New NHS regulator, the Care Quality Commission (CQC), yesterday published its ratings on England’s 392 trusts.

From April 2010, the CQC will gain new powers to be able to shut any ‘underachieving’ trusts down.

The CQC press statement said: ‘Overall, our ratings for 2008/09 show the NHS: is performing well on quality and has significantly improved its financial management.

‘However, we are concerned about the 20 trusts rated weak on quality, particularly those rated weak over a number of years; and 27 trusts rated fair for too long without improving.’

Cynthia Bower, CQC Chief Executive, warned: ‘Next year, all trusts must register with us to legally function.

‘It is clear that many have significant work to do and a short time in which to do it. They should be in no doubt that we will take firm action if we deem it necessary.’

Health Minister, Mike O’Brien added: ‘Earlier this year we introduced a tough new performance regime and will not hesitate to trigger this if we need to.’

Commenting on the ratings, Dr Hamish Meldrum, Chairman of Council at the BMA, said: ‘Overall, this is a positive picture, reflecting the commitment of NHS staff to providing high quality care in the face of financial constraints and a target culture.

‘It is crucial that future drives to reduce NHS costs do not take the NHS backwards, or result in cuts that penalise patients.

‘Where trusts are underperforming we need to find out why.

‘A proper dialogue with clinicians will help managers identify the problems and look at workable solutions rather than taking a bureaucratic top-down approach.’

Karen Jennings, Head of Health for Unison said: ‘Despite the recession and concerns over jobs, this report shows that staff have again stepped up to the challenge and delivered significant improvements in patient care.’

BMA Council member, consultant surgeon Mrs Anna Athow warned: ‘In the name of improving quality, a mechanism has been put in place to close hospitals and transfer them to private sector managment or ownership, or create huge mergers.

‘Hospitals are being judged on clinical quality and use of resources by a host of criteria. If the hospitals can’t tick enough boxes, they are graded “fair” or “poor”.

‘These judgements will then be used by the Care and Quality Commission to say they are not fit for registration.

‘Once a hospital has failed registration, it can be closed, merged or taken over by new management. This is the mechanism by which they hope to hand over hospitals to the private sector.

‘What hospitals need is the restoration of proper direct block funding to provide for all the needs in their area, and an end to foundation trust status, whereby hospitals are forced to run as a business and compete.

‘It is urgent that the health unions organise action to defend NHS hospitals.

‘NHSTogether hasn’t even called a day of action, and today’s development underlines the urgent need of it.’