Among the talk of recessions, crunches and squeezes, there is some good news - the Healthcare Commission's valedictory annual health check again reveals substantial improvement.

For the first time, more trusts have scored good and excellent than fair and weak.

Acute, ambulance and mental health trusts have all leapt in performance since the test was introduced three years ago.

Perhaps the most powerful evidence of the sheer hard work staff have put in to improving services is that more than three-quarters of acute trusts are now rated good or excellent, against demanding, comprehensive criteria.

Areas of excellence

Areas in which staff have excelled include improving privacy and confidentiality, tackling infections, providing information on treatments and handling medicines safely.

The one part of the service that has not yet turned up to the improvement party is primary care, with more than two thirds of PCTs rated fair or weak. Most worryingly, this is almost unchanged since the first annual health check.

Next year's assessment will be a crucial milestone in judging their chances of long term success.

The Department of Health does not expect the first year of world class commissioning to deliver top flight results. But PCTs will need to show they will eventually match the excellence becoming increasingly common across the rest of the NHS.

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