Regulation in the NHS and other high risk industries

The research will map the current regulatory landscape in the NHS and the relationships between regulators and regulated. An assessment of the impact of regulation on two NHS organisations will be part of the research as will illustrative case studies of regulation in safety critical industries.

External oversight and regulation of the NHS in England has been a growth industry over the last 20 years. Regulation in the NHS is implemented through a mix of command-and-control, self-regulation and varying forms of agency. In recent years, new regulatory techniques and instruments have been developed and expanded, including risk-based profiling, national quality standards and outcome indictors. Yet the impacts from patient safety improvement of these measures have largely been assumed rather than explored. The available literature provides little evidence that regulatory activity improves organisational performance and patient outcomes, beyond some acceleration of existing improvement plans. 

There is a highly complex regulatory environment with multiple, overlapping assurances sought by external bodies, this research seeks to address gaps in understanding. Many challenges lie ahead that deserve systematic, high-quality scrutiny.

Effective regulation is held to be one of the foundations of high quality, safe patient care. Huge reliance is placed on regulation as a guarantor of quality and safety with inspections from Care Quality Commission and others taken very seriously by provider organisations.

Contact details

For more details about this project, please email Dr Jane Carthey at the University of Oxford.