Star ratings for Primary Care Trusts (PCTs)

The Commission for Health Improvement (CHI), a regulatory body established in 2000 following the Health Act 1999 and the 1997 whitepaper The new NHS: modern, dependable, published star ratings of PCTs for the first time in 2003.

Star ratings had been produced for hospitals from 2001 onwards, and from May 2002, the Social Services Inspectorate published the first star ratings of local authority social services departments. Previously, this had been the responsibility of the NHS executive.

In 2003 CHI published ratings for PCTs, as well as for mental health trusts, for the first time.

Confirmed lists of indicators, and the technical specifications (or constructions) used to calculate them, were published in advance. Unlike the previous star ratings awarded by the NHS Executive, CHI's ratings took into account its assessment of clinical governance in acute, specialist and mental health trusts.

PCTs were rated against a range of indicators covering access, health improvement and service provision, including:

• access to quality services (indicators included access to NHS dentistry, emergency readmission rates following treatment for a fractured hip and A&E admission waits)
• improving health (indicators included rates of vaccination, teenage pregnancies, death rates from cancer)
• service provision (indicators included the prescribing of antibacterial drugs, patient complaints procedure and staff opinion survey data).

The 304 PCTs in England received the following ratings:

• Three stars: 45 PCTs
• Two stars: 139 PCTs
• One star: 98 PCTs
• Zero stars: 22 PCTs.