Consolidation of some content from the multiple data platforms that currently exist would help in this regard, to facilitate transparency and public understanding of the quality of care. Although there is much to praise in Scotland’s local, or bottom-up, approach to quality monitoring and improvement, these initiatives could at times be supported by stronger national frameworks. Consideration should also be given to the creation of a more independent mechanism for assessing health system performance (separate from the improvement function), and ensuring that primary and community care services are subject to the same level of scrutiny as hospital services.