. . . as Kennedy warns failures

Healthcare Commission chair Professor Sir Ian Kennedy has warned that the new inspectorate - launched today - will not shrink from singling out individual senior managers or trust boards held responsible for failure.

The commission's corporate plan describes its 'fundamental purpose' as being 'to promote improvements in healthcare and public health'. But in an exclusive interview with HSJ, Sir Ian said this approach would not prevent the inspectorate from taking a robust response to failure.

'If we find that those responsible for a failed [healthcare] system - at whatever level - could or should have known about it and done something about it, then we'll say so, whether It is the board, the chief executive or anyone else.

'From day one, I want your readership to know that we are there and mean business.'

He said the commission was 'looking to hold everyone who provides care to account'.

While Sir Ian promised to 'celebrate good news', he stressed that in the case of failure the commission would 'stay on the case to see if improvement is being delivered - and if not, why not'.

As well as its declared ambition to help failing trusts improve, the commission has a number of sanctions at its disposal, most notably its ability to recommend 'special measures' to the health secretary that should be taken to rectify a situation - a power not available to its predecessor, the Commission for Health Improvement. The commission has yet to spell out what the measures might include.

Sir Ian promised that any criticism of individuals or groups would only be levelled after 'a proper look at the evidence', and would be based on the idea that 'responsibility is assigned pursuant to some recognised criteria' to be set by the commission.

These criteria are due to be set by the end of this year.

The commission's plan reveals the five strategic goals it aims to meet by 2008. These include a reduction in the burden of regulation and movement towards similar assessment processes across the NHS and private sector.

The commission will develop a 'concordat' between organisations responsible for healthcare inspection which will provide the basis for a more co-ordinated approach to visits and requests for information.

It promises to publish by June.

But Sir Ian cautioned that it was proving 'quite difficult to identify the whole range of bodies who see themselves as statutorily required' to inspect.

He promised that if legislation or regulation made it impossible to reduce the regulatory burden, the commission would lobby government to make the necessary changes.

For the next two years, star-ratings published under the auspices of the commission will rely on an approach developed by the Department of Health and CHI.

Sir Ian said that after that, he was keen to ensure the approach fostered an increasing focus on local priorities rather than national targets.

And he said managers and other NHS staff should expect 'invitations to get engaged [with the commission] on understanding local priorities/targets'.

Three pilots will be set up to explore the commission's 'local presence'. These will examine how much work should be done locally and centrally, and whether it would be wise to develop 'miniHealthcare Commissions' at local level or to have the relationship with local stakeholders managed more remotely.