Published: 19/08/2004, Volume II4, No. 5919 Page 20

I thought it unfair on strategic health authorities to have missed out on all the benefits of the star-ratings. SHAs have a major influence on the quality of health services by monitoring levels of investment and involvement in the overall modernisation agenda.

I have therefore produced mental health star-ratings for SHAs by multiplying the number of mental health trusts in each SHA by the maximum number of stars each could have achieved - ie three. An SHA with four trusts could achieve a maximum score of 12. The table shows the percentage of the total score achieved by each SHA. For example, Essex SHA got five stars out of a maximum six and therefore gets a rating of 83 per cent. I have then set the threshold for the SHA 'star-ratings': 80 per cent for three stars; 50 percent for two stars; 40 per cent for one star.

I have then allocated ratings roughly in proportion to the actual number of mental health trusts in each category.

South East London shows that even trusts delivering services in one of the toughest patches can shine. Cambridgeshire. National director for mental health Professor Louis Appleby will be despatched to the doorsteps of those in the relegation zone (no stars) if they reappear in the basement next year.

John Mahoney Director National Institute for Mental Health in England - Eastern