The Healthcare Commission's plans for the annual healthcheck ratings are 'bordering on performance management', the NHS Confederation has warned.

The commission's proposals to overhaul the 2007-08 healthcheck of NHS trusts were out for consultation until last week. They include an increased emphasis on safety and healthcare-associated infection.

In an article for HSJ online, NHS Confederation chief executive Dr Gill Morgan says there is a careful balance to be struck between good regulation, which helps trusts drive improvement, and bad regulation, which has a negative impact.

'The latest Healthcare Commission consultation on the annual healthcheck for 2007-08 comes dangerously close to tipping this balance,' she writes.

Dr Morgan says the commission is extending its remit and responsibilities 'to an extent which is bordering on performance management', which was 'inappropriate' given the drive to give local NHS organisations more power and autonomy to run local services.

Foundation Trust Network director Sue Slipman said that while she did not think anyone would disagree with the principles the commission had set out, she said the proposals 'don't work to support those principles'.

She said the commission was 'working to an old arrangement' with regulation as performance management. 'Regulation needs to be proportionate,' she said.

But Healthcare Commission chief executive Anna Walker said she could not see where the conflict lay.

In particular, she agreed 'there should be a dividing line between performance assessment and performance management' and 'we believe that's where we are'.

But she added: 'We do have to use information to assess how the boards are doing. It isn't sufficient for us to say it's the responsibility of the boards.'