on HKZ vs ISO 9001. The European healthcare standard NEN-EN 15224 is also covered on that page.

A practical example

A fictional childcare organisation with five locations sees a quality requirement in a new municipal tender. The text says: “Certification is a requirement for award.” That is a hard requirement. Whether an ongoing process is enough is stated in the same documents. Read that yourself or ask the buyer.

If another tender from the same municipality asks for a “quality policy” without using the word quality mark, HKZ is not mandatory. A policy document is enough then. This difference is exactly why you need to read the text of each tender yourself.

Checklist

Does the tender or framework contract list HKZ as a “must”?
Which HKZ scheme does the client name?
Is there a deadline for submitting the certificate?
Does the client accept another quality mark, such as ISO 9001?
Have you received written confirmation of the answer?

If HKZ is listed as a “must” in the tender, you need it for that contract. Otherwise it is a choice you weigh against the costs.