David Bennett has admitted Monitor is intervening more regularly at foundation trusts than in the past, due to a “a declined appetite for risk”.

Speaking to HSJ, the regulator’s chief executive said foundation trusts were “largely autonomous organisations, left to get on and do their own thing, but with an arm’s length relationship with a regulator”. He added: “That’s effectively what the legislation says, but what it doesn’t say is how long that arm should be.”

Mr Bennett said evidence of persistently poor performance had previously been required for Monitor “to take a closer look”.

“In the current environment our arm does actually need to be a little shorter than that,” he said. “If you’ve got a trust that for three consecutive quarters has missed its A&E target, then it’s a bit late for us to say: ‘OK, let’s see what’s going on here.’”

In December it was revealed that health secretary Jeremy Hunt had asked Monitor to scrutinise foundation trusts’ A&E performance on a weekly, rather than quarterly, basis this winter. This increased monitoring was due to “a declined appetite for risk” among “Parliament, the government and the public”, Mr Bennett said.

He defended the health secretary’s decision to schedule meetings on a weekly basis with him and the heads of the Care Quality Commission and NHS Trust Development Authority to discuss winter planning, insisting that if they helped to avoid a winter crisis “that will be good for the people who use the NHS”.

“I have no quarrel at all with what he’s trying to achieve and I have no problem with having fairly frequent dialogue with him about how we’re trying to achieve it,” he said. “What I wouldn’t recognise is a statement that he’s micromanaging us.”