A hospital trust - which featured in a Panorama documentary about its cleaning regime - has been awarded top honours in the latest performance ratings.
Heart of England NHS Foundation Trustruns the Heartlands Hospital and has been given three stars.
Two staff were suspended as a result of the BBC programme.
The trusts that run the city's Children's, Women's, Royal Orthopaedic and Queen Elizabeth hospitals all got three stars.
Sandwell and West Birmingham NHS trusts each get two.
Walsall and Wolverhampton NHS trusts, as well as the West Midlands Ambulance service, lose a star, leaving them all with just one. Good Hope remains on one star.
Mental health services in Wolverhampton have been praised. They have risen from no stars last year to the maximum three this year.