The quality of care being provided by some parts of the NHS has improved markedly, England’s health watchdog has found. But a significant proportion of the 392 trusts rated by the Care Quality Commission in the past year are providing persistently substandard care. These organisations have considerable work to do if they are to qualify for the commission’s new registration system being introduced next April or face being closed down.

Under the commission’s rigorous assessment on quality and financial management, trusts are scored on a four point scale of excellent, good, fair, or weak. On quality, 15% of trusts in the English NHS were rated as excellent, 47% good, 33% fair, and 5% weak. On financial management, 26% were rated as …