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And they're worst in use of resources

They may control 75 per cent of health service spending, but PCTs are worst of all NHS trusts in their use of resources.

Some 279 PCTs (92 per cent) were judged either 'fair' or 'weak'. Only 24 PCTs were 'good' and none was 'excellent'.

While trusts automatically scored 'weak' if they had an end-of-year deficit, the Healthcare Commission said many would have scored poorly anyway.

Rating on use of resources was based on an analysis of a PCT's ability to plan and manage its finances, its accounting and reporting systems, its medium-term strategy for spending and management of risk and ability to make and improve value for money.

PCTs in Central England scored most poorly, with 55 of the 100 in the region rated 'weak' on use of resources. London scored the best, with eight of its PCTs (15 per cent) achieving a good use of resources.

Professor Sir Ian Kennedy, chair of the Healthcare Commission, said trusts were making progress in meeting targets on quality of care, but 'findings in financial management make far less happy reading'.

An analysis by the Audit Commission, which underpinned the Healthcare Commission's health check, found 41 per cent of PCTs demonstrated 'inadequate' financial performance. No PCTs were judged to be performing strongly.

What PCTs did well

•Smoking cessation

•Cutting teenage pregnancies

•Waiting times, especially for cancer and access to MRI and CT scans

•Experience of patients

is good

What PCTs did badly

•Commissioning of crisis resolution for mental health patients

•60-min target for treatment with thrombolysis

•National targets for category B emergency calls

•Access to GU clinics

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