Both regulators leaderless as Monitor fails to appoint chair

The failure to appoint a chair for the foundation trust regulator follows Care Quality Commission chair Barbara Young’s unexpected resignation, revealed exclusively last week on hsj.co.uk.

From the ground it looks like an unholy mess. The system lacks credibility

Mr Moyes will leave Monitor at the end of January. His post is being split into two roles - chair and chief executive.

HSJ has learnt that interviews for the role of chair have not resulted in an appointment and headhunters have so far failed to find other candidates.

This raises the prospect that neither regulator - both of which have been criticised following high profile hospital failings - will have a permanent chair until after the general election.

A source close to the regulators said: “They haven’t been able to attract the kind of candidates they wanted, who were prepared to work three days a week.

“This could leave us with two major health regulators without substantive chairs in post for a long time.”

There were already concerns the Monitor appointment was taking longer than expected.

Some managers felt potential candidates would be put off by suggestions that the government had cooled on the idea of all trusts becoming foundations and was not looking for a strong chair.

Managers have told HSJ they are unclear about the direction of regulation in the wake of public rows over the credibility of the inspection model, and disparities with Dr Foster’s Hospital Guide. These rows, between regulators and with the government, are thought to be behind Baroness Young’s decision to go.

An acute trust chief executive in the Midlands said: “From the ground it looks like an unholy mess. The system lacks credibility, not only among managers and staff but also members of the public.”

He highlighted the fact that Mid Staffordshire Foundation Trust was lambasted by the CQC but was one of the better performers in the Dr Foster guide.

A senior NHS manager said: “It was disappointing that the spat between CQC and Dr Foster confused the public about the nature of quality in our services. There’s an opportunity in the change of leadership at the CQC and Monitor to try and work out the relationship so it creates more synergy.”

Last week health secretary Andy Burnham announced plans for a “stronger inspection regime” to start in January, rather than April, when trusts must register with the CQC.

Council for Healthcare Regulatory Excellence chief executive Harry Cayton said the NHS should not “overreact” by adding more regulation. “We need better regulation not more - focused on outcomes not processes and on supporting clinical quality and professionalism,” he said.

NHS Confederation policy director Nigel Edwards said NHS regulation was an “unresolved policy question”.

“The question we’re all wrestling with is what’s the model of regulation that works best,” he said.

A DH spokeswoman said: “The process to recruit a new chairman for Monitor is currently underway. This is an important post and it is only right that we take the necessary steps to find the best candidate.

“The successful candidate will only be offered the post after a thorough interview process and approval by the secretary of state.”

● In an attempt to better align inspection information, the Oneplace website, which holds the results of the comprehensive area assessment, was jointly launched this week by the six public service inspectorates, including the CQC. It aims to paint a picture of the standard of public services in communities and flag indicators on progress against locally identified priorities.