THIS year is the first time that the health trust ratings have been carried out by the Commission for Health Improvement.

Every acute hospital trust, ambulance trust, primary care trust and mental health trust in England has been given a star rating, from a maximum of three to a minimum of zero.

CHI, the independent health inspectors, judged the trusts on their ability to meet a series of key targets, as well as looking at many other areas of practice.

The controversial system has been criticised for damaging staff morale at low-rated trusts, but the Government says it helps health chiefs to see where more work needs to be done.

It says it also allows it to see which trusts need the most Government help.

The impact of the star rating is greatest on the acute hospital trusts. Only those awarded three stars this year can become independent foundation hospital trusts.

Four of the 29 trusts that had been earmarked for foundation status lost their three-star ratings this year.

One of these was Walsall Hospitals Trust, whose chief executive, John Rostill, is set to take over Worcestershire Acute Hospitals NHS Trust in September.

Dame Deirdre Hine, CHI chairman, said the ratings procedure had been a massive undertaking, involving the processing of many thousands of pieces of data, with more trusts being rated than ever before.

"Star ratings capture a snapshot of performance of NHS organisations, presented in an accessible form," she said.

"The indicators behind the ratings represent a great deal of information for NHS managers and clinicians. The same information can also be accessed by patients and the public on CHI's website.'' For more information about the ratings, visit the website, www.chi.nhs.uk/ratings

HEREFORD Hospitals Trust received one star after failing to meet two of its seven key targets.

It did not re-admit enough patients within 28 days after cancelling operations, and did not hit the target for two-week cancer waits.

It also struggled with A&E emergency admission waits.