This review was comissioned by the Secretary of State for Health to examine whether ratings of provider performance should be used in health and social care. This report is the final output of the review process. It concludes that the costs and benefits in implementing a ratings system may be favourable for providers of social care and for general practices (given the potential for choice and the nature of care provided in those settings). The benefits are less certain for hospitals, given the way that ratings were designed and used in the past. It lists a number of conditions that would have to be fulfilled for any potential benefits of hospital ratings to be fully realised.