The impact of hospital regulation on performance
The University of Manchester · Academic
Expired The latest version ended on 1 November 2025. The September 2026 register still lists the agreement, but its term has passed.
- Reference
- DARS-NIC-23410-W8N9L
- Latest version
- v4.10
- Term of latest version
- 19 May 2023 to 1 November 2025
- Start date
- Before 28 November 2017
- Data controller
- Sole Data Controller
- Commercial purposes
- No
- Sublicensing
- No
- Files released to date
- 36
Why the data was released
Objective for processing
The research set out to examine how providers, the public and other stakeholders respond to provider ratings, and what impacts inspection and ratings have on the quality of care and on improving performance. Understanding how ratings work, as part of the wider inspection process, is essential if the Department of Health are to increase the potential benefits for the quality of healthcare and reduce the costs and any adverse or unintended consequences. The University of Manchester was awarded research funding from the Department of Health Policy Research Programme to analyse the impact of the Care Quality Commission's (CQC) new inspection and rating system on provider performance.
There were four main questions in the research:
- How is the system of ratings meant to work, and bring about improvements in the quality of care?
- How does it work in practice, and what do providers, the public and others do in response to ratings?
- What impact does the system of ratings have on measures of the quality of care and provider performance?
- How could the system of ratings be improved?
Hospital performance would be measured in the following way:
- Mortality [within hospital/out of hospital/within 30 days]
- Readmissions within 30 days
- Length of stay
- Waiting times
- Occurrence of adverse events
- Cancellations of surgery
- Patient Reported Outcome Measures (PROMs)
The University of Manchester is the sole data Controller who also processes the data.
The lawful basis for processing personal data under the UK GDPR is:
Article 6(1)(e) - processing is necessary for the performance of a task carried out in the public interest or in the exercise of official authority vested in the controller;
The lawful basis for processing special category data under the UK GDPR is:
Article 9(2)(j) - processing is necessary for archiving purposes in the public interest, scientific or historical research purposes or statistical purposes in accordance with Article 89(1) based on Union or Member State law which shall be proportionate to the aim pursued, respect the essence of the right to data protection and provide for suitable and specific measures to safeguard the fundamental rights and the interests of the data subject.
The processing of data under this agreement is in the interest of public because it adheres to the UK Policy Framework for Health and Social Care Research and aims to understand how ratings work as part of the wider inspection process, what impacts inspection and ratings have on the quality of care and on improving performance by reducing the costs and any adverse or unintended consequences.
The data provided by NHS England would only be used by the members of the research team detailed in this Agreement. The analysis conducted on these data would feed into the evaluation of the CQC which also includes qualitative researchers based at the University of Manchester and The Kings Fund. Only employees of the University of Manchester would process the data. Only aggregated outputs would be shared with researchers outside of the University and small numbers will be suppressed in line with the HES Analysis Guide.
The data was used to uncover the relative impact of healthcare regulation, compared to other influences, on hospital performance. It would not be possible to measure hospital performance and therefore evaluate the CQC, without the datasets requested.
This project has now ended (v4) and the research and the associated processing are now complete. The final report for this CQC work has been submitted to the Department of Health and Social Care (DHSC) and shared with the CQC. In addition, the findings have been presented to and discussed with the CQC board.
The University of Manchester are now applying to retain the existing data for the purposes of archiving research data. This is in accordance with the University of Manchester's Research Data Management policies and the Records Retention Schedule which state that research data and records should be archived for a minimum of 5 years after publication.
The last output from this project was the journal article published in Health Policy in November 2020, therefore the University of Manchester will archive the data until November 2025.
No additional data will be requested from NHS England.
This Agreement does not permit any further processing that involves analysis or linkage other than for the purpose of verifying findings in line with the original objectives of the study. Following publication of study findings, it is possible that the findings will be questioned or challenged by third parties through direct contact with the University of Manchester, contact via the publishing journal or an open letter. In such circumstances, the University of Manchester may re-run previous analyses to verify that the published results were accurate and may publish or write a response directly to the challenger.
The University of Manchester are not permitted to undertake different analyses to those undertaken during the original analysis.
This Agreement does not permit any onward sharing of the data with the exception that the data may be viewed for the purpose of an audit by a regulator such as the Medicines and Healthcare products Regulatory Agency (MHRA).
The data controller themselves may exercise the right to audit.
If any further data processing is required in addition to the above purposes, or if the data needs to be moved to a different location/organisation, the applicants must submit a request to amend this Agreement to NHS England before data is accessed or migrated.
The following NHS England data will be retained:
• Hospital Episode Statistics
• Admitted Patient Care
• Accident & Emergency
• Outpatients
• Civil Registration Mortality
• Patient Reported Outcome Measures (PROMS)
The data was minimised as follows:
• Limited to data between 2007 and 2018
The level of all the above data will be pseudonymised data only.
All decisions concerning the retention and any potential reuse of the data are taken by the University of Manchester. The University of Manchester are therefore deemed to be sole data controller for the purpose of this Agreement.
The data will be archived and will not be accessed by any individuals other than substantive employees of the University of Manchester or employees of the auditing organisation and strictly for purposes described above.
Processing activities
Pseudonymised HES, PROMs, and mortality data was supplied by NHS England to the University of Manchester.
This Agreement permits the secure storage of the data. The University of Manchester will be retaining this data for the purposes of archiving research data. Under this Agreement, data can only be processed in the circumstance that any queries arise as a result of publications. In such a case, data processing is restricted to repeated analysis.
The following text describes the processing activities which were permitted under previous versions of this Data Sharing Agreement. All processing activities described are now complete.
- The data was analysed in order to measure hospital performance.
The data was analysed using the statistical package Stata. Regression methods were used to output regression results tables. No record level data was produced as an output at any stage, only aggregated outputs by year and/or area level (e.g., Lower Layer Super Output Area (LSOA)/Hospital provider/ Clinical Commissioning Group (CCG) /GP practice), such as predicted cost of service use at varying levels of aggregation for each financial year. Examples of levels of aggregation include:
• LSOA-age-gender (and higher level organisational structures linked to GP practice such as Middle Layer Super Output Area (MSOA), Lower Tier local authority to upper (LTLA) and Upper Tier Local Authority boundaries (UTLA))
• GP practice-age – gender (and higher level organisational structures linked to GP practice such as CCG)
• Hospital provider-age-gender
Small numbers will be suppressed in line with the HES Analysis Guide. Descriptive statistics tables of the data will be produced which will aggregate the data by year. Graphs will be produced to describe the data and these graphs will also aggregate the data by year or area level. The outputs produced cannot be used to identify patients or sensitive information.
Equinix and Digital Reality provides IT hosting services to the University of Manchester and will store the data as contracted by the University of Manchester. The hardware in the data centres belong to University of Manchester, the network infrastructure is also University of Manchester, nothing is shared. The data is stored in a dedicated space and is caged off. The study has dedicated UoM staff who manage the UoM infrastructure in both the data centres.
Processing of the data will take place on the interactive Computational Shared Facility (iCSF) infrastructure of the University of Manchester.
A valid Active Directory account is required to login to the iCSF. Account credentials are unique to each member of staff and only the account owner knows the password.
The data will be securely stored at the University of Manchester.
The data may be accessed for a purpose specified above only. In all such circumstances, the data must remain on the University of Manchester servers, with access restricted to substantive employees of the University of Manchester or substantive employees of the organisation auditing the study.
Expected output
This Agreement permits the secure storage of the data only. No new outputs will be produced during the term of this Data Sharing Agreement.
The CQC evaluation which has now been completed has resulted in the following outputs:
- University of Manchester Final Report: Impact of the Care Quality Commission on provider performance. https://www.research.manchester.ac.uk/portal/files/77461382/cqc_provider_performance_report_september2018.pdf
- The Kings Fund Final Report: Impact of the Care Quality Commission on provider performance Room for improvement? https://www.kingsfund.org.uk/sites/default/files/2018-09/CQC-summary-september2018.pdf
- Journal article #1 published in Health Policy 2020: The measurement and improvement of maternity service performance through inspection and rating: An observational study of maternity services in acute hospitals in England. https://www.sciencedirect.com/science/article/pii/S0168851020302177
- Journal article #2 published in BJGP in 2020: Using quality indicators to predict inspection ratings: cross-sectional study of general practices in England. https://bjgp.org/content/bjgp/70/690/e55.full.pdf?versioned=true
- Journal article #3 published in the Emergency Medicine Journal 2019: Measurement and improvement of emergency department performance through inspection and rating: an observational study of emergency departments in acute hospitals in England. https://emj.bmj.com/content/36/6/326
- Journal article #4 published in International Journal for Quality in Health Care 2019: Do performance indicators predict regulator ratings of healthcare providers? Cross-sectional study of acute hospitals in England. https://academic.oup.com/intqhc/article/32/2/113/5625739
- Journal article #5 published in Health Expectations in 2018: User involvement in regulation: A qualitative study of service user involvement in Care Quality Commission inspections of health and social care providers in England. https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/hex.12849
Presentations were given at national and international conferences to audiences of academics and health professionals.
Expected measurable benefits
This data sharing agreement permits the secure retention of the existing data for the purposes of archiving research data and therefore no new benefits are expected. However, from recent completed analysis, the expected benefits are as follows:
The Care Quality Commission developed its system of provider ratings as part of its new regulatory model and inspection regime in 2013, piloted it in the NHS acute care sector in 2013-14 and is now developing it for use in other sectors. The new approach is radically different from the model it replaced. It uses larger and more expert inspection teams, a wider range of data and fieldwork, and produces provider ratings in five domains (safe, effective, caring, responsive and well-led) using a four-point rating scale (inadequate, requires improvement, good or outstanding) as part of a detailed narrative inspection report.
The key purpose of these provider ratings is to drive improvements in the quality of care and in provider performance, but the ways in which this might happen are complex, and there is potential for unintended consequences. This research will help CQC, the DHSC and other stakeholders to understand how the system of provider ratings works, and to find ways to increase its impact on the quality of care, minimise costs and prevent or reduce any adverse or unintended effects. This will allow the DHSC to impact on the future direction of policy, and also contribute to a wider body of knowledge on regulation/inspection and performance ratings.
The final report to the DHSC was submitted in March 2018. Since then, an additional final report was published by The Kings Fund and 5 journal articles have been published. Several meetings have been held with the CQC to establish links by which the research can be disseminated within the CQC. These updates are in addition to the final report and journal articles.
Overall, this research project has helped inform the CQC about its inspection and rating system, helping to shape the development of future health regulation policy.
Benefits reported so far
The final report for the CQC work has been submitted to the DHSC and shared with the CQC. The University of Manchester have also produced an additional final report which was published by The Kings Fund and 5 journal articles have been published. The final report was cited 35 times. Published journal articles have been cited 44 times.
In addition, the findings have been presented to and discussed with the CQC board. Feedback was received but this did not explain any additional benefits. The research is being discussed by the DHSC and CQC and has potential to be used to inform the future DHSC strategy on healthcare inspections but specific benefits beyond this are not known.
Datasets on the latest version
Legal basis for provision: Health and Social Care Act 2012 – s261(2)(a)
| Dataset | Type of data | Sensitivity | Frequency | Confidential data |
|---|---|---|---|---|
| Civil Registrations of Death - Secondary Care Cut | Anonymised - ICO Code Compliant | Sensitive | One-Off | Does not include the flow of confidential data |
| HES:Civil Registration (Deaths) bridge | Anonymised - ICO Code Compliant | Non-Sensitive | One-Off | Does not include the flow of confidential data |
| Hospital Episode Statistics Accident and Emergency (HES A and E) | Anonymised - ICO Code Compliant | Non-Sensitive | One-Off | Does not include the flow of confidential data |
| Hospital Episode Statistics Admitted Patient Care (HES APC) | Anonymised - ICO Code Compliant | Non-Sensitive | One-Off | Does not include the flow of confidential data |
| Hospital Episode Statistics Outpatients (HES OP) | Anonymised - ICO Code Compliant | Non-Sensitive | One-Off | Does not include the flow of confidential data |
| Patient Reported Outcome Measures (Linkable to HES) | Anonymised - ICO Code Compliant | Sensitive | One-Off | Does not include the flow of confidential data |
Files released
Files released counts only files released externally by DARS. Access granted in NHS England's own systems, such as its Secure Data Environment, is not included.
Patient opt-outs were not applied to any of the 36 files released under this agreement, across every version. About opt-outs
No files recorded as released under the latest version. 36 were released under earlier versions, shown in the version history.
Version history
The register lists each renewal of this agreement as a separate row. This site has 3 versions — earlier versions existed before this site's records begin.
DARS-NIC-23410-W8N9L-v4.10 19 May 2023 to 1 November 2025
- Title
- The impact of hospital regulation on performance
- Commercial
- No
- Sublicensing
- No
- Datasets
- 6
- Files released
- 0
Datasets: Civil Registrations of Death - Secondary Care Cut; HES:Civil Registration (Deaths) bridge; Hospital Episode Statistics Accident and Emergency (HES A and E); Hospital Episode Statistics Admitted Patient Care (HES APC); Hospital Episode Statistics Outpatients (HES OP); Patient Reported Outcome Measures (Linkable to HES)
What changed from DARS-NIC-23410-W8N9L-v3.10
Text removed is struck through; text added is underlined. Unchanged paragraphs are summarised rather than repeated.
| Field | Was | Became |
|---|---|---|
| Title | The impact of hospital regulation on performance | |
| Start date | 2023-05-19 | |
| End date | 2025-11-01 | |
| Civil Registrations of Death - Secondary Care Cut: legal basis | Health and Social Care Act 2012 – s261(2)(a) | |
| HES:Civil Registration (Deaths) bridge: legal basis | Health and Social Care Act 2012 – s261(2)(a) | |
| Hospital Episode Statistics Accident and Emergency (HES A and E): legal basis | Health and Social Care Act 2012 – s261(2)(a) | |
| Hospital Episode Statistics Admitted Patient Care (HES APC): legal basis | Health and Social Care Act 2012 – s261(2)(a) | |
| Hospital Episode Statistics Outpatients (HES OP): legal basis | Health and Social Care Act 2012 – s261(2)(a) | |
| Patient Reported Outcome Measures (Linkable to HES): legal basis | Health and Social Care Act 2012 – s261(2)(a) |
Datasets:
− Emergency Care Data Set (ECDS)
Objective for processing
This Data Sharing Agreement permits the retention of the data provided under previous iterations of this Agreement for an interim period in which the University of Manchester intends to apply to amend this Agreement.
The research set out to examine how providers, the public and other stakeholders respond to provider ratings, and what impacts inspection and ratings have on the quality of care and on improving performance. Understanding how ratings work, as part of the wider inspection process, is essential if the Department of Health are to increase the potential benefits for the quality of healthcare and reduce the costs and any adverse or unintended consequences. The University of Manchester was awarded research funding from the Department of Health Policy Research Programme to analyse the impact of the Care Quality Commission's (CQC) new inspection and rating system on provider performance.
Data held by the University of Manchester must be securely stored and not otherwise processed.
The following provides background information on the purpose for which the data was provided. This purpose is now complete and no further processing of the data for this purpose is permitted.
The University of Manchester was awarded research funding from the Department of Health Policy Research Programme to analyse the impact of the Care Quality Commission's new inspection and rating system on provider performance.
The data was used to uncover the relative impact of healthcare regulation, compared to other influences, on hospital performance. It would not be possible to measure hospital performance, and therefore evaluate the CQC, without the datasets requested.
The research set out to examine how providers, the public and other stakeholders respond to provider ratings, and what impacts inspection and ratings have on the quality of care and on improving performance. Understanding how ratings work, as part of the wider inspection process, is essential if the Department of Health are to increase the potential benefits for the quality of healthcare, and reduce the costs and any adverse or unintended consequences.
[12 paragraphs unchanged]
- PROMs
- Patient Reported Outcome Measures (PROMs)
The data provided by NHS Digital would only be used by the members of the research team detailed in this application. The analysis conducted on these data would feed into the evaluation of the CQC which also includes qualitative researchers based at the University of Manchester and The Kings Fund. Only employees of the University of Manchester would process the data. Only aggregated outputs would be shared with researchers outside of the University and small numbers will be suppressed in line with the HES Analysis Guide
The University of Manchester is the sole data Controller who also processes the data.
The final report has been submitted.
The lawful basis for processing personal data under the UK GDPR is:
Article 6(1)(e) - processing is necessary for the performance of a task carried out in the public interest or in the exercise of official authority vested in the controller;
The lawful basis for processing special category data under the UK GDPR is:
Article 9(2)(j) - processing is necessary for archiving purposes in the public interest, scientific or historical research purposes or statistical purposes in accordance with Article 89(1) based on Union or Member State law which shall be proportionate to the aim pursued, respect the essence of the right to data protection and provide for suitable and specific measures to safeguard the fundamental rights and the interests of the data subject.
The processing of data under this agreement is in the interest of public because it adheres to the UK Policy Framework for Health and Social Care Research and aims to understand how ratings work as part of the wider inspection process, what impacts inspection and ratings have on the quality of care and on improving performance by reducing the costs and any adverse or unintended consequences.
The data provided by NHS England would only be used by the members of the research team detailed in this Agreement. The analysis conducted on these data would feed into the evaluation of the CQC which also includes qualitative researchers based at the University of Manchester and The Kings Fund. Only employees of the University of Manchester would process the data. Only aggregated outputs would be shared with researchers outside of the University and small numbers will be suppressed in line with the HES Analysis Guide.
The data was used to uncover the relative impact of healthcare regulation, compared to other influences, on hospital performance. It would not be possible to measure hospital performance and therefore evaluate the CQC, without the datasets requested.
This project has now ended (v4) and the research and the associated processing are now complete. The final report for this CQC work has been submitted to the Department of Health and Social Care (DHSC) and shared with the CQC. In addition, the findings have been presented to and discussed with the CQC board.
The University of Manchester are now applying to retain the existing data for the purposes of archiving research data. This is in accordance with the University of Manchester's Research Data Management policies and the Records Retention Schedule which state that research data and records should be archived for a minimum of 5 years after publication.
The last output from this project was the journal article published in Health Policy in November 2020, therefore the University of Manchester will archive the data until November 2025.
No additional data will be requested from NHS England.
This Agreement does not permit any further processing that involves analysis or linkage other than for the purpose of verifying findings in line with the original objectives of the study. Following publication of study findings, it is possible that the findings will be questioned or challenged by third parties through direct contact with the University of Manchester, contact via the publishing journal or an open letter. In such circumstances, the University of Manchester may re-run previous analyses to verify that the published results were accurate and may publish or write a response directly to the challenger.
The University of Manchester are not permitted to undertake different analyses to those undertaken during the original analysis.
This Agreement does not permit any onward sharing of the data with the exception that the data may be viewed for the purpose of an audit by a regulator such as the Medicines and Healthcare products Regulatory Agency (MHRA).
The data controller themselves may exercise the right to audit.
If any further data processing is required in addition to the above purposes, or if the data needs to be moved to a different location/organisation, the applicants must submit a request to amend this Agreement to NHS England before data is accessed or migrated.
The following NHS England data will be retained:
• Hospital Episode Statistics
• Admitted Patient Care
• Accident & Emergency
• Outpatients
• Civil Registration Mortality
• Patient Reported Outcome Measures (PROMS)
The data was minimised as follows:
• Limited to data between 2007 and 2018
The level of all the above data will be pseudonymised data only.
All decisions concerning the retention and any potential reuse of the data are taken by the University of Manchester. The University of Manchester are therefore deemed to be sole data controller for the purpose of this Agreement.
The data will be archived and will not be accessed by any individuals other than substantive employees of the University of Manchester or employees of the auditing organisation and strictly for purposes described above.
Processing activities
This Agreement permits the secure storage of the data and no other processing for any purpose.
Pseudonymised HES, PROMs, and mortality data was supplied by NHS England to the University of Manchester.
This Agreement permits the secure storage of the data. The University of Manchester will be retaining this data for the purposes of archiving research data. Under this Agreement, data can only be processed in the circumstance that any queries arise as a result of publications. In such a case, data processing is restricted to repeated analysis.
[1 paragraph unchanged]
- Data will only flow from the NHS Digital to the University of Manchester.
- The data was analysed in order to measure hospital performance.
- No data will be shared with third parties.
The data was analysed using the statistical package Stata. Regression methods were used to output regression results tables. No record level data was produced as an output at any stage, only aggregated outputs by year and/or area level (e.g., Lower Layer Super Output Area (LSOA)/Hospital provider/ Clinical Commissioning Group (CCG) /GP practice), such as predicted cost of service use at varying levels of aggregation for each financial year. Examples of levels of aggregation include:
- The data will be analysed in order to measure hospital performance. This will not involve linking data to other datasets (apart from the linkage to PROMs and ONS provided by NHS Digital). Trends in hospital performance over the period of time requested will be analysed.
• LSOA-age-gender (and higher level organisational structures linked to GP practice such as Middle Layer Super Output Area (MSOA), Lower Tier local authority to upper (LTLA) and Upper Tier Local Authority boundaries (UTLA))
- Requested are the years prior to the introduction of the CQC inspection in order to accurately account for historic trends in performance. This is a standard approach and required in order to measure changes in these trends, which may be due to the CQC inspection.
• GP practice-age – gender (and higher level organisational structures linked to GP practice such as CCG)
The data will be analysed using the statistical packages Stata and R. Regression methods will be used which will output regression results tables. No record level data will be produced as an output at any stage, only aggregated date (with small numbers suppressed in line with the HES Analysis Guide). Descriptive statistics tables of the data will be produced which will aggregate the data by year. Graphs will be produced to describe the data and these graphs will also aggregate the data by year. The outputs produced cannot be used to identify patients or sensitive information.
• Hospital provider-age-gender
Both Data Centres are owned by third parties. The hardware in the data centres belong to University of Manchester, the network infrastructure is also University of Manchester, nothing is shared. Dedicated space and caged off. The study have dedicated UoM staff who manage the UoM infrastructure in both the data centres.
Small numbers will be suppressed in line with the HES Analysis Guide. Descriptive statistics tables of the data will be produced which will aggregate the data by year. Graphs will be produced to describe the data and these graphs will also aggregate the data by year or area level. The outputs produced cannot be used to identify patients or sensitive information.
Processing of the data will take place on the iCSF infrastructure of the University of Manchester.
Equinix and Digital Reality provides IT hosting services to the University of Manchester and will store the data as contracted by the University of Manchester. The hardware in the data centres belong to University of Manchester, the network infrastructure is also University of Manchester, nothing is shared. The data is stored in a dedicated space and is caged off. The study has dedicated UoM staff who manage the UoM infrastructure in both the data centres.
Processing of the data will take place on the interactive Computational Shared Facility (iCSF) infrastructure of the University of Manchester.
[1 paragraph unchanged]
The iCSF, aka Incline, is a service designed specifically for interactive computationally-intensive work, such as development and testing of parallel or data-intensive code, or interactive (GUI-based) use of applications such as Abaqus, Matlab, R, and Stata.
The data will be securely stored at the University of Manchester.
Access to the iCSF is limited. An isilon storage share is mounted on in the researcher’s user area. Access to the storage share is via an active directory group, set up with only those users described within the data sharing plan having access to data on the iCSF.
The data may be accessed for a purpose specified above only. In all such circumstances, the data must remain on the University of Manchester servers, with access restricted to substantive employees of the University of Manchester or substantive employees of the organisation auditing the study.
PROMS terms and Conditions will be adhered to.
Expected output
[1 paragraph unchanged]
CQC evaluation:
The CQC evaluation which has now been completed has resulted in the following outputs:
This research has been completed and resulted in the following outputs:
[7 paragraphs unchanged]
Presentations were given at national and international conferences to audiences of academics and health professionals.
Typical conferences are the UK Health Economists' Study Group.
The objective of the data processing activities performed on these data is to produce statistical outputs for rapid-response research as part of the PRU or other policy research as part of projects funded by the PRU or externally. The outputs will be to be used in peer-reviewed journal articles, presentations, and project reports.
These outputs will predominantly consist of three types:
• descriptive tables summarising the data.
• graphs and figures summarising the data; and
• tables of regression estimates.
Outputs will contain only data, which is aggregated, with any small numbers suppressed in line with the HES Analysis Guide. The number of outputs - specifically articles, presentations and reports, will be determined by the findings of the analysis and by academic peer-review.
Presentations will be given at national and international conferences to audiences of academics and health professionals. Reports and journal articles will be published online and made available to all. Submitted versions of all journal articles will be freely available on the University of Manchester library website.
Findings are intended to be submitted to academic journals for scientific peer-review. The journals targeted for published works include:
• British Medical Journal.
• British Journal of General Practice.
• Health Economics.
• The Journal of Health Economics.
• Health Services Journal; and
• Journal of Health Services Research & Policy.
Outputs related to GM evaluations: The objective of the data processing activities performed on these data is to produce statistical outputs to be used in peer-reviewed journal articles, presentations and reports for the NIHR, Tameside Council and the Greater Manchester Combined Authority (GMCA).
These outputs will consist of three types:
• descriptive tables summarising the data.
• graphs and figures summarising the data; and
• tables of regression estimates.
Outputs will contain only data, which is aggregated, with any small numbers suppressed in line with the HES Analysis Guide.
The number of outputs - specifically articles, presentations, and reports, will be determined by the findings of the analysis and by academic peer-review.
Presentations will be given at national and international conferences to audiences of academics and health professionals. Reports and journal articles will be published online and made available to all. Submitted versions of all journal articles will be freely available on the University of Manchester library website. Findings may also provide real-time learning for:
• Health Innovation Manchester (HInM) and the NIHR, the body responsible for the NIHR-Applied Research Collaboration (ARC).
• The Health Foundation.
• Greater Manchester Combined Authority; and
• Tameside Metropolitan Borough Council.
This will be facilitated through presentations and seminars to the staff of the listed organisations.
Findings are intended to be submitted to academic journals for scientific peer-review. The journals targeted for published works include:
• British Medical Journal.
• Health Economics.
• The Journal of Health Economics.
• Health Services Journal; and
• Journal of Health Services Research & Policy.
Reports and journal articles will be published online and made available to all. Submitted versions of all journal articles will be freely available on the University of Manchester library website.
Expected measurable benefits
This data sharing agreement permits the secure retention of the existing data for the purposes of archiving research data and therefore no new benefits are expected. However, from recent completed analysis, the expected benefits are as follows:
[4 paragraphs unchanged]
NIHR Policy Research Units (PRUs), such as PRUComm, undertake research to inform government and arms-length bodies making policy decisions about health and social care. PRUComm provides evidence to inform the DHSC policy on the health and social care systems and commissioning to maximise outcomes for patients.
Globally, increasing demand has highlighted the importance of rapid identification, prioritisation, and evaluation of innovations in service design and delivery to meet that demand. Equally, there is recognition of the changing population demographics and the importance of ensuring that research reflects those changes. Enhancing timeliness of research and its generalisability while maintaining rigour are critical to ensuring impact of applied health research and care. Specifically, the projects funded through PRUComm or the aligned externally funded projects, provide detailed policy evaluations, and increase the evidence base around health policy.
GM evaluations: It is a key aim of the GM NIHR ARC to ensure that service innovations deliver improvements in the health and wellbeing of the GM population. It is therefore required that appropriate evaluation methodology be defined and then subsequently applied - including the impacts on the entire health economy – including the impacts on secondary care.
In addition to defining and applying appropriate evaluation methodology to local innovations in GM health and social care settings, understanding the impact of Devo Manc is critical to informing future government policies relating to the devolution of decision-making power. Public services in England are highly-centralised compared with much of Western Europe, and the University of Manchester’s evaluation of the success of this devolution deal will guide the future direction of policy, in particular whether health and social care powers will be included in any future devolution deals to other English regions. It will also contribute to wider literature on the consequences of enhanced community care for secondary care use, expenditure, and efficiency. Through real-time learning, this research may also contribute to the success of devolution in Greater Manchester.
Outputs from the research proposed will include innovative methods to support rapid evaluation for wider adoption, and a portfolio of tested methods to allow research to be conducted with and in the populations most affected.
Benefits reported
The final report for the CQC work has been submitted to the DHSC and shared with the CQC. In addition the findings have been presented to and discussed with the CQC board. The research is being discussed by the DHSC and CQC and will be used to inform future policy and practice for health care regulation. Additional benefits will be understood once feedback is received from the DHSC.
The final report for the CQC work has been submitted to the DHSC and shared with the CQC. The University of Manchester have also produced an additional final report which was published by The Kings Fund and 5 journal articles have been published. The final report was cited 35 times. Published journal articles have been cited 44 times.
In addition, the findings have been presented to and discussed with the CQC board. Feedback was received but this did not explain any additional benefits. The research is being discussed by the DHSC and CQC and has potential to be used to inform the future DHSC strategy on healthcare inspections but specific benefits beyond this are not known.
DARS-NIC-23410-W8N9L-v3.10 4 October 2021 to 3 October 2022
- Title
- Evaluating innovations in health and social care settings in Greater Manchester and England
- Commercial
- No
- Sublicensing
- No
- Datasets
- 7
- Files released
- 0
Datasets: Civil Registrations of Death - Secondary Care Cut; Emergency Care Data Set (ECDS); HES:Civil Registration (Deaths) bridge; Hospital Episode Statistics Accident and Emergency (HES A and E); Hospital Episode Statistics Admitted Patient Care (HES APC); Hospital Episode Statistics Outpatients (HES OP); Patient Reported Outcome Measures (Linkable to HES)
What changed from DARS-NIC-23410-W8N9L-v2.30
Text removed is struck through; text added is underlined. Unchanged paragraphs are summarised rather than repeated.
| Field | Was | Became |
|---|---|---|
| Title | Evaluating innovations in health and social care settings in Greater Manchester and England | |
| Start date | 2021-10-04 | |
| End date | 2022-10-03 | |
| Civil Registrations of Death - Secondary Care Cut: legal basis | Health and Social Care Act 2012 - s261 - 'Other dissemination of information' | |
| HES:Civil Registration (Deaths) bridge: legal basis | Health and Social Care Act 2012 - s261 - 'Other dissemination of information' | |
| Hospital Episode Statistics Accident and Emergency (HES A and E): legal basis | Health and Social Care Act 2012 - s261 - 'Other dissemination of information' | |
| Hospital Episode Statistics Admitted Patient Care (HES APC): legal basis | Health and Social Care Act 2012 - s261 - 'Other dissemination of information' | |
| Hospital Episode Statistics Outpatients (HES OP): legal basis | Health and Social Care Act 2012 - s261 - 'Other dissemination of information' | |
| Patient Reported Outcome Measures (Linkable to HES): legal basis | Health and Social Care Act 2012 - s261 - 'Other dissemination of information' |
Datasets: + Emergency Care Data Set (ECDS)
Objective for processing
The University of Manchester has been awarded research funding from the Department of Health Policy Research Programme to analyse the impact of the Care Quality Commission's new inspection and rating system on provider performance.
This Data Sharing Agreement permits the retention of the data provided under previous iterations of this Agreement for an interim period in which the University of Manchester intends to apply to amend this Agreement.
The data will be used to uncover the relative impact of healthcare regulation, compared to other influences, on hospital performance. It would not be possible to measure hospital performance, and therefore evaluate the CQC, without the datasets requested.
Data held by the University of Manchester must be securely stored and not otherwise processed.
The research sets out to examine how providers, the public and other stakeholders respond to provider ratings, and what impacts inspection and ratings have on the quality of care and on improving performance. Understanding how ratings work, as part of the wider inspection process, is essential if the Department of Health are to increase the potential benefits for the quality of healthcare, and reduce the costs and any adverse or unintended consequences.
The following provides background information on the purpose for which the data was provided. This purpose is now complete and no further processing of the data for this purpose is permitted.
There are four main questions in the research:
The University of Manchester was awarded research funding from the Department of Health Policy Research Programme to analyse the impact of the Care Quality Commission's new inspection and rating system on provider performance.
The data was used to uncover the relative impact of healthcare regulation, compared to other influences, on hospital performance. It would not be possible to measure hospital performance, and therefore evaluate the CQC, without the datasets requested.
The research set out to examine how providers, the public and other stakeholders respond to provider ratings, and what impacts inspection and ratings have on the quality of care and on improving performance. Understanding how ratings work, as part of the wider inspection process, is essential if the Department of Health are to increase the potential benefits for the quality of healthcare, and reduce the costs and any adverse or unintended consequences.
There were four main questions in the research:
[4 paragraphs unchanged]
Hospital performance
will
would
be measured in the following way:
[7 paragraphs unchanged]
The data provided by NHS Digital
will
would
only be used by the members of the research team detailed in this application. The analysis conducted on these data
will
would
feed into the evaluation of the CQC which also includes qualitative researchers
[5 words unchanged]
Manchester and The Kings Fund. Only employees of the University of Manchester
will
would
process the data. Only aggregated outputs
will
would
be shared with researchers outside of the University and small numbers will be suppressed in line with the HES Analysis Guide
The amendment to the original application is related to the same objective. The final report has been submitted but The University of Manchester have agreed with the department of health to update the analysis using the most recent data. This is due to a shorter period of data being available for some hospitals inspected later in the CQC cycle.
The final report has been submitted.
Processing activities
This Agreement permits the secure storage of the data and no other processing for any purpose. The following text describes the processing activities which were permitted under previous versions of this Data Sharing Agreement. All processing activities described are now complete. [11 paragraphs unchanged]
Expected output
The purpose of the data processing activities performed on these data is to produce statistical outputs to be used in peer-reviewed journal articles, presentations and reports for the Department of Health Policy Research Programme. These statistical outputs will be of three types: 1) descriptive tables summarising the data, 2) graphs and figures summarising the data, and 3) regression results tables. Outputs will contain only data which is aggregated, with any small numbers suppressed in line with the HES Analysis Guide.
This Agreement permits the secure storage of the data only. No new outputs will be produced during the term of this Data Sharing Agreement.
The overall research project includes a number of work packages: systematic review package, qualitative package and quantitative package (using the requested data). Seminars will be held for invited participants from the research case studies and interested organisations, for feedback on early and emerging findings and member checking as well as to promote knowledge mobilisation. For case studies, a short report will be produced and the findings may be presented locally to stakeholders in the “system of care”.
CQC evaluation:
The number of outputs, in terms of articles/presentations/reports, will be determined by the findings of the analysis and by the academic peer-review process. There is a PPI (Patient and Public Involvement) forum who will be engaged in producing these reports and their dissemination.
This research has been completed and resulted in the following outputs:
The aim is to produce a series of journal articles investigating hospital performance and how it is affected by regulation and inspection. Journals that will be targeted for these publications will be: 'Health Economics', 'The Journal of Health Economics', 'Health Services Journal', 'Journal of Health Services Research & Policy'.
- University of Manchester Final Report: Impact of the Care Quality Commission on provider performance. https://www.research.manchester.ac.uk/portal/files/77461382/cqc_provider_performance_report_september2018.pdf
Target journal publication dates are as follows:
- The Kings Fund Final Report: Impact of the Care Quality Commission on provider performance Room for improvement? https://www.kingsfund.org.uk/sites/default/files/2018-09/CQC-summary-september2018.pdf
a. Journal Article 1 submission target: December 2017 (submitted June 2018 to Emergency Medical Journal)
- Journal article #1 published in Health Policy 2020: The measurement and improvement of maternity service performance through inspection and rating: An observational study of maternity services in acute hospitals in England. https://www.sciencedirect.com/science/article/pii/S0168851020302177
b. Journal Article 2 submission target: September 2018 (targeting maternity journals)
- Journal article #2 published in BJGP in 2020: Using quality indicators to predict inspection ratings: cross-sectional study of general practices in England. https://bjgp.org/content/bjgp/70/690/e55.full.pdf?versioned=true
c. Journal Article 3 submission target: February 2019 (targeting Social science and medicine)
- Journal article #3 published in the Emergency Medicine Journal 2019: Measurement and improvement of emergency department performance through inspection and rating: an observational study of emergency departments in acute hospitals in England. https://emj.bmj.com/content/36/6/326
Presentations will be given at national and international conferences to audiences of academics and health professionals. Typical conferences are the UK Health Economists' Study Group.
- Journal article #4 published in International Journal for Quality in Health Care 2019: Do performance indicators predict regulator ratings of healthcare providers? Cross-sectional study of acute hospitals in England. https://academic.oup.com/intqhc/article/32/2/113/5625739
Reports will be provided for the Department of Health Policy Research Programme on the progress and outcome of the research.
- Journal article #5 published in Health Expectations in 2018: User involvement in regulation: A qualitative study of service user involvement in Care Quality Commission inspections of health and social care providers in England. https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/hex.12849
Target report publication dates are as follows:
Presentations were given at national and international conferences to audiences of academics and health professionals. Typical conferences are the UK Health Economists' Study Group.
a. Department of Health final report: March 2018 (Submitted March 2018)
The objective of the data processing activities performed on these data is to produce statistical outputs for rapid-response research as part of the PRU or other policy research as part of projects funded by the PRU or externally. The outputs will be to be used in peer-reviewed journal articles, presentations, and project reports.
These outputs will predominantly consist of three types:
• descriptive tables summarising the data.
• graphs and figures summarising the data; and
• tables of regression estimates.
Outputs will contain only data, which is aggregated, with any small numbers suppressed in line with the HES Analysis Guide. The number of outputs - specifically articles, presentations and reports, will be determined by the findings of the analysis and by academic peer-review.
Presentations will be given at national and international conferences to audiences of academics and health professionals. Reports and journal articles will be published online and made available to all. Submitted versions of all journal articles will be freely available on the University of Manchester library website.
Findings are intended to be submitted to academic journals for scientific peer-review. The journals targeted for published works include:
• British Medical Journal.
• British Journal of General Practice.
• Health Economics.
• The Journal of Health Economics.
• Health Services Journal; and
• Journal of Health Services Research & Policy.
Outputs related to GM evaluations: The objective of the data processing activities performed on these data is to produce statistical outputs to be used in peer-reviewed journal articles, presentations and reports for the NIHR, Tameside Council and the Greater Manchester Combined Authority (GMCA).
These outputs will consist of three types:
• descriptive tables summarising the data.
• graphs and figures summarising the data; and
• tables of regression estimates.
Outputs will contain only data, which is aggregated, with any small numbers suppressed in line with the HES Analysis Guide.
The number of outputs - specifically articles, presentations, and reports, will be determined by the findings of the analysis and by academic peer-review.
Presentations will be given at national and international conferences to audiences of academics and health professionals. Reports and journal articles will be published online and made available to all. Submitted versions of all journal articles will be freely available on the University of Manchester library website. Findings may also provide real-time learning for:
• Health Innovation Manchester (HInM) and the NIHR, the body responsible for the NIHR-Applied Research Collaboration (ARC).
• The Health Foundation.
• Greater Manchester Combined Authority; and
• Tameside Metropolitan Borough Council.
This will be facilitated through presentations and seminars to the staff of the listed organisations.
Findings are intended to be submitted to academic journals for scientific peer-review. The journals targeted for published works include:
• British Medical Journal.
• Health Economics.
• The Journal of Health Economics.
• Health Services Journal; and
• Journal of Health Services Research & Policy.
[1 paragraph unchanged]
Expected measurable benefits
[1 paragraph unchanged]
The key purpose of these provider ratings is to drive improvements in
[19 words unchanged]
there is potential for unintended consequences. This research will help CQC, the
Department of Health
DHSC
and other stakeholders to understand how the system of provider ratings works,
[16 words unchanged]
prevent or reduce any adverse or unintended effects. This will allow the
Department of Health
DHSC
to impact on the future direction of policy, and also contribute to a wider body of knowledge on regulation/inspection and performance ratings.
The final report to the
Department of Health will be
DHSC was
submitted in March 2018.
Since then, an additional final report was published by
The
dissemination of
Kings Fund and 5 journal articles have been published. Several meetings have been held with the CQC to establish links by which
the research
findings will include journal articles published after
can be disseminated within
the
final report. The University will continue
CQC. These updates are in addition
to
work on the data following
the final report
due to the lengthy peer review/revisions stage for
and
journal articles.
The CQC and the Department of Health will both receive regular updates on the research methods and outputs. Several meetings have already been held with the CQC to establish links by which the research can be disseminated within the CQC. These updates are in addition to the final report and journal articles.
Overall, this research project has helped inform the CQC about its inspection and rating system, helping to shape the development of future health regulation policy.
NIHR Policy Research Units (PRUs), such as PRUComm, undertake research to inform government and arms-length bodies making policy decisions about health and social care. PRUComm provides evidence to inform the DHSC policy on the health and social care systems and commissioning to maximise outcomes for patients.
Globally, increasing demand has highlighted the importance of rapid identification, prioritisation, and evaluation of innovations in service design and delivery to meet that demand. Equally, there is recognition of the changing population demographics and the importance of ensuring that research reflects those changes. Enhancing timeliness of research and its generalisability while maintaining rigour are critical to ensuring impact of applied health research and care. Specifically, the projects funded through PRUComm or the aligned externally funded projects, provide detailed policy evaluations, and increase the evidence base around health policy.
GM evaluations: It is a key aim of the GM NIHR ARC to ensure that service innovations deliver improvements in the health and wellbeing of the GM population. It is therefore required that appropriate evaluation methodology be defined and then subsequently applied - including the impacts on the entire health economy – including the impacts on secondary care.
In addition to defining and applying appropriate evaluation methodology to local innovations in GM health and social care settings, understanding the impact of Devo Manc is critical to informing future government policies relating to the devolution of decision-making power. Public services in England are highly-centralised compared with much of Western Europe, and the University of Manchester’s evaluation of the success of this devolution deal will guide the future direction of policy, in particular whether health and social care powers will be included in any future devolution deals to other English regions. It will also contribute to wider literature on the consequences of enhanced community care for secondary care use, expenditure, and efficiency. Through real-time learning, this research may also contribute to the success of devolution in Greater Manchester.
Outputs from the research proposed will include innovative methods to support rapid evaluation for wider adoption, and a portfolio of tested methods to allow research to be conducted with and in the populations most affected.
Benefits reported
The final report
for the CQC work
has been submitted to the
Department of Health
DHSC
and shared with the CQC. In addition the findings have been presented to and discussed with the CQC board. The research is being discussed by the
DH
DHSC
and CQC and will be used to inform future policy and practice for health care regulation. Additional benefits will be understood once feedback is received from the
DH.
DHSC.
Objective for processing
This Data Sharing Agreement permits the retention of the data provided under previous iterations of this Agreement for an interim period in which the University of Manchester intends to apply to amend this Agreement.
Data held by the University of Manchester must be securely stored and not otherwise processed.
The following provides background information on the purpose for which the data was provided. This purpose is now complete and no further processing of the data for this purpose is permitted.
The University of Manchester was awarded research funding from the Department of Health Policy Research Programme to analyse the impact of the Care Quality Commission's new inspection and rating system on provider performance.
The data was used to uncover the relative impact of healthcare regulation, compared to other influences, on hospital performance. It would not be possible to measure hospital performance, and therefore evaluate the CQC, without the datasets requested.
The research set out to examine how providers, the public and other stakeholders respond to provider ratings, and what impacts inspection and ratings have on the quality of care and on improving performance. Understanding how ratings work, as part of the wider inspection process, is essential if the Department of Health are to increase the potential benefits for the quality of healthcare, and reduce the costs and any adverse or unintended consequences.
There were four main questions in the research:
- How is the system of ratings meant to work, and bring about improvements in the quality of care?
- How does it work in practice, and what do providers, the public and others do in response to ratings?
- What impact does the system of ratings have on measures of the quality of care and provider performance?
- How could the system of ratings be improved?
Hospital performance would be measured in the following way:
- Mortality [within hospital/out of hospital/within 30 days]
- Readmissions within 30 days
- Length of stay
- Waiting times
- Occurrence of adverse events
- Cancellations of surgery
- PROMs
The data provided by NHS Digital would only be used by the members of the research team detailed in this application. The analysis conducted on these data would feed into the evaluation of the CQC which also includes qualitative researchers based at the University of Manchester and The Kings Fund. Only employees of the University of Manchester would process the data. Only aggregated outputs would be shared with researchers outside of the University and small numbers will be suppressed in line with the HES Analysis Guide
The final report has been submitted.
Expected output
This Agreement permits the secure storage of the data only. No new outputs will be produced during the term of this Data Sharing Agreement.
CQC evaluation:
This research has been completed and resulted in the following outputs:
- University of Manchester Final Report: Impact of the Care Quality Commission on provider performance. https://www.research.manchester.ac.uk/portal/files/77461382/cqc_provider_performance_report_september2018.pdf
- The Kings Fund Final Report: Impact of the Care Quality Commission on provider performance Room for improvement? https://www.kingsfund.org.uk/sites/default/files/2018-09/CQC-summary-september2018.pdf
- Journal article #1 published in Health Policy 2020: The measurement and improvement of maternity service performance through inspection and rating: An observational study of maternity services in acute hospitals in England. https://www.sciencedirect.com/science/article/pii/S0168851020302177
- Journal article #2 published in BJGP in 2020: Using quality indicators to predict inspection ratings: cross-sectional study of general practices in England. https://bjgp.org/content/bjgp/70/690/e55.full.pdf?versioned=true
- Journal article #3 published in the Emergency Medicine Journal 2019: Measurement and improvement of emergency department performance through inspection and rating: an observational study of emergency departments in acute hospitals in England. https://emj.bmj.com/content/36/6/326
- Journal article #4 published in International Journal for Quality in Health Care 2019: Do performance indicators predict regulator ratings of healthcare providers? Cross-sectional study of acute hospitals in England. https://academic.oup.com/intqhc/article/32/2/113/5625739
- Journal article #5 published in Health Expectations in 2018: User involvement in regulation: A qualitative study of service user involvement in Care Quality Commission inspections of health and social care providers in England. https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/hex.12849
Presentations were given at national and international conferences to audiences of academics and health professionals. Typical conferences are the UK Health Economists' Study Group.
The objective of the data processing activities performed on these data is to produce statistical outputs for rapid-response research as part of the PRU or other policy research as part of projects funded by the PRU or externally. The outputs will be to be used in peer-reviewed journal articles, presentations, and project reports.
These outputs will predominantly consist of three types:
• descriptive tables summarising the data.
• graphs and figures summarising the data; and
• tables of regression estimates.
Outputs will contain only data, which is aggregated, with any small numbers suppressed in line with the HES Analysis Guide. The number of outputs - specifically articles, presentations and reports, will be determined by the findings of the analysis and by academic peer-review.
Presentations will be given at national and international conferences to audiences of academics and health professionals. Reports and journal articles will be published online and made available to all. Submitted versions of all journal articles will be freely available on the University of Manchester library website.
Findings are intended to be submitted to academic journals for scientific peer-review. The journals targeted for published works include:
• British Medical Journal.
• British Journal of General Practice.
• Health Economics.
• The Journal of Health Economics.
• Health Services Journal; and
• Journal of Health Services Research & Policy.
Outputs related to GM evaluations: The objective of the data processing activities performed on these data is to produce statistical outputs to be used in peer-reviewed journal articles, presentations and reports for the NIHR, Tameside Council and the Greater Manchester Combined Authority (GMCA).
These outputs will consist of three types:
• descriptive tables summarising the data.
• graphs and figures summarising the data; and
• tables of regression estimates.
Outputs will contain only data, which is aggregated, with any small numbers suppressed in line with the HES Analysis Guide.
The number of outputs - specifically articles, presentations, and reports, will be determined by the findings of the analysis and by academic peer-review.
Presentations will be given at national and international conferences to audiences of academics and health professionals. Reports and journal articles will be published online and made available to all. Submitted versions of all journal articles will be freely available on the University of Manchester library website. Findings may also provide real-time learning for:
• Health Innovation Manchester (HInM) and the NIHR, the body responsible for the NIHR-Applied Research Collaboration (ARC).
• The Health Foundation.
• Greater Manchester Combined Authority; and
• Tameside Metropolitan Borough Council.
This will be facilitated through presentations and seminars to the staff of the listed organisations.
Findings are intended to be submitted to academic journals for scientific peer-review. The journals targeted for published works include:
• British Medical Journal.
• Health Economics.
• The Journal of Health Economics.
• Health Services Journal; and
• Journal of Health Services Research & Policy.
Reports and journal articles will be published online and made available to all. Submitted versions of all journal articles will be freely available on the University of Manchester library website.
Benefits reported
The final report for the CQC work has been submitted to the DHSC and shared with the CQC. In addition the findings have been presented to and discussed with the CQC board. The research is being discussed by the DHSC and CQC and will be used to inform future policy and practice for health care regulation. Additional benefits will be understood once feedback is received from the DHSC.
DARS-NIC-23410-W8N9L-v2.30 28 November 2017 to 27 November 2020
- Title
- The impact of hospital regulation on performance
- Commercial
- No
- Sublicensing
- No
- Datasets
- 6
- Files released
- 36
Datasets: Civil Registrations of Death - Secondary Care Cut; HES:Civil Registration (Deaths) bridge; Hospital Episode Statistics Accident and Emergency (HES A and E); Hospital Episode Statistics Admitted Patient Care (HES APC); Hospital Episode Statistics Outpatients (HES OP); Patient Reported Outcome Measures (Linkable to HES)
Objective for processing
The University of Manchester has been awarded research funding from the Department of Health Policy Research Programme to analyse the impact of the Care Quality Commission's new inspection and rating system on provider performance.
The data will be used to uncover the relative impact of healthcare regulation, compared to other influences, on hospital performance. It would not be possible to measure hospital performance, and therefore evaluate the CQC, without the datasets requested.
The research sets out to examine how providers, the public and other stakeholders respond to provider ratings, and what impacts inspection and ratings have on the quality of care and on improving performance. Understanding how ratings work, as part of the wider inspection process, is essential if the Department of Health are to increase the potential benefits for the quality of healthcare, and reduce the costs and any adverse or unintended consequences.
There are four main questions in the research:
- How is the system of ratings meant to work, and bring about improvements in the quality of care?
- How does it work in practice, and what do providers, the public and others do in response to ratings?
- What impact does the system of ratings have on measures of the quality of care and provider performance?
- How could the system of ratings be improved?
Hospital performance will be measured in the following way:
- Mortality [within hospital/out of hospital/within 30 days]
- Readmissions within 30 days
- Length of stay
- Waiting times
- Occurrence of adverse events
- Cancellations of surgery
- PROMs
The data provided by NHS Digital will only be used by the members of the research team detailed in this application. The analysis conducted on these data will feed into the evaluation of the CQC which also includes qualitative researchers based at the University of Manchester and The Kings Fund. Only employees of the University of Manchester will process the data. Only aggregated outputs will be shared with researchers outside of the University and small numbers will be suppressed in line with the HES Analysis Guide
The amendment to the original application is related to the same objective. The final report has been submitted but The University of Manchester have agreed with the department of health to update the analysis using the most recent data. This is due to a shorter period of data being available for some hospitals inspected later in the CQC cycle.
Expected output
The purpose of the data processing activities performed on these data is to produce statistical outputs to be used in peer-reviewed journal articles, presentations and reports for the Department of Health Policy Research Programme. These statistical outputs will be of three types: 1) descriptive tables summarising the data, 2) graphs and figures summarising the data, and 3) regression results tables. Outputs will contain only data which is aggregated, with any small numbers suppressed in line with the HES Analysis Guide.
The overall research project includes a number of work packages: systematic review package, qualitative package and quantitative package (using the requested data). Seminars will be held for invited participants from the research case studies and interested organisations, for feedback on early and emerging findings and member checking as well as to promote knowledge mobilisation. For case studies, a short report will be produced and the findings may be presented locally to stakeholders in the “system of care”.
The number of outputs, in terms of articles/presentations/reports, will be determined by the findings of the analysis and by the academic peer-review process. There is a PPI (Patient and Public Involvement) forum who will be engaged in producing these reports and their dissemination.
The aim is to produce a series of journal articles investigating hospital performance and how it is affected by regulation and inspection. Journals that will be targeted for these publications will be: 'Health Economics', 'The Journal of Health Economics', 'Health Services Journal', 'Journal of Health Services Research & Policy'.
Target journal publication dates are as follows:
a. Journal Article 1 submission target: December 2017 (submitted June 2018 to Emergency Medical Journal)
b. Journal Article 2 submission target: September 2018 (targeting maternity journals)
c. Journal Article 3 submission target: February 2019 (targeting Social science and medicine)
Presentations will be given at national and international conferences to audiences of academics and health professionals. Typical conferences are the UK Health Economists' Study Group.
Reports will be provided for the Department of Health Policy Research Programme on the progress and outcome of the research.
Target report publication dates are as follows:
a. Department of Health final report: March 2018 (Submitted March 2018)
Reports and journal articles will be published online and made available to all. Submitted versions of all journal articles will be freely available on the University of Manchester library website.
Benefits reported
The final report has been submitted to the Department of Health and shared with the CQC. In addition the findings have been presented to and discussed with the CQC board. The research is being discussed by the DH and CQC and will be used to inform future policy and practice for health care regulation. Additional benefits will be understood once feedback is received from the DH.
Register history
When this agreement appeared in, or was edited in, each monthly edition of the register. Built by comparing every edition this site holds, the earliest of which is July 2021.
-
July 2021 —
already listed in the earliest edition this site holds, so it may be older. 1 version: DARS-NIC-23410-W8N9L-v2.30
-
November 2021
1 version added: DARS-NIC-23410-W8N9L-v3.10
-
December 2022
Register-wide edit DARS-NIC-23410-W8N9L-v2.30 — Datasets: legal basis: “
s261(1) and” taken out. Made to 639 agreements in this edition, so it is reported once, on the changes page, and not counted as an amendment of this agreement. -
July 2023
1 version added: DARS-NIC-23410-W8N9L-v4.10
Cite this page
NHS England (2026) Data Uses Register, September 2026 edition, agreement DARS-NIC-23410-W8N9L, “The impact of hospital regulation on performance”. Read via NHS Data Access Explorer (unofficial), https://healthdatauses.uk/agreements/dars-nic-23410-w8n9l/ (accessed [date]).
This address stays the same, but the page is rebuilt with each monthly edition, so the citation names the edition it shows. Every edition's data is kept in the facts store.
Source: datausesregister_september2026.xlsx, September 2026 edition of the NHS England Data Uses Register. Search that workbook for DARS-NIC-23410-W8N9L to see the original rows.