Financial optimism is still riding high, according to the latest Barometer survey of primary care trust chief executives. Confidence in breaking even at the end of 2007-08 stands at an all-time high of 9.45 out of 10, up on August's figure of 8.73.

However, increasing confidence that a greater plurality of providers will improve patient care proved to be short lived. After a sharp rise in August, the figure has dipped back down to 5.36.

Also on the wane is confidence in the national IT programme, having dropped to 4.5 out of 10.

But 61 per cent rate their confidence that their PCT provides comprehensive out-of-hours care at 8 or above.

The Barometer survey is based on a panel of 90 PCT chief executives and is carried out every two months. The panel gives a score of 1-10 against key indicators. It was set up in association with NHS Networks (www.networks.nhs.uk). The next PCT Barometer will appear in December.

Elective activity: 6.38

Emergency activity: 6.38

Breaking even at end of 2007-08: 9.54

National IT programme: 4.5

GP contract: 5.66

Negotiating with acute trusts: 7.5

Workforce - numbers of GPs to deliver care: 8.27

Demand management capability: 6.2

Plurality improving patient care: 5.36

Model contract: 6.33

Confidence over time

Negotiating with acute trusts: 7.5

National IT programme: 4.5

GP contract: 5.66

Demand management: 6.2

Plurality: 5.36

How confident are you that greater plurality of providers will improve the quality of primary care?

1-3 22%

4-5 28%

6-7 36%

8-10 14%

Relationship with acute trusts: How has your relationship with you local acute foundation trust changed in the past year?

Much better: 47%

A little better: 28%

A little worse: 3%

A lot worse: 3%

About the same: 19%

How confident are you that your trust is providing a comprehensive out-of-hours service?

1-3 3%

4-5 9%

6-7 27%

8-10 61%