Cynthia Bower sets out her vision for Care Quality Commission

Cynthia Bower said any who fail will have conditions attached to their registration and will be given “very tight timescales” of as little as a week to improve. Inspectors will then return to check on progress, if necessary handing out statutory warnings, fines and, as a last resort, closing services.

Ms Bower said she wanted the new regime to be “rigorous and fair”, involving a constant dialogue with trusts.

By 1 April, all organisations providing NHS services will have to prove compliance with the code in order to register with the CQC, which takes over from the Healthcare Commission, Commission for Social Care Inspection and Mental Health Act Commission.

Unregistered trusts will not be permitted to run services.

Great expectations

Ms Bower said she was “absolutely clear” that managers already knew what was expected of them.

She said: “Healthcare associated infections are something the public and government put an enormous amount of attention on.

“If we see hospitals where there’s still a material risk to patients because of some failure to meet the registration standards, then we will impose conditions on them and we will give them very tight timescales.”

She expected the “vast majority” of trusts to comply fully, but said some would be given conditions: for example a ban on using decontamination services deemed unsafe.

Ms Bower said: “We absolutely see registration as a process of improvement. It’s not a game of crime and punishment.”

Valued qualities

Asked which aspects of the current system she most valued, she cited the enthusiasm of staff employed by her predecessors, the focus on service users and the move to risk-based assessments.

She described her vision of a “partnership in improvement” where organisations felt a “sense of ownership” of standards.

She said despite the strengthened regulator and increasing numbers of foundation trusts that will fall under the scrutiny of Monitor, there was still plenty of room for strategic health authorities to carry out their performance management role.

“It’s still a vitally important role and we’ll still see the SHAs as one of our key allies,” she said.

As HSJ went to press the CQC had not been given its 2009-10 budget. CQC chair Barbara Young told HSJ last summer it would need more than the planned annual £160m. But Ms Bower hinted this would not be the case for the first year.

She said: “The DH has been absolutely clear. Next year is a transitional year. We’re not implementing the full system of regulation. As we cost and understand the new registration system we can talk to them about that.”