Primary care trusts will be assessed on the quality of commissioning as part of next year's health check.
The proposal is in the Healthcare Commission's blueprint for the annual health check 2008-09, which goes out to consultation today.
It follows criticism of PCTs' commissioning skills and their disappointing performance in last year's health check, in which they were the worst-performing sector for the second year running.
Under the plans, trust boards will have to declare whether they have complied with the 24 national core standards for their commissioning and providing functions. This will then form an overall rating. It has not yet been decided how the scores for each function will be weighted.
Healthcare Commission chief executive Anna Walker hinted that any trust failing to meet the standards could face problems in registering with new health regulator the Care Quality Commission. 'We're saying it's very important that you meet these standards by the time the registration requirement comes into being because otherwise there will be questions,' she said.
The Health and Social Care Bill states that all trusts will have to register with the new commission by 2009 but does not set out what registration requirements will be.
Last year, less than half of trusts met all of the core standards.
The commission will also publish comparative information on PCTs' performance on national and local priorities, the former taken from the 2008-09 operating framework.
Every acute trust will be inspected on infection control under the plans. At the moment, trusts are visited by inspectors only if they are suspected of missing targets or are subject to a random spot check.
Ms Walker said: 'Patients and their families are very concerned about infection control and prevention. It's clearly an issue that we as a country have to grapple with.'
Mental health trusts and community hospitals could also be visited by inspectors.
A more rounded set of indicators is being drawn up for mental health, ambulance and learning disability trusts in order to create a more 'tailored' health check. The commission also wants the 2008-09 assessment to be more focused on clinical quality and hopes to canvass clinicians' opinions on this.
It will also carry out three reviews: palliative care, commissioning for learning disability services; and the management of medicines prescribed in primary care.