The first official assessments of the quality of care in NHS hospitals has revealed a mixture of both excellence and underachievement.
The inspections of three English hospitals, by the commission for health improvement (CHI), found that all were generally well run, despite isolated pockets of poor performance.
The findings will come as a relief to ministers battling to retain public confidence in the NHS against a backdrop of intense media scrutiny of health service performance.
The CHI reports examined the quality of care, what steps hospitals had taken to improve care and reduce clinical risks, how staff treat patients and the level of information provided to patients.
The three hospitals studied were Chesterfield and North Derbyshire Royal Hospital NHS trust, City Hospitals Sunderland NHS trust, and Southampton University Hospitals NHS trust.
CHI chief executive Peter Homa said: "The three hospitals we report on today are well run, they all have areas that demonstrate good practice in the health service and they all have aspects that need improvement."
"Each of the trusts has produced an action plan in response to our report. If the action plans are carried out, the quality of care for patients at these hospitals will be even better that it is now."
"Everyone knows that standards vary across the NHS. CHI will raise standards across the board by highlighting excellence and not just pulling its punches where improvement is needed."
Chesterfield and North Derbyshire Royal NHS trust
According to the report, the trust has a "significantly higher mortality rate than the national average". It has the highest death rate of large acute trusts in England for emergency admissions and the second highest for non-emergencies. But CHI says the trust "has a number of strengths to build on", and although it is not able to explain its high death rates, it has instituted a internal review.
City Hospitals Sunderland NHS trust
The trusts's urology service is experiencing "serious difficulties" as a result of the departure of several members of senior medical staff, says the report. CHI also found evidence that some senior clinical staff felt "excluded" from decision making. But the report also found a "high commitment to patient care" at the trust, and a "strong performance culture". Many of its clinical services compare well to those of similar trusts in England.
Southampton University Hospitals NHS trust
CHI says it has "strong concerns" over the quality of care given to patients on trauma and orthopaedic wards, which suffered from nurse shortages, bed closures, long treatment waiting times and delays once patients were in hospital for treatment. The report also found, however, that trust performance in six out of seven clinical areas was "better than average", that it had a good record of developing innovative clinical practice, and that "most" of the trusts patients were "satisfied" with the quality of care they receive.
CHI was set up in 1999 to monitor standards of patient care in the NHS, and began its work in April this year. It aims to examine standards in every trust, health authority and primary care group or trust in England and Wales over the next four years.
It also investigates failing health services at the request of the secretary of state for health. It recently published two reports into poor care at hospitals in Carlisle and Carmarthenshire.
