The decision by Care Quality Commission chair Jo Williams to ask Andrew Lansley to remove non-executive director and “whistleblower” Kay Sheldon from the CQC board raised eyebrows in Whitehall and Westminster.

Such a move is only wise if you have exhausted all internal avenues and are very confident that your view will be accepted. For obvious reasons, working alongside someone whose sacking you have requested would be highly difficult - especially at the top of an organisation such as the CQC, which is trying hard to improve its reputation and performance.

It was not the CQC’s intention to make the letter’s existence public, but it will have been aware of the possibility and how that would raise the stakes even higher.

Now, after careful consideration and legal consultation, Mr Lansley has decided that Ms Sheldon should stay on the board. The decision cannot help but give weight to Ms Sheldon’s sharp criticisms of the CQC expressed in herevidence to the Mid Staffordshire Foundation Trust inquiry, an appearance which inquiry chair Robert Francis QC praised for its “great courage”.

HSJ has no intention of joining the blanket criticism of the CQC - the regulator has succeeded in its fearsomely difficult task as much as it has failed.

The arrival of new chief executive David Behan gives it a great opportunity to take a decisive step forward. However, Dame Jo must now consider whether her continued presence as CQC chair will help or hinder that process of renewal.

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