Published: 11/08/2005, Volume II5, No. 5967 Page 9

The principles behind the Healthcare Commission's new system of assessment have been widely applauded. It is a broaderbrush approach. It is qualitative rather than quantitative. It focuses on issues that matter to patients.

But there are hurdles still to overcome. Trust boards have to sign the draft declaration that they are meeting the 24 core standards in around two months.

And HSJ understands that some strategic health authorities are asking to examine the declarations as early as the end of August.

'There is a question about the role of SHAs in the annual health check, ' said one primary care trust director of development. 'There are concerns that some SHAs are asking for a copy of the draft declaration before the October deadline and that is creating some anxiety.' One director of governance at a trust in the South East said: 'Our SHA wish to see our declaration by the end of August so it has foreshortened the time We have got to do the work.

'It is not unreasonable that the SHA wants to see it; It is the timing. The Healthcare Commission does not need it until October. It feels like the SHA needs a month to look at what we are saying and That is giving them as long as we have to actually do the work.' Meanwhile other trusts are concerned about the intricacies of actually signing off the declaration.

Despite initially demanding it should be signed off by all board members, the Healthcare Commission has since established it has no legal powers to insist on this.

The minimum requirement is now that the declaration bares the signatures of the chair and chief executive, although the commission says it would add credibility if boards signed it collectively.

Some trusts fear the number of signatures could be used as a risk indicator. One ambulance trust head of governance said: 'I remain to be convinced that if they get a statement signed by the chair and the chief executive and somebody has sent one in signed by the chair, chief executive, finance director, medical director and all the nonexecutive directors, they [the trusts with more than two signatures] are not going to be seen as the best.'