At least one medical director has already “fallen on their sword” following a visit from one of the Care Quality Commission’s new inspection teams, the chief inspector of hospitals has said.

Sir Mike Richards added that he believed that the new inspection regime’s attention to whether or not healthcare providers were “well led” was “probably the biggest area of difference between what CQC has done before and what it’s doing now”.

He made the remarks at a dinner for NHS leaders in the north west, attended by HSJ, where he was asked what happened when his inspections came across senior managers or board members who were not “up to it”.

“Are you finding people are just falling on their swords as a result of perhaps a word in their ear, or self-discovery that perhaps the job isn’t quite what they thought it was?” one guest asked.

Sir Mike replied: “I don’t think we get enough information in a three day visit or a two day visit to be able to point the finger and say, ‘he or she must go’.

“I think that would be wrong. But I think you put your finger on it by saying sometimes they realise themselves, and I think at least one medical director has moved on since our visits already.”

He told the dinner organised by headhunters Odgers Berndtson: “I think that may happen more. And I’ve heard of one that may be moving before we get there. So, yes, that will happen.”

Sir Mike went on to say that at some point he and his counterpart chief inspectors for primary and social care would probably experiment with inspecting an entire health economy.

“First and foremost we’re charged with looking at organisations, the accountable organisations for whatever care it may be,” he said. “That’s our primary task…

“But in some cases we may decide that we want to assess whole health economies.

“Now, with my colleague looking at social care, my other colleague looking at primary care, and me looking at hospitals in the middle, we have the ability to say let’s look at this county, and let’s put it all together.

“We will probably pilot that at some point, on top of our separate inspections. We’re certainly open to that.”