Every NHS trust in England has been given a star rating by the country's independent health watchdog, the Commission for Health Improvement. For primary care trusts, it is the first time the exercise has been done.

Matt Tee, project director for the star ratings initiative, and Dame Deirdre Hine, chairman of CHI, who admitted that capturing patients' experience was one of CHI's biggest challenges

Credit: MARK THOMAS

Although acute and specialist trusts show a general shift towards a higher ranking, there has been a slide in ratings among ambulance and mental health trusts, suggesting little improvement or a fall in standards in these services.

The commission has rated each of the 579 English NHS trusts according to its performance across a range of indicators including whether it achieved government targets; clinical factors such as surgery outcomes and infection rates; patient satisfaction; and managerial …