NHS regulators will “no longer be sustainable” in their present form if the trend to partnership working between trusts and councils continues, according to a report from the Centre for Public Scrutiny.

Total Place, a pilot that sees trusts, councils and other bodies work by area to identify duplicated services and cut waste, will change the regulatory landscape, the report says.

Continuing the silo accountability arrangements for services is not going to be adequate

The pilots – which were  heralded in last month’s Budget as having the potential to make significant savings – could have an impact on existing regulators.

The report says the “blurring of executive responsibility” implicit in Total Place areas would mean “individual accountability arrangements for individual organisations are no longer sustainable”.

The report continues: “Work is going to have to be put into identifying and dealing with the governance implications of this huge change.”

That could mean a further shake-up of healthcare regulation, which was only reformed last year with the establishment of the Care Quality Commission.

But a spokesman for the commission said that it had “no active plans” on separate regulation procedures for health services that are run jointly by the health service and local authorities.

Centre for Public Scrutiny deputy executive director Tim Gilling believes the kind of regulatory framework the report envisages would have provided an “earlier warning” of cases like Mid Staffordshire Foundation Trust.

He said: “Lots of people had concerns but because there was no forum for bringing all that together, their voices didn’t get heard.”

“Continuing the silo accountability arrangements for services is not going to be adequate,” said Mr Gillling.

“There will need to be new accountability arrangements. We are arguing for a comprehensive network.”