Care Quality Commission chief executive Cynthia Bower has defended NHS regulation after a string of events threatened to shatter public confidence in the safety of services.

Serious failings at two foundation trusts and the ongoing furore over mortality rates have led to calls for increased scrutiny of NHS organisations.

It was always going to be a difficult transition from a ratings system where some of the information is 18 months old…to a system that’s more real time, that’s forward looking and not a snapshot of the quality of care

Shadow health secretary Andrew Lansley called the NHS inspection regime “fatally flawed” and said the CQC needed tougher powers.

Health secretary Andy Burnham told Parliament that plans to strengthen the CQC and publish more timely data from 1 April would be brought forward to January.

His comments sparked concern from managers that the deadline for organisations to register with the regulator or risk fines and closure would also be brought forward.

But Ms Bower told HSJ no changes to the timescale were necessary. The CQC was already planning to publish “quality and risk” profiles identifying potential threats to safety and performance at every NHS organisation from January, she said. She added it had always planned to base decisions on attaching conditions to trusts’ registration on information gathered in January.

She said: “My understanding is that we will be able to talk to trusts about where we might have concerns but we won’t have the powers to issue conditions until April.”

Trusts will know whether they will have conditions attached to their registration and be issued with notices before April.

NHS insiders have speculated that this avoids a “big bang” with a list of failing trusts produced in the middle of a general election campaign. Ms Bower admitted that the need to avoid politically sensitive announcements after an election day is announced was “an interesting challenge for us”.

She said: “It was the CQC that got under the skin of [problems at Basildon and Thurrock University Hospitals Foundation Trust] by a whole range of regulatory activity.

“It was always going to be a difficult transition from a ratings system where some of the information is 18 months old…to a system that’s more real time, that’s forward looking and not a snapshot of the quality of care.”

NHS Confederation policy director Nigel Edwards said regulation did not need to be strengthened beyond plans already in place.

He said: “Inspection is hugely burdensome. Regulation should be a backstop - the foundation stone is board and professional accountability.”

Timeline

Wednesday 4 November: HSJ reveals online that Colchester Hospital University Foundation Trust chair Richard Bourne (right) has accused Monitor of “intimidation”. The regulator admits concerns about standards and governance at the trust.

Thursday 12: Several hospitals tell HSJ they are “surprised and frustrated” by their upcoming Dr Foster mortality ratios being unexpectedly high.

Thursday 26: BBC reveals the Care Quality Commission’s report on Basildon and Thurrock University Hospitals Foundation Trust. Monitor later announces it has intervened at the trust in cooperation with the CQC.

Friday 27: Monitor announces it has sacked Colchester chair Richard Bourne and appointed University College London Hospitals Foundation Trust chair Sir Peter Dixon (right) as interim replacement. Andy Burnham asks regulators to check if other trusts require “immediate investigation”.

Sunday 29: Dr Foster’s 2009 hospital guide is published and reported in The Observer as “Eleven more NHS hospitals at centre of safety scandal”. The Department of Health says the CQC will “keep the situation under close review and report back to the health secretary with any further concerns”.

Monday 30: Health secretary Andy Burnham (left) asks the CQC to speed up the implementation of the new inspection system to “bring it in from January”.