Quality at a cost is the fourth annual statement from QualityWatch, a joint research programme from the Nuffield Trust and Health Foundation. 

Please go to QualityWatch to find out more about the research and to download the report


Amid growing pressures on the NHS, including budget constraints and increasing demand, this report identifies some aspects of care that are performing well, but also highlights that improvement is slowing in other areas and waiting times for some services are increasing.

QualityWatch routinely monitors over 300 indicators spread across all domains of quality. This report considers a selection of areas from within this set, covering different stages of a patient’s experience of the health service, to give a picture of quality in 2016. It looks across six main areas: 

  • Public health 
  • Primary care
  • Ambulances
  • Hospital care
  • Mental health
  • Condition-specific care (stroke and hip fracture)

We observe that financial pressures did not impact on quality measures straight away, potentially because of the hard work and good will of staff. But given the extent of the challenges facing the NHS we should be on high alert for any further decline in quality of care.

More about QualityWatch 

QualityWatch is a major research programme from the Nuffield Trust and the Health Foundation that provides independent scrutiny into how the quality of health and social care is changing over time. For further resources and analysis from this programme of work, visit the dedicated QualityWatch website.

Further reading