The Audit Commission has published a report examining progress towards modernising the NHS.

BBC News Online examines the report's findings and its implications for the health service.

What is the Audit Commission?

The Audit Commission is an independent statutory body responsible for ensuring that public money is spent economically, efficiently and effectively to achieve high-quality local and national services for the public.

What does this report look at?

This latest report examines the progress being made by NHS trusts towards meeting key government targets set out in the NHS Plan, which was published in July 2000.

What has it found?

The Audit Commission assessed the performance of every trust in England At a glance

The report paints a mixed picture. It shows that trusts have made "significant progress towards some of the targets outlined in the NHS Plan".

However, it has raised questions over the way trusts are meeting these targets and has expressed doubts over whether the improvements are permanent.

It has also found that many trusts are failing to meet other key targets set out by the government.

Where are trusts doing well?

Trusts are succeeding in meeting key targets to cut patient waiting times. Ministers have pledged maximum waiting times for patients waiting to see a GP, hospital doctor and for operations.

Most trusts are meeting these targets. However, the report suggests many are using quick-fix solutions to achieve them. These include diverting money from other areas and paying private hospitals and consultants to carry out extra operations.

This has led auditors to question whether these improvements can be sustained over the long-term.

Where are trusts failing?

The report suggests trusts are failing in a number of key areas.

The vast majority have been struggling to meet targets to reduce the length of time patients wait in A&E and to improve services for people with mental health problems and for elderly patients.

They have also found it hard to ensure patients whose operations are cancelled are re-admitted within 28 days.

In addition, ambulance trusts are struggling to meet their targets to improve response times.

But hasn't the NHS already met some of these targets?

The government has claimed that some of these targets, such as reducing A&E waits and improving ambulance response times, have been met.

However, doctors and others have raised doubts about this and have questioned the accuracy of the government's figures.

The Audit Commission report raises further questions about the reliability of their data.

What changes have the auditors recommended?

The Audit Commission has called for many of the government's targets to be scrapped.

It has proposed fewer targets and for NHS managers and medical staff to be left to decide how best to meet them.

It has also called for tougher checks to be carried out on those hospital trusts that have applied to become foundation trusts.

These trusts will be given greater freedom from government. However, the report has found that at least four of the 29 trusts earmarked for foundation status have serious management and financial problems.

The auditors have warned that these could run up huge deficits or even go bust if changes are not made.

What is the government saying?

Sir Nigel Crisp, chief executive of the NHS, has criticised the report. He has said it is a snap shot study and does not reflect the true picture in the NHS.