There has been considerable debate about the impact of external quality assurance in higher education. This paper describes a discussion at the INQAAHE workshop in The Hague, attended by representatives of agencies, exploring the effects of external quality processes on institutions and programmes. The summary, probably for the first time, illuminates the varied impacts that quality processes have from the point of the agencies themselves. The main impacts identified include changes evident from one review to the next; improvements in performance indicators; adoption of formal internal quality processes by institutions; student feedback indicating positive changes and employer perceptions about the improvement in graduate abilities.