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Logos of some NHS regulatory bodies
Logos of some NHS regulatory bodies


The findings of the Francis and Berwick reports have led to an increasing recognition that the current prescriptive regulatory culture has failed to protect many patients. These reports led to sweeping changes to NHS external oversight and regulatory regimes. Despite this proliferation of external oversight and regulation within the NHS, relative little is known about the impact that it has on the NHS at the receiving end. Regulators do not collect routine information about the impact of their activity: either in terms of the costs that are imposed on the service providers that they oversee, or the benefits that are achieved in terms of improvements in service performance and patient outcomes.  Given this renewed focus on external oversight and regulation by policymakers at the highest level, there is an urgent need to understand the impact that these regimes have on the organisations and individuals who are ultimately responsible for delivering high quality healthcare services to patients.

The research program will explore the strengths and weaknesses of the current approach to regulation in the NHS and compare the approach in healthcare with that of other high risk industries. In this initial exploratory program we address four broad research questions:

We aim to address four broad research questions:

  1. What regulatory activities are carried out in the NHS and for what purpose?
  2. What is the impact of regulation on NHS trusts in terms of resources consumed, financial and opportunity costs?
  3. What evidence is there that regulation improves patient outcomes and organisational performance in the NHS?
  4. What can be learned from approaches to regulation used in other industries?

The publication is available open access here: 

 Funded by

The Health Foundation 

Research TEAM

This project is led by Charles Vincent and Carl Macrae in collaboration with Eirini Oikonomou.