The chief inspector of hospitals said he would ‘love’ the Care Quality Commission to rate local health systems, rather than specific providers, but suggested there were potential obstacles to inspecting clinical commissioning groups.

Sir Mike Richards faced questions from provider chief executives at the NHS Confederation conference today, with many calling for a broader inspection regime to focus on commissioners and wider health systems.

Sir Mike said: “Yes we’d love to look at systems. Technically we’re regulators of individual providers but we’re getting to the point now where we can look at localities, and we can start looking at ‘Blankshire’ in the round.”

Man with clipbaord making notes

Sir Mike Richards said the CQC was in a position to start inspecting health systems

However, he added: “There’s an interesting conversation about commissioning because we are not the regulators of commissioning.”

He said the CQC’s new inspection reports already highlight wider systems issues and take commissioning decisions into account.

Some provider leaders, including Dr Lucy Moore, interim chief executive at Colchester Hospital University Foundation Trust, raised concerns over the “unintentional consequences” of a negative inspection report on staff morale, turnover and recruitment.

Her trust was rated “inadequate” by the regulator in January, and she said it now has a 20 per cent vacancy rate.

Sir Mike said there was usually a “short term” effect on morale, but added that the CQC is often contacted by front line staff saying “thank God you spotted that”.

Also on the panel with Sir Mike was Helen Buckingham, chief of staff at Monitor, who spoke about the new measures to curb spending on agency staff and management consultants in the NHS.

She said Monitor has been “guilty of asking trusts to use consultants” and there needed to be better sharing of consultancy work between organisations.

“What we’ve not said is you may not use agency staff or management consultants,” she added. “That would be wrong because there’s absolutely times where they are needed. What we want is to work with you to make sure you’re able to use them in the best way possible.”