Inspectorates involved in the assessment and regulation of healthcare, education and other public services should be themselves assessed to instil public confidence, leading health researchers suggest.
In a new opinion article published in the BMJ today, Professor Richard Lilford from the University of Birmingham and Professor Timothy Hofer from University of Michigan Medical School highlight how healthcare regulation in many countries around the world has not been properly evaluated.
Following a commitment from the UK Government to reform the Care Quality Commission, Lilford and Hofer suggest that measuring the reliability of inspections of organisations like hospitals and schools would be a meaningful step towards appropriate scrutiny of regulators. Furthermore, their opinion piece highlights how only two randomised controlled trials of health facility regulation “have been published that coupled the inspection with provision of managerial support”.
Professor Richard Lilford CBE from the University of Birmingham said:
“The public want to know that the provision of healthcare is good quality, and regulating this through inspections is undoubtedly a significant and important task that should instil public confidence. We have however identified that there is a major gap in the evaluation of this work.
“As policy makers ask questions about how to reform the way healthcare providers are inspected, it is only right that properly evidence-based assessments are made about the reliability of inspections. We have identified how this scrutiny of the scrutinisers could be effectively carried out, and we suggest that any judgements made about the future reform will best serve the public when they are based on high quality evaluations.”
Lilford and Hofer’s article also identifies that there are a range of downstream benefits from inspection including providing internal incentives for organisations to ensure they are organised, and that inspections instil some level of confidence that healthcare providers are being held to account.
Full text: Lilford R J, Hofer T P. Regulation of health facilities: often criticised but seldom evaluated BMJ 2024; 387 :q2388 doi:10.1136/bmj.q2388
