THREE NHS Trusts in the London area have been told to take urgent steps to improve after being branded as "weak" by a government watchdog.

Barnet and Chase Farm, Surrey and Sussex, and West Hertfordshire trusts were ordered to better the quality of their services and sort out their finances in a report released today by the Healthcare Commission.

The study of 570 trusts in England rated primary care trusts (PCTs), acute hospital trusts, mental health trusts and ambulance trusts on a four-point scale from "excellent" to "weak"

The survey said that 88 percent of the country's NHS Trusts needed to improve and rated 37 percent of them as weak.

"Immediate action" needed

Chairman of the commission Ian Kennedy said in a statement released by his office in London today: "Patients will want the NHS to raise its game still further.

"They need a universal guarantee that trusts are meeting general standards. These are things that really matter to patients."

Mr Kennedy called for "immediate action" in 24 trusts that made poor use of their resources and delivered poor services. The trusts must respond with action plans within 30 days.

Overall the commission found that acute care and specialist hospital trusts performed best but identified eight which were failing, including the three in London.

Primary Care Trusts in Guildford and Waverly and East Elmbridge and Mid Surrey were also denounced as weak.

All trusts which were in deficit in 2005/6, including at least a dozen around London, were automatically rated weak in their use of resources.

It was not all bad news for London's health services though. The Royal Marsden NHS Foundation Trust, a specialist cancer trust, was one of only two trusts in the country to receive the accolade "excellent" in both service delivery and use of resources, along with Harrogate and District NHS Foundation Trust.

However, the report, based on self-assessment by the trusts, has come under attack from critics who say it is not a true reflection of patient experience.

Gordon Lishman of Age Concern England said: "The performance assessment ratings largely bypass patients' views and are the equivalent of asking students to mark their own exam papers."