Commenting on the Care Quality Commission's NHS performance ratings for 2008/09 Steve Barnett, chief executive of the NHS Confederation, which represents over 95 per cent of NHS organisations, said:

"It is extremely heartening to see that for the first time ever, more than 100 trusts scored excellent for financial management - at the same time it is concerning that some continue to experience performance issues."

"With the NHS entering the most demanding period of financial pressure in its history the reasons for this need to be understood if the performance of the best trusts is to be reflected across the whole of the system."

"The decline in ratings at some hospital trusts and also in child safeguarding measures seems to reflect, at least in part, a more self-critical approach following high profile cases of failures this year but that does not mean there is not still room for improvement and more work in these areas."

"There are welcome successes, including marked improvements on healthcare acquired infection controls, A&E and cancer waiting times and the 18 week referral to treatment time, which show what can be achieved when a problem is identified and tackled."

"These figures provide leaders in the NHS with a focus on where they can do better in the year ahead and highlight where improvements need to be made – the challenge is to make sure that they are."