Healthcheck ratings: Audit Commission focuses on 37 trusts that failed in key areas

The Audit Commission has voiced concern about 37 organisations deemed to be failing in three key financial areas. It compiled findings from local auditors for 2005-06 and scored all non-foundation organisations in the category of 'use of resources', which makes up half of the healthcheck ratings.

Performance was examined in five sub-categories: financial management, control, value for money, standing and reporting, with organisations given between one and four points, which were converted into the Healthcare Commission's own four-point rating.

The commission expressed 'particular concern' about the 37 organisations which failed on financial management, value for money and financial standing. It also highlighted six trusts judged to have an 'inadequate performance' across all five areas.

Foundation trusts were assigned points under a parallel scheme, which saw the five-point risk rating given to them by Monitor, the result of assessment across four criteria - achievement of plan, underlying performance, financial efficiency, and liquidity - converted into the four-point scale. Monitor's risk rating of 1 or 2 equated to excellent under the Healthcare Commission's system.

Overall, 19 organisations - all now foundation trusts - were given the top rating, 17 from assessments by Monitor, and two from assessment for the Audit Commission before they gained foundation status.

Audit Commission head of health Andy McKeon described as 'disappointing' the small number of organisations in the top category. 'A small minority of organisations need to make significant progress across the board,' he said.

He urged organisations which scored poorly to improve their performance and to call on each other for help. 'Part of the reason we have produced this is so that trusts can see where best practice is and ask what the organisations that are succeeding are doing,' he said.

Mr McKeon said strategic health authorities had the 'primary responsibility' for 'rolling out best practice' across their patches. 'If not a buddy system they [SHAs] need to identify successful areas and draw on that for others,' Mr McKeon said.

The Department of Health has published audited figures showing the state of NHS finances across the country. They show a£35m increase on the£512m unaudited figure published in June.

The largest discrepancy between audited and unaudited figures comes in NHS East of England, where the total deficit recorded was£235m, compared with the£214m estimate.

The bulk -£12.2m - came from Mid Essex Hospital Services trust, which went from a predicted£1m surplus to an£11.2m deficit in the six weeks between provisional figures and finalised accounts. A spokesperson for the trust blamed accounting procedures which meant that the sale of St John's Hospital in Chelmsford for£8m plus some smaller NHS estate sales could not be included in the 2005-06 figures.

The other major contributor was Ipswich Hospital trust, which turned in a deficit of£16.7m,£4.8m above forecast. The trust had been going through a financial turnaround exercise which had resulted in its deteriorating position.

The organisations 'of particular concern'

Airedale trust

Avon Ambulance Service trust

Avon and Wiltshire Mental Health Partnership trust

Barking, Havering and Redbridge Hospitals trust

Barnet and Chase Farm Hospitals trust

Brighton & Sussex Uni Hospitals trust*

Cheshire West PCT

Dacorum PCT

Daventry and S Northants PCT

East and North Hertfordshire trust

Eastbourne Downs PCT

Hertsmere PCT

Hillingdon PCT*

Hinchingbrooke Health Care trust*

Hounslow PCT

Hull and East Yorkshire Hospitals trust

Ipswich Hospital trust

Kennet and North Wiltshire PCT

Kensington and Chelsea PCT

Kingston PCT

North Somerset PCT

North Stoke PCT

Northern Devon Healthcare trust

Queen Mary's Sidcup trust

Scarborough and N E Yorks Health Care trust*

Selby and York PCT

Shrewsbury and Telford Hospital trust

St Albans and Harpenden PCT

Surrey and Sussex Healthcare trust*

Sussex Downs and Weald PCT

Trafford Healthcare trust

University Hospitals of North Staffordshire trust

Watford and Three Rivers PCT

West Hertfordshire Hospitals trust

West Wiltshire PCT

W Yorks Metropolitan Amb Service trust

Whipps Cross University Hospital trust*

*Scoring one in all five areas: financial management, financial standing, value for money, internal control and financial reporting