Cynthia Bower, the chief executive of the Care Quality Commission, has resigned after the publication of a critical report by the Department of Health.

She has been under severe pressure in recent months with damning reports on the performance of the commission emerging from the National Audit Office (BMJ 2011;343:d7873, doi:10.1136/bmj.d7873) and the health select committee (BMJ 2011;343 doi:10.1136/bmj.d5882). The final blow was the department’s Performance and Capability Review, the first of its kind, published on 23 February, which repeated many of the same criticisms.

The commission failed to register health providers quickly enough, and was forced to divert staff from inspections to make up the backlog. Along with the department, it underestimated the scale of the task it faced, but should have done more to manage …