The chair of the Care Quality Commission has pledged to get tough with NHS and social care organisations languishing in the bottom 10 per cent of performance tables.

Baroness Barbara Young said the regulator, established last month, would examine the worst performing providers and commissioners and “do a bit of a number on them”.

Speaking at the Westminster Health Forum last week, she said: “That bottom 10 per cent mustn’t be allowed to bump along recording poor performance year on year. We’ll give them extra attention.”

She did not specify what criteria the CQC would use to identify the bottom 10 per cent. However, in last year’s annual health check there were six organisations scoring “weak” for both quality of services and use of resources.

They were East of England Ambulance Service trust, Brent teaching primary care trust, Great Yarmouth and Waveney PCT, North Yorkshire and York PCT, Royal National Orthopaedic Hospital trust and Scarborough and North East Yorkshire Healthcare trust.

The CQC is developing a performance alert system to pick up problems earlier by assessing factors such as changes in managers, staff turnover and absence rates. It will also examine the assurance processes used by trust boards.

“We need to get smarter about anticipating and being pro-active,” Baroness Young said. The annual health check would become a “more rolling process”.

She said: “A big bang, once a year approach may well be a snapshot but we don’t want it to be such a cataclysmic one-off event [as] it has been in the past.”

After the event, she told HSJ that trusts would probably still be labelled weak, fair, good and excellent, but status could change throughout the year in response to information picked up from investigations and special reviews.

The CQC also wants to spend more time on promoting good practice.

Baroness Young said: “I think we want to work differently, improving the quality of care, not just exposing poor performance.

“It will be a mark of our failure if we don’t achieve improvement across the whole system.”

Asked by an audience member whether the CQC would try to influence government policy, she said: “It would be immoral and unwise of us not to use the information we gain to help or challenge policy-setting departments across government to… ensure the quality of care for people we’re here to work for.”