NHS under pressure

The quality of care delivered to patients and service users is under significant scrutiny following several high-profile inquiries and investigations, such as the Francis Inquiry, Sir Bruce Keogh’s investigation into 14 NHS trusts and the Morecambe Bay investigation. At the same time, the NHS faces a number of profound challenges, such as severe spending constraints, organisational changes and increasing levels of chronic disease in an ageing population.

A key concern must be the extent to which the quality of NHS and social care services are changing in response to these pressures. If providers of care are unduly focused on making financial ends meet, will this focus come at the expense of quality, as previous cases show?

Introducing QualityWatch

While many national organisations are monitoring the quality of care, the Nuffield Trust and the Health Foundation believe there is also a need for independent scrutiny by non-statutory bodies.

There is a need for independent scrutiny by non-statutory bodies.

That’s why we launched QualityWatch, a joint research programme monitoring how the quality of health and social care is changing over time. We hope it will both augment and inform the work of other statutory national bodies and initiatives.

QualityWatch aims to:

    • provide an authoritative resource on the overall quality of health and social care
    • independently monitor and comment on changes over time
    • highlight areas where improvement is possible 
    • contribute to improving measures of quality.

Key elements of the programme include over 300 care quality indicators, a series of in-depth research reports, an annual statement on quality and a range of events.


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Care quality indicators

Our 300+ indicators feature interactive charts and maps designed to explore changes in the quality of health and social care over time. They are categorised by domain and sector and more will be added throughout the lifetime of the project.

What is QualityWatch - sectors and domains

Where possible, we consider regional variation within England and draw comparisons with other countries. We generally use existing sources of data but may commission new ones.

Our focus is on monitoring change in recent years, setting our analysis within the context of longer term changes over the last decade where possible. 

Monthly indicator updates

Each month we update a selection of indicators and publish a summary of our analysis. We may also invite experts from across the wider health sector to comment in a blog. 


In-depth research

Through a series of ‘Focus on’ research reports, QualityWatch provides in-depth analysis of key topics that are critical to the quality of care. Each report employs a range of methods and is accompanied by additional commentary and analysis to provide wider context.  


Annual statement

Each year we publish an annual statement commenting on the current state of care quality in the NHS in England, drawing on information from our extensive range of care quality indicators and in-depth reports, as well as findings from other organisations.


Expert advisers

QualityWatch is supported by an advisory group consisting of a number of external experts. It is chaired by Professor Sir Nick Black, Research Professor of Health Services Research at the London School of Hygiene and Tropical Medicine. He jointly established the Journal of Health Services Research & Policy, which he continues to edit, and chairs the National Advisory Group for Clinical Audit & Enquiries. Professor Black is also a Senior Associate at the Nuffield Trust


Have your say

We welcome comments on the programme, suggestions for areas on interest and are always interested in working with experts in their areas. To get involved and leave suggestions, please visit the ‘Have your say’ section of the website

You can also feed back on any aspect of the programme by email

External contributors

We publish a range of blogs on topics linked to health and social care quality. Please contact us if you would like to submit an article for consideration. Any views expressed in blog posts or comments do not necessarily reflect the views of the Nuffield Trust or Health Foundation. We cannot be responsible for the content of any external websites linked to from this site.


Individual cases

We aim to provide an overview of the health and social care system and are not in a position to comment or respond to individual cases. The Care Quality Commission provides useful information on what to do if you have a complaint or concern about a care service or provider.


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