The naming of 34 trusts as poor performers will strike fear into the managers in charge.

Although the performance framework of which they have fallen foul has been around for over a year, this is the first time miscreants have been outed.

Most of these trusts are “under review”. The road to Hades, where managers endure the inferno of a full blown failure regime, is signposted by further categories, “underperforming” and “challenged”.

The performance rules show how intent the Department of Health is on dealing with the stragglers. This is a commendable aim, but the NHS Confederation is right to stress the need for the DH and strategic health authorities to intervene in a way that is appropriate and proportionate.

Excessive emphasis on management firing squads will do little to turn these trusts around while exacerbating the problem of up and coming talent being deterred from applying for the top jobs.