The Healthcare Commission is too quick to 'scapegoat' trusts that seek patient safety advice, potentially deterring chief executives from seeking help.

Ruth Harrison, former chief executive of Buckinghamshire Hospitals trust, made the claims in response to the commission's view that her trust put targets before safety during the 2005 Stoke Mandeville Hospital Clostridium difficile outbreak (news, page 5, 15 March).

Ms Harrison has written to HSJ warning managers 'to check with other chief executives who have asked for assistance and found themselves out of a job'.

She said she found the commission overly critical on how the trust had tried to tackle the outbreak.

'This sort of scapegoating is not uncommon,' she said, adding the commission should look instead to developing a 'no-blame culture'.

Commission chief executive Anna Walker said: 'Our role is to encourage improvement. We want to work with the service to achieve that but where patient safety is at risk we have to act.'