 The ratings are based on key government targets |
This year's NHS star ratings have sparked a furious row between the government, doctors and opposition MPs. Ministers say the ratings show that NHS services are improving across England.
But doctors and opposition parties have dismissed the claim, saying the ratings are "ludicrous", "pathetic" and "unfair".
 | ACUTE TRUST RATINGS 53 three stars 68 two stars 31 one star 14 zero stars |
And Dr Evan Harris, Liberal Democrat health spokesman, said patients were dying because hospitals were forced to try to meet meaningless targets, rather than concentrate on providing appropriate care. Overall, 53 out of 156 acute hospitals were awarded the top rating of three stars this year - up from 45 last year.
However, more hospitals also received a zero stars rating - 14 compared with 10 last year.
Four trusts which scored three stars last year have been downgraded to just two stars. They lose their right to apply to become foundation trusts.
'No political pressure'
Trusts were assessed on a variety of government targets, from the length of time patients wait for treatment to the number of patients who die after surgery.
The ratings also include primary care trusts (PCTs) for the first time. Of the 304 PCTs in England, 45 were awarded three stars while 22 received no stars.
Ambulance and mental health trusts were also assessed.
Ten out of 31 ambulance trusts received three stars. Five were given a zero stars rating.
Fourteen out of 88 mental health trusts received three stars. Three received no stars.
The figures were compiled by the independent watchdog, the Commission for Health Improvement (CHI), for the first time. However, trusts were told what targets they would be measured against.
Dame Deirdre Hine, chairman of the CHI, said there had been no political pressure to boost the ratings.
| PCT RATINGS 45 three stars 139 two stars 98 one star 22 zero stars |
"The targets and many of the indicators were set by the Department of Health but we have compiled the ratings this year. "I would reiterate that there has been no pressure from ministers and these have been produced absolutely independently."
Health Secretary John Reid welcomed the figures.
"I am encouraged that CHI has found that hospitals are improving although obviously I am disappointed that there are four more zero-rated hospital trusts," he said.
"The purpose of this exercise is not to condemn or shame those trusts who fail to make the grade on any particular indicator but to help them overcome local difficulties and offer better services for patients in the future."
'Time to reconsider
But the British Medical Association rejected that claim.
Its chairman Mr James Johnson said: "Nobody should judge how well a hospital is doing by looking at star ratings.
| AMBULANCE TRUST RATINGS 10 three stars 7 two stars 9 one star 5 zero stars |
"They measure little more than hospitals' ability to meet political targets, and take inadequate account of quality of clinical care, or factors such as social deprivation. "It is grossly unfair on staff working in low-rated trusts that public confidence in them is being undermined."
Dr Beverly Malone of the Royal College of Nursing said: "The RCN has great concerns about how performance ratings can affect patients' confidence and staff morale."
Those views were echoed by opposition parties.
Shadow Health Secretary Dr Liam Fox said: "The star ratings system is ludicrous and should be scrapped.
| MENTAL HEALTH TRUST RATINGS 14 three stars 43 two stars 28 one star 3 zero stars |
"The ratings bear no relation to the quality of care that patients are receiving." Dr Harris said the system encouraged hospitals to concentrate on patients who had long-term conditions, rather than those who were critically ill.
He said: "This rating system is a pathetic measure of hospital performance.
"It shows whether hospitals can hit targets, tick boxes, and fill in spreadsheets, but it tells us absolutely nothing about the clinical outcomes that should matter to patients.
"This is a political exercise which costs patients' lives."
Dr Gill Morgan of the NHS Confederation, which represents health service managers, said: "We would like to see the ratings based on more detailed information about individual services to help patients choose the right service for them."
John Appleby, chief economist at the health think tank The King's Fund, said: "It's time for the government to reconsider the whole picture of NHS targets, indicators and rankings."
Their comments follow last month's report by the Audit Commission.
It suggested the NHS was wasting millions of pounds trying to meet "piecemeal" targets.
It also raised concerns over whether recent improvements, such as cuts in waiting times, can be sustained in the long-term.
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