Published: 04/07/2002, Volume II2, No. 5812 Page 5

Star-ratings due out later this month look set once again to highlight poor performance among hospitals in the south of England, HSJ understands.

The assessments of the Commission for Health Improvement give strong clues as to how the performance of trusts is likely to be judged, and the growing number of clinical governance reviews published in the last year means CHI's assessments will have a much wider impact.

When the first set of star-ratings were announced last September, CHI had published 29 reports, and two trusts were relegated to the no-star league because of adverse reviews. Now, CHI has issued 108 reports.

Almost all the trusts CHI has criticised in the last year are in the South, generally in the South East or London. These include twostar Bromley Hospitals trust; twostar East Kent Hospitals trust;

no-star Barnet and Chase Farm Hospitals trust; no-star Royal United Hospital Bath trust; nostar Oxford Radcliffe Hospitals trust and no-star East and North Hertfordshire trust.

However, Bromley chief executive Mark Rees said: 'We are certain we are not going to get zero stars.'

Some of last year's no-star trusts have moved forward: Medway trust will probably get two stars if last year's criteria are applied this year, HSJ sources have pointed out - and could even make a leap from no stars to three. Nearby Dartford and Gravesham trust has also seen improvements and Portsmouth Hospitals trust is predicted to get a star.

But Brighton Health Care trust got a lukewarm CHI report - and has recently undergone a merger with another trust. Chief executive Stuart Welling - one of the few no-star chief executives to survive - now heads the merged organisation. The majority of trusts given no stars last year have lost, or are losing, the chief executives who were in place when last year's data was collected.

At University Hospitals Coventry and Warwickshire trust, no-one yet knows whether last year's CHI report will count against it again. Chief executive David Loughton announced his resignation months after the damning CHI review was followed by a no-star rating.

'We feel that, broadly, we will have done as well as we did last year, ' said a spokesman. 'What that means in terms of stars, we do not know - we do not know whether the CHI report effect lasts for just one year or until the next CHI visit.'

The trust would have got two stars if the CHI report had not 'disqualified' it, he pointed out.

The critics' choice

Attention is likely to focus on trusts known to have had difficulties over the last year, but which have not yet had their CHI reviews published.

Whipps Cross University Hospital trust in east London had problems with waiting times in accident and emergency and is likely to be criticised by CHI within the next few weeks.

And Maidstone and Tunbridge Wells trust had problems towards the end of last year, which led to speculation that it was in danger of losing its star, although the situation has eased.A spokesperson for Kent and Medway strategic health authority said: 'Certainly there are some issues at Maidstone and Tunbridge Wells but we have no reason to believe we are looking at any zero stars.'