Most NHS trusts in the South West have improved their scores in this year's Annual Health Check published today by the Healthcare Commission but Wiltshire PCT, the county's ambulance service and the Royal United Hospital at Bath have all received the lowest possible marks.

Of the 40 NHS organisations in the region, 33 have shown improvement or maintained their scores, and seven have deteriorated.

This was despite a year of facing financial challenges and implementing Commissioning A Patient Led NHS, which resulted in major reconfiguration.

Seventeen trusts improved their scores and one in the region scored a double "excellent" rating - Yeovil District Hospital NHS Foundation Trust.

Organisations were rated by the Healthcare Commission as Excellent, Good, Weak or Fair in two separate categories - quality of services, and use of resources.

Six NHS trusts in the South West received "weak" ratings in both categories. These are: Devon Primary Care Trust, Great Western Ambulance Service NHS Trust, Northern Devon Healthcare NHS Trust, Royal Cornwall Hospitals NHS Trust, Royal United Hospital Bath and Wiltshire Primary Care Trust.

The double "weak" ratings are a cause for concern and the organisations involved are required to deliver stringent action plans setting out how they will improve. However, in the main, the weak' ratings either reflect historic debt problems, or compliance with core standards which are being addressed.

It is important to recognise that the Healthcare Commission's ratings highlighted performance at 31 March 2007, and improvements and progress has already been made.

All double weak' rated trusts have new leadership teams. In each of the organisations either the Chair or Chief Executive, or both are new, and the changes being made are expected to lead to improvements in the 2007/2008 ratings.

The Healthcare Commission has also announced that it is looking into concerns at the Royal Cornwall Hospitals NHS Trust because of its performance on core standards.

Improvements in the South West can be seen, for example, at Devon Partnership NHS Trust and Gloucestershire Partnership NHS Foundation Trust (both Mental Health Trusts) where quality of services have moved from "fair" last year to "excellent" in 2006/7.

Poole Hospital NHS Trust improved its use of resources from "fair" to "good" and quality of services at Plymouth Hospitals NHS Trust and at Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust improved from "fair" to "good".

United Bristol Healthcare NHS Trust quality of services improved from "good" to "excellent" and use of resources at Taunton and Somerset NHS Trust improved from "fair" to "good".

Quality of services at The Royal Devon and Exeter NHS Foundation Trust Improved from "fair" to "good" and top scoring Yeovil District Hospital NHS Foundation Trust shifted from "fair" quality of services and "good" use of resources to a double "excellent" this year.

The latest Patient Survey by the Healthcare Commission showed that nine out of ten patients in the South West were happy with the care they received.

Sir Ian Carruthers OBE, Chief Executive at NHS South West, said: "The Annual Health Check provides a valuable picture of where Primary Care Trusts and NHS trusts are doing well, and where improvements are required.

"The picture in the South West is mixed. It is not a surprise given some of the challenges that trusts have faced for many years in the South West. Overall there has been significant improvement, but there is no room for complacency.

"This assessment is made up of national standards and self declarations by Trusts covering both quality of service and use of resources, providing an independent overview which is helpful to patients, staff, and members of the public.

"We share the concerns highlighted by the Healthcare Commission about those trusts rated as weak for both quality of service and use of resources, and we are already working with these organisations to deliver the improvements rightfully expected.

"My expectation is that many organisations will continue to drive improvement, so that even more progress is demonstrated in 2007/2008.