Abstract

The Healthcare Commission is the independent regulator of the NHS in England, and carries out inspections, investigations, and annual ratings of all hospitals and primary care trusts. They have a commitment to the ‘intelligent use’ of the vast quantity of information to which they have access, and we have recently been collaborating in the development and application of appropriate statistical methods. Solutions to a range of challenges will be described: allowance for chance variability around targets set for MRSA reductions in hospitals, a major re-design of the entire hospital inspection regime into a ‘risk-based’ system, and the design of an automatic surveillance system for large numbers of indicators on hundreds of organisations. Technical issues include allowance for over-dispersion, hierarchical aggregation of performance indicators, risk-adjusted sequental analysis, and the control of false discovery rates.