Performance ratings for acute trusts

1 September 2001

In September 2001, all non-specialist acute NHS trusts were issued with a performance rating (star rating) based on their performance during 2000/01.

The number of stars assigned to an organisation was based on delivery of national targets and overall performance. The star ratings were broadly based on the following criteria:

  • 0 stars = those trusts that showed the poorest levels of performance
  • 1 star = those trusts that gave some cause for concern
  • 2 stars = those trusts that were performing well overall
  • 3 stars = those trusts performing at the highest level.

Those trusts that had been rated as having zero stars were required to produce a performance action plan to address their poor performance. The star system was widely criticised and seen as unreliable. While it identified some areas of concern, other trusts with performance issues were missed.

In a House of Commons debate on the new ratings system, a number of concerns were raised. Regarding these concerns, Tim Loughton asked:

'Is this not merely another gimmick to allow the secretary of state to shift the finger of blame away from the department? In any case, what real choice does the scheme create for patients whose local hospitals have received zero stars? What does it give them besides the knowledge that they are now officially forced to attend a failing hospital?'

In response to this, Secretary of State for Health Alan Milburn said:

'For the first time, the star ratings show that the National Health Service is a less monolithic organisation than it used to be. As every patient and member of staff knows, the NHS – an enormous and complex organisation – is characterised by some outstandingly good performance and, sadly, by some rather poorer performance. It is about time that we came clean to patients about where the performance is good, poor or indifferent. I should have thought that the Hon. Gentleman would be persuaded of the case for more openness and devolution.'


Department of Health.
Departmental report 2002.
Department of Health; 2002.

House of Commons.
Oral Answers to Questions: Health. HC Deb 11 Dec 2001 cc 696-697.
Hansard; 2001.