London's sick-list hospitals

NHS care in London is lagging behind the rest of England and getting worse, a Government health watchdog declared today.

Among London's 31 primary care trusts, responsible for GPs, six were awarded the minimum zero stars while none achieved the maximum three. The result shows a widening health gap, with patients suffering from some of the worst standards of care in the NHS.

Of 32 acute hospital trusts in London, 11 had their ratings cut by the Health Commission. Only seven saw them rise, with 14 unchanged.

Two - Barnet and Chase Farm, and Royal National Orthopaedic - were awarded zero stars. Last year, none of the capital's trusts scored zero. And there was a question mark over the foundation status of Moorfields Eye Hospital after it saw its three stars cut to two. The trust's management has been asked to explain to an independent regulator why it lost the star and what action it is taking.

Only three-star hospitals can be awarded foundation status, giving them greater financial freedom, but once it has been granted it does not automatically disappear with the loss of a star.

There was also a blow for Chelsea and Westminster, which is seeking foundation status. Its two stars were cut to one.

Across the country, 43 per cent of trusts achieved the maximum three-star rating. But in London only 10 trusts managed the feat, including three that improved this year - Hammersmith, Bromley and Royal Brompton and Harefield.

Commission chief executive Anna Walker said poor standards in London were due in part to the city's highly mobile and mixed population, which made healthcare more complex. Moorfields lost its third star after it submitted inaccurate data. Chief executive Ian Balmer said: "This is a big disappointment. These errors should not have happened, and we are well on the way to rectifying them.

"However, the important fact is that none of them reflect on the level of clinical care we provide, our ability to meet waiting time targets or patient satisfaction with their treatment."

There was also a setback for Tony Blair's health policy as three more foundation trusts lost their three-star status - Addenbrooke's, Papworth and Peterborough, all in Cambridgeshire. But the Department of Health said it would try to keep them on track for foundation status, adding: "The department will work with those prospective trusts that have not secured their three-star rating with a view to them obtaining approval to go forward." Nationwide, the number of three-star acute trusts increased from 63 to 74, while the number of zero-star acute trusts fell from 14 to 10. Star ratings were introduced to help NHS patients judge the hospitals they are treated in. But critics claim they are too simplistic.

Scores are based on targets and performance indicators including waiting times in emergency departments, waits for surgery and financial management.

Commission chairman Sir Ian Kennedy said ratings for mental health trusts were marred by poor collection of information about users of the services.

He said the way NHS trusts were rated would be reviewed, but he would not say whether star ratings would stay or go.

The new system, to be introduced in 2005, "will allow a broader picture of performance to be presented each year".