LONDON (Reuters), Oct 13 - England's health watchdog has ordered immediate action at 24 health trusts judged to be "weak" in both the quality of care and their financial management.
The Healthcare Commission said on Thursday strategic health authorities would be calling for action plans within 30 days for the trusts concerned.
The group comprises 11 primary care trusts, eight acute hospital trusts, four ambulance trusts, and one mental health trust.
"What is causing concern in some areas includes lack of access to crisis resolution teams, management of patient records and the handling of medical equipment," said Commission Chairman, Ian Kennedy.
The 24 trusts were identified as part of the first annual health check of 570 National Health Trusts in England, replacing the previous "stars" rating system.
The commission found overall that trusts were performing better in the quality of care they provided than in their financial management.
It said there had been significant improvements in a number of areas in the past five years, including better ambulance response times, shorter outpatient waiting times, and reduced time spent in accident and emergency.
The commission also highlighted improvements in waiting times for cancer patients and for access to chest pain clinics.
On quality of care, 4% of trusts achieved the highest rating of excellent, 36% were ranked good, 51% were judged fair, and 9% were weak.
But for use of resources, 37% received the lowest grade of weak, and 47% were fair. Only 3% were found to be excellent and just 12% were good.
The 24 trusts requiring action plans were found to be weak on both measures.
Only two trusts were awarded the top excellent rating in both categories: Harrogate and District NHS Foundation Trust and The Royal Marsden Hospital in London.
"This is a worrying picture of an NHS where financial management is not good enough," said Healthcare Commission Chief Executive Anna Walker.
"It is no secret that the NHS has struggled with finances over the past year.
"But this assessment shows it is not only deficits that are the problem. It shows that many organizations do not have adequate financial systems in place."
Surrey and Sussex Healthcare NHS Trust, one of the 24 identified as weak in both categories, said it had replaced its board and executive team over the last year in moves to address areas of "underachievement."
"I am confident that if this assessment was done today, our overall score for both quality of service and use of resources would be dramatically improved," said the trust's director of nursing, Irene Scott.
The King's Fund health think tank said poor performance of many trusts was unacceptable.
"There is clearly a mountain to climb here especially in financial management -- in part a legacy of the health service not grappling with underlying deficits early enough," said King's Fund Chief Executive Niall Dickson.
Health Secretary Patricia Hewitt said millions of people were receiving high quality and safe health services every day.
"The best of the NHS is amongst the best in the world and we should all be proud of its achievements," she said. "This is the toughest and most comprehensive assessment of the NHS.
"Any organization that has scored weak on both assessments will be required to work with their Strategic Health Authority to produce an improvement plan.
"I will expect these to be developed within a month."
Hewitt revealed earlier this week the NHS ran up a deficit of 547 million pounds last year, but said the health service was on track to break even by the end of the current financial year.
By Tim Castle
Last Updated: 2006-10-12 12:00:14 -0400 (Reuters Health)
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