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Regulator reports improvement in PCT performance

By Gareth Iacobucci

The Care Quality Commission has reported improvement in PCTs' performance in its first round of ratings for all NHS trusts in England, published today.

Over half of PCTs were rated ‘good' or ‘excellent', compared to just a third in the Healthcare Commission's last annual health-check, before it disbanded to make way for the new regulator.

The CQC rated 2% of PCTs ‘excellent', 51% ‘good', 45% ‘fair' and 3% ‘weak', compared to 6%, 27%, 62% and 5% respectively in 2007/08.

However, the regulator expressed concerns that fewer acute hospital trusts were rated ‘excellent' and more ‘fair'.

PCTs' improvement was attributed to greater compliance with core standards and improved performance against some measurements, including that related to chlamydia screening.

This comes despite CQC chair Baroness Young recently warning that many ‘laggard' trusts were falling well short of the minimum standards for the new registration system, which the regulator will introduce next year.

Only two PCTs scored weak in 2008/09, down from six in 2007/08. However, for both trusts - Buckinghamshire and Enfield - it is the third consecutive year they have scored ‘weak'.

Comparing this year with last year, 58 (38%) PCTs received a higher overall score, 64 (42%) received the same score, and 30 (20%) received a lower score.

PCTs singled out for their improvement were Barnet, Bath and North East Somerset, Brighton and Hove City, Mid Essex, North Somerset, Sheffield, and South Staffordshire.

However, the four PCTs that scored ‘weak' in 2008/09 - Barking and Dagenham, Havering, Redbridge and Tower Hamlets - all performed better the previous year.

Overall compliance with core standards – said to be a good indication of whether a trust is ready for registration - increased from 95% to 96%. However, only about half of trusts fully met all core standards, and compliance declined in the acute sector with 59% fully meeting standards this year compared to 69% last year.

Cynthia Bower, CQC chief executive, praised the improvements, but warned that some still had a long way to go: ‘The NHS has performed well on quality, which is good news in the face of a rigorous assessment.'

‘But it is clear that some trusts are struggling and that some issues are proving tough nuts to crack. My biggest concern is those trusts that are ‘weak' and persistently ‘weak' or ‘fair'.

‘I want to ring the alarm bell in the boardrooms of these organisations. Next year, all trusts must register with us to legally function. It is clear that many have significant work to do and a short time in which to do it.'

The King's Fund chief executive Niall Dickson warned that trusts would find it increasingly difficult to maintain or improve performance with shrinking resources.

‘It is worth remembering that the current performance has been achieved in a period of funding growth - the big challenge going forward will be to maintain and improve those standards when money is tight,' he said.

Baroness Barbara Young, CQC chair, said strongly-performing trusts would be 'named and famed'.

'We want to acknowledge publicly the achievements of these trusts and thank them for all they have done on behalf of patients.'

CQC chair Baroness Young CQC chair Baroness Young

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