More than 200 hospital trusts have been branded "weak" in the way they manage their resources under tough new performance ratings by the Healthcare Commission.
The new health checks, which combine self-assessment, external reports and patient views, find 37 per cent of the 570 trusts in England are failing in this area and a further nine per cent are providing a "weak" quality of service.
Overall, 24 trusts have been branded weak on both their resources and services and have been ordered to take urgent action to improve their performance within the next 30 days.
Primary care trusts (PCTs), which are responsible for commissioning dentistry and GP care, make up 11 of these and overall do not fare well - 58 per cent offer a fair or weak quality of service, and 92 per cent are fair or weak on resources. None are excellent.
However, the Healthcare Commission's new assessment procedure also reveals that four per cent of trusts provide "excellent" quality of services and 36 per cent are "good". On resource management, three per cent were excellent and 12 per cent good.
Acute trusts and specialist hospitals were singled out for praise - half of these offer an excellent or good quality of service, and 30 trusts are excellent or good in the way they manage their resources.
The results are the first from the new assessment process that replaced the 'star-rating' system. They take into account 24 core standards, existing targets on issues such as waiting times and reviews of specific services such as drugs misuse and mental health.
Health secretary Patricia Hewitt welcomed today's report as the "toughest and most comprehensive assessment of the NHS", and said it would provide patients with detailed and easily understandable information about their local health services.
"There is no doubt that the NHS has made big improvements, particularly on waiting times, access to cancer treatment, community mental health service and treating patients with respect and dignity," she said.
"But as these results show, there needs to be even more improvement and we are working with the NHS to ensure that all organisations meet the core standards as soon as possible."
However, the British Medical Association (BMA) blamed the poor performance of PCTs on the "constant reorganisation and restructuring" over the past few years.
Jonathan Fielden, chairman of the BMA's consultants' committee, noted that foundation trusts, which do not have to balance their books every year, generally performed better than other trusts which were. Any recorded deficits resulted in a weak rating, he said.
Nigel Edwards, director of policy at the NHS Confederation, made a similar point, arguing: "The spread of results across different types of NHS organisations is proof that the latest round of reorganisations has adversely affected services."
But he added: "When looking at these results it is important to remember that fair does not mean 'failing' and weak does not imply 'unsafe'."
For more information visit the Healthcare Commission.