The Commission for Health Improvement is likely to start its programme of clinical governance reviews with four pilot studies of acute trusts.

Helen Causley, a member of CHIs clinical governance review group, said it was looking at the work of other bodies, such as the Audit Commission, to see how they conducted reviews and to avoid duplication.

She said the first four trusts reviewed would not be the worst or the best in the country, but would instead be a spread to test the methodology being developed.

CHI is planning to set up a primary care group review team to follow on behind the trust programme.

The government expects it to review every hospital and PCG within four years and publish the results.

At CHIs first board meeting in London last week, chief executive Peter Homa said it was preparing a report for health minister John Denham on its proposed approach and work programme.

It is also liasing with cancer czar Professor Mike Richards and the Audit Commission on its first review of services - an investigation of the implementation of the Calman-Hine cancer reforms that must report by early 2001.