NHS trusts in the South East are performing poorly compared with those in other parts of the country, a watchdog report has revealed.
According to the latest Healthcare Commission reports, the South East Coast Strategic Health Authority (SHA)was the worst for quality of services.
It was also one of the worst-performing for use of resources, despite showing the most improvement in that area.
The commission has warned weak trusts they would face intensive monitoring.
The South East Coast SHA serves 4.2 million people in Kent, Surrey and Sussex through a total of 26 NHS trusts and has an annual budget of £6bn and almost 100,000 staff.
Health check
Across England, overall NHS performance has improved after three years of the watchdog's so-called health check.
However, Maidstone and Tunbridge Wells NHS Trust, which was at the centre of the country's biggest C. difficile outbreak, was rated weak for quality of services in the latest report, though bosses claim improvements have been made.
Chief executive Glenn Douglas said: "The improvements we've made towards the end of last year have not been reflected in this particular report. If you were to take a snapshot now we would be significantly better."
"We recognise there is still more to do and we are working hard with organisations and staff to ensure that further progress is made"
Overall, seven trusts in the region received an excellent rating for quality of services, three were rated good and 16 were rated fair or weak.
For use of resources, the South East Coast SHA had the highest proportion of fair (46%) trusts and the lowest proportion of excellent trusts (8%), and the only SHA in the county not to increase that rate.
Candy Morris, South East Coast SHA chief executive, said: "It is fantastic to see that growing numbers of trusts have been independently assessed as routinely delivering the highest possible quality care for patients.
"We recognise there is still more to do and we are working hard with organisations and staff to ensure that further progress is made and improvements continue in the future."
She also confirmed recent changes in regional financial management will have a "positive impact".
'Notable improvement'
The commission also assessed the core standards that all healthcare organisations in England should achieve and found the South East Coast to be the worst performing SHA.
It also had the highest proportion of weak trusts for new and existing national standards.
It did however show the biggest increase - 20% - in top-rated trusts for new national standards, after nine were rated excellent.
South East Coast Ambulance Service NHS Trust was praised for reaching all four existing national targets in 2007/08.
The report described it as a "notable annual improvement".
However, it failed to implement clinical guidelines concerning stroke patients and failed to score maximum points for new national targets.
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