Confidence in the positive effect of choice has finally taken a dip, according to the latest Barometer survey of acute trust chief executives.

November's figure stands at 5.52, falling from September's peak of 6 out of 10.

Optimism over meeting the 18-week target is also sliding and is now down to 7.82 - September's figure was 8.29 out of 10.

It is not all bad news, however, as confidence in achieving break-even or surplus in 2007-08 continues to climb to an all-time high of 9.05 out of 10.

Also on the increase is confidence in primary care trust commissioning quality, which has started to nudge upwards again, reaching 3.35 against September's 2.96.

This is the last acute barometer in the current series. Our thanks go to everyone who took part.

Confidence scores out of 10

Positive effect of choice on my trust - 5.52

Foundation status by end of 2007-08 - 1.83

Achieving break even or surplus in 2007-08 - 9.05

Positive effect of PBC - 3.47

IT programme - 3.81

Clinical improvement - 8

PCT commissioning quality - 3.35

Confidence in 18 week target - 7.82

Confidence over time

Finance - 9.05

IT Programme - 3.81

Clinical Improvement - 8

PCT Commissioning - 3.35

Elective activity - compared with planned

Higher - 27%

Lower - 43%

Same - 30%

Financial outlook 2007-08

Surplus more than£10m - 11%

Surplus under£10m - 68%

Deficit under£10m - 5%

Deficit of£20m+ - 0

Confidence in staffing numbers

Medical staff - 7.91

Nursing staff - 7.48

Therapy staff - 7.67

Healthcare scientists - 7.27

How confident are you that patient choice will have a beneficial effect on your trust in 2008?

1-3 - 26%

4-5 - 14%

6-7 - 46%

8-10 - 14%

How concerned are you that payment by results will have a negative effect on your trust's financial position in 2007-08

1-3 - 54%

4-5 - 19%

6-7 - 8%

8-10 - 19%