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Health check of NHS singles out PCTs as weakest performers

By Ian Cameron

Primary care trusts are performing woefully at delivering health care and are the worst part of the NHS.

The most comprehensive analysis of the NHS yet has concluded that the overall quality of services in 180 PCTs, nearly two-thirds of the total, is only 'fair' – the second lowest of four categories.

A further 24 PCTs (8 per cent) were found to have weak quality of services in the first annual 'health check' of all NHS bodies conducted by the Healthcare Commission.

Trusts were also measured for their financial performance. Some 11 PCTs were rated weak in both categories.

The commission said the performance of PCTs stood out as the worst among acute and specialist, foundation, ambulance, mental health and learning disability trusts and was a cause for concern.

Only 93 PCTs (31 per cent) were found to have 'good' quality of services and just six (2 per cent) were deemed 'excellent' in the analysis for 2005/6.

The commission measured quality of services against a combination of 24 core standards, 20 existing national targets and 24 new national

targets. Specific reviews into key areas such as children's services and substance misuse also fed in.

Only 50 per cent of PCTs fully met the core clinical standards, only 22 per cent fully met the existing national targets and 19 per cent fully met new national targets.

London and the South East performed the worst, with 84 per cent of PCTs having either fair or weak quality of services.

The Central region scored best, with 44 per cent of

its PCTs rated excellent or good.

Anna Walker, chief executive of the Healthcare Commission, said there was a clear link between PCTs' performance and the fact they had been reorganised.

She added that PCTs suffered from having to respond to more targets than any other group of trusts, reflecting the move to provide more care in community settings.

The worst-performing trusts will have to agree action plans to address shortcomings with their strategic health authorities in the next 30 days.

'PCTs need to step up to the mark,' Ms Walker said.

Dr John Williams, a GP in Guildford, said Guildford and Waverley PCT's double weak rating was deserved because it had repeatedly made cuts to save money, only to have to reinstate the service later.

Dr Laurence Buckman, dep-uty GPC chair and a GP in Golders Green, north London, said the 'weak' result for both his local PCT and NHS trust bore no relation to his experience.

He said: 'GPs provide high quality of services and the hospital trust is a modern, efficient hospital with good outcomes. These are still star ratings – just more detailed.'

The weakest PCTs*

•Bedfordshire Heartlands

•Cheshire West

•East Elmbridge and Mid Surrey

•Guildford and Waverley

•Kennet and North Wiltshire

•North Somerset

•Oldbury and Smethwick

•Rowley Regis and Tipton


•Watford and Three Rivers

•West Wiltshire

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