This will allow us to get on with improving services for patients

Michelle Atkinson

They will be given the opportunity to set up not-for-profit companies to run their trusts free from government interference.

The hospitals would still be subject to national standards and external inspections but managers would otherwise be given complete independence in all areas, including staff pay and conditions.

Among the top performers is the North Tees and Hartlepool NHS Trust.

Head of communications Michelle Atkinson told BBC News Online: "This is good news, we are delighted.

"We will not be looking to set up our own limited company, but this will allow us to get on with improving services for patients without having to worry about so much bureaucracy."

Nick Fairclough, head of communications for another three star performer, the Royal Devon and Exeter NHS Trust, said: "Any additional resources and freedoms will allow us to concentrate on improving patient services."

Poor performer

Conversely, Health Secretary Alan Milburn has signalled that outside managers will be parachuted into units that are failing.

Charities, external NHS managers and experts from the private sector will be allowed to bid for "franchises" to take over failing hospitals.

University Hospitals of Coventry & Warwickshire NHS Trust is one unit where this is a possibility.

It is one of a dozen in England that failed to obtain any stars in the government's performance tables.

The trust covers three hospitals the Walsgrave Hospital, the Coventry and Warwickshire Hospital and the hospital of St Cross in nearby Rugby.

It received a highly critical report from the NHS watchdog the Commission for Health Improvement (CHI) in September.

If you can make things better for patients by bringing in outside management expertise then how can anyone object to it?

John Richardson

CHI inspectors complained about cramped conditions in wards and accident and emergency units placed miles from intensive care units which compromised patient safety.

Their routine inspection also revealed rows between senior doctors and managers.

John Richardson, the trust's head of communications, told BBC News Online that the principles outlined by Health Secretary Alan Milburn were "very sound".

He said: "I don't see how anybody could argue with the principle. If you can make things better for patients by bringing in outside management expertise then how can anyone object to it?"

Action taken

However, Mr Richardson said the trust had taken action since receiving the CHI report.

A three year action plan had been drawn up in collaboration with CHI and the West Midlands NHS Regional Office to address all the points of concern.

He said: "We are targeting the areas of concern with a deal of energy, and we are doing okay.

"I am sure that CHI would be pleased with the progress that has been made on the ground.

"The place is not perfect, but we feel that we got some unfair press.

"We have got some good managers here, and if we continue to meet the recommendations set out in the action plan then we would consider this as a successful trust."