Learning how to make routinely available data useful in guiding regulatory oversight of hospital care.

Though the past 20 years have seen a series of changes to the independent regulation of healthcare,1 there is surprisingly little empirical work that evaluates the effectiveness of different approaches. Even in the related area of accreditation, where there are more studies of impact, the literature is ‘limited’.2 There is no shortage of strongly held opinions on the best approach. Though most agree about the need for some form of regulation to offer an independent review of the quality of healthcare, there is less agreement about the best style and methods to be adopted. In England, the situation is further complicated in that national healthcare regulators have been subject to periodic regime changes and regularly review and revise their approaches.Systems of government-funded but independent regulation of healthcare providers have been created in a number of countries as recognition of the limitations of both pure healthcare markets, on the one hand, and of a centralised controlling bureaucracy, on the other.3 The regulators work within a legislative framework and seek to minimise the chances of major quality lapses and to protect the markets for healthcare. In England, regulation goes beyond accreditation and public reporting of quality—it can carry sufficient weight to affect the survival of individual organisations and on the jobs of individuals and boards within those organisations. Yet it remains at armu0027s length from direct government control. In many countries, “governments have turned to ‘regulation’ as an appropriate balance between over-centralised governmental control on the one hand and an unbridled market on the other”.4The central task regulators perform at national level is daunting. For example, the national regulator in England (the Care Quality Commission (CQC)) describes its role as “to monitor, inspect and regulate services to make sure they meet fundamental standards of quality and safety …