Inspection is a widely used strategy in the regulation of healthcare, yet its effectiveness is less certain than its ubiquity might suggest. Drawing on regulatory theory and empirical studies, this Element examines how inspection is intended to work, what it can be expected to achieve, and why rigorous evaluation is challenging. We position inspection within the broader regulatory system, identifying its role in a cybernetic model of regulation that includes standard‑setting, monitoring, and modification. Across the literature, evidence of impact is limited and often methodologically weak. However, it is clear that inspection can play valuable roles in detecting failure, supporting improvement, and providing assurance. A discussion of the challenges of designing and implementing inspection is offered, along with some critiques. The Element proposes that - to support improvement - inspection needs to be proportionate, coherent, attentive to context, and supportive of learning, while retaining the capacity for enforcement where needed. This title is also available as open access on Cambridge Core.
