Open access. The Care Quality Commission (CQC) is responsible for ensuring the quality of healthcare in England. To that end, CQC has developed statistical surveillance tools that periodically aggregate large numbers of quantitative performance measures to identify risks to the quality of care and prioritise its limited inspection resource. These tools have, however, failed to successfully identify poor-quality providers. Facing continued budget cuts, CQC is now further reliant on an ‘intelligence-driven’, risk-based approach to prioritising inspections and a new effective tool is required.