Clinical governance and maintaining high quality clinical and patient reported outcomes (PROMS) are crucial within the healthcare sector. The Francis report (2015) and the Paterson inquiry (2020) highlighted systemic patient safety risks within the NHS and private healthcare sector. As a large independent organisation, providing NHS cataract surgery from 17 hospitals performed by over 30 Consultant Ophthalmologists, a system was required to benchmark surgeons. Previous measures used in surgeon appraisal and revalidation provide only a snapshot of selected PROMs and outcomes. Methodology A red, amber, green (RAG) rating was developed using clinical and PROMs following cataract surgery. Data was collated from the electronic medical records following review by an independent optometrist. An algorithm was constructed based on national standards presented as a quarterly RAG score. Surgeons scoring red received an intervention from the Medical Director. Results RAG rating has ensured the maintenance of high clinical and PROMs. Often working independently, the RAG rating has enabled cataract surgeons to benchmark against peers. We have examples of surgeons improving their clinical outcomes and patient interactions after successive RAG ratings that have benchmarked them against their peers and nudged them to change their behaviour. Discussion Through regular feedback and benchmarking surgeons against their peers, this system has improved the quality of surgical outcomes and patient interactions. RAG rating combining clinical skills and softer communication skills and behaviour can be used to continuously monitor and benchmark surgeons. Such RAG ratings can highlight to managers surgeons who require an intervention, and to monitor change following the intervention. This is particularly useful for a multi-site organisation that wants to ensure high quality surgical outcomes consistently throughout their organisation.