COMMENT - INSPECTION

Published: 28/07/2005, Volume II5, No. 5966 Page 3

Few will shed tears over the demise of star-ratings. The system's flaws meant it was never accepted as an entirely fair measure of overall performance.

But it is worth remembering that much of the work managers and their colleagues did in stretching for higher ratings resulted in improved services for patients. Yes, the goals set were sometimes a distraction, and many improvement initiatives needed no external incentive. But for some trusts the ratings provided useful focus.

Trusts which have seen their number of stars rise in 2005 should feel proud of their achievement.

Our piece on the new inspection system which will replace the ratings (pages 1415) shows there are still issues to overcome.

The new structure boils down to one thing: trust. Yes there are checks and balances, but essentially the Healthcare Commission is putting its faith in the NHS to tell it how it is.

Executive and non-executive directors will bear responsibility of signing off a declaration that standards are - or are not - being met. This year, a third of trusts did not reach the financial management standard. Given that this is, at least in part, a reflection of board's ability to gauge the performance of its organisation there is clearly much work to do if the new system is to achieve the credibility that star-ratings lacked.