In the modern Health Service frequent inspection has become commonplace. These inspections are often viewed with a degree of suspicion by clinicians and none has fallen into greater disrepute than the visits conducted for the Clinical Negligence Scheme for Trusts, CNST. These visits are often seen as a ‘Tick box’ exercise, more important to the finances of the Trust than the care of patients. Fortunately as with many other generalisations this is incorrect. Although one can always disagree with individual standards examined during this inspection the fundamental principles that these standards are based upon are often suggested by medical colleges and are founded on sound risk management theory.