2005 performance ratings in full
Summary results for all trusts

DESPITE rapidly increasing budgets, more than a third of hospitals and a quarter of all NHS trusts failed to break even last year.

The Healthcare Commission, publishing its annual star ratings, said that the overall deficit was £500 million, a small fraction of the NHS budget of £69.7 billion.

But, with the NHS facing a tougher future, with no big increases in funding after 2008 and a new and riskier financial regime, the failure hints at future problems and should be taken seriously, Anna Walker, the chief executive of the commission, said. “Financial management is really important. Patient care will suffer if it is not put right,” she added.

“Quality of care is inextricably linked to good financial management. Temporary instability must not lead to a permanent problem. If it does, patients will lose out because the standards of care will suffer.”

The 2004-05 star ratings — the last that will appear in this form — also show that tighter targets in accident and emergency departments have caught hospitals out.

For the first nine months of the year, all trusts met the target that 90 per cent of patients should wait less than four hours. But, when the bar was raised to 98 per cent for the last three months of the year, 62 out of 159 trusts with A&E departments failed to meet the higher standard.

The star ratings will be replaced by a new system that, to the casual eye, may not look very different. The “annual health check” promised by the commission will provide, it says, a more comprehensive picture of performance, but it will end, just like the star ratings, with a four-point scale, ranging from excellent to weak.

For excellent, read three stars; for weak, no stars.

The star ratings’ final hurrah paints a picture of gradual improvement across the NHS, despite the financial problems. Sir Ian Kennedy, the chairman of the commission, said: “There is no doubt that star ratings have been an important step on the road to effective measurement of the performance of the NHS.

“They have played a part in the improvement of care, not least in a significant reductions in waiting times. But the system has not provided a comprehensive picture. We need a richer picture, reflecting the needs of patients.”

Gill Morgan, chief executive of the NHS Confederation, which represents hospital managers, relished the demise of star ratings. She said: “The scrapping of star ratings is a good day for patients who may believe that their local hospital has lost a star because its services have deteriorated over the past year.

“In fact, trusts have been measured against targets that have become progressively tougher and so some NHS trusts may earn fewer stars this year despite providing a better standard of care. We believe that, in some instances, star ratings have become a perverse system that scares patients and the public unnecessarily and demoralises hard-working NHS staff. That’s why we are delighted that star ratings are being abolished and replaced with a new, fairer system of assessment.”

This year’s figures show improvements in death rates for diseases such as heart disease and cancer and a more rapid service in hospitals, with waiting times for elective operations halved from 18 to 9 months.

While 13 more Primary Care Trusts achieved a three-star rating, only 19 per cent in all earned the top status — compared with 42 per cent of ambulance trusts. But Ms Walker said that they also had concerns about the performance of trusts in the South East, an affluent part of the country with fewer health problems than more deprived areas in the North.

“There are some hospitals that are not performing so well,” she said. “Whether this is really a pattern or is random we don’t yet know.”

But Andrew Lansley, the Shadow Health Secretary, said that the star ratings did not reflect the reality of clinical standards in the NHS.

“Many clinical priorities aren’t recorded and some targets, like A&E and GP bookings, create more problems than they solve,” he said.

“However, the star ratings do reflect the reality of financial performance. NHS finances are close to meltdown. One quarter of NHS trusts failed to break even last year and more are facing deficits this year.

Explore UK News

• Crime News

• Education News

• Health News

• Scotland News

Times Recommends

• 6 reasons not to give gifts this Christmas
• Remembrance Day: All the lonely heroes