Burdensome regulation of the NHS

BMJ 2016; 353 doi: https://doi.org/10.1136/bmj.i3414 (Published 20 June 2016) Cite this as: BMJ 2016;353:i3414
  1. Nigel Edwards, chief executive
  1. Nuffield Trust, London W1G 7LP, UK
  1. nigel.edwards{at}nuffieldtrust.org.uk

The insatiable demand for information is part of a wider problem of trust within the service

Internationally, there is a trend towards increasing regulation of healthcare organisations and professionals, and a less trusting and more bureaucratic approach to overseeing them. The resulting burden of data collection, inspection, and reporting upwards has been the grounds for consistent and growing complaints.

A 2013 review of bureaucracy in the English NHS estimated that the main regulators imposed costs of £300m-£500m (€380m-€630m; $420m-$710m), with perhaps three times more being generated by the rest of the system—for example, commissioners.1 But reaching any sort of precision—and even more importantly, working out how much can be justified—is fraught with difficulties. Not least of these is the confusing mix of different organisations that carry out regulatory functions or collect information from providers.

The Care Quality Commission (CQC) carries out periodic inspections and requires providers to submit information for an annual review of quality. Recently its remit was extended to include assessing …

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