Barbara Young strode into her role as Care Quality Commission chair last year promising to “talk softly and carry a big stick”.

While she has shown no qualms about using a big stick when it comes to underperforming services, no one would accuse her of talking softly.

Her jargon free language reflects an upfront approach and a dynamism that has carried her through a varied career at English Nature, the BBC, the Environment Agency and the now defunct Parkside Health Authority.

As a former Labour peer who moved to the cross-benches on becoming a regulator, she was the subject of some concerns about her early reservations regarding the internal market and the purchaser-provider split. But she has retained a fiercely independent voice, attacking failing services and standing up to criticism from other government agencies. This year she has also overseen the first annual health check in which primary care trusts’ commissioning functions have been given their own, separate, assessment. As the personification of the CQC’s tough approach, she faces an important test next April, when all NHS organisations will be required to register - the climax of the regulator’s work so far.