The Echocardiography Quality Framework (EQF) is a unique, comprehensive, holistic approach to improving all aspects of an echocardiography service. The EQF is a patientcentered program, combining Quality Assurance and Continuous Service Improvement. The framework encompasses measures of (i) the quality of echocardiography, (ii) reproducibility and consistency, (iii) education and training, and (iv) customer feedback. The EQF is scalable and adaptable to benefit any echocardiography service. A catalogue or library of supporting documents is being developed by the British Society of Echocardiography (BSE), to be made available to any participating department. A mechanism and online infrastructure for (optional) national registration or assessment is being developed, to be used as a standalone adjunct or linked to BSE Departmental Accreditation. The principles that underpin the EQF may be applied to other imaging disciplines and, ultimately, other medical or surgical specialties.