Government publishes first NHS league tables, spotlighting worst-performing trusts across England

The government on Tuesday published for the first time comprehensive league tables ranking hospitals, ambulance services and mental health providers across England, identifying the lowest-performing NHS trusts and highlighting long-standing pressures on waiting times, clinical targets and finances.

The tables score trusts on seven areas including waiting times for operations, cancer treatment, time spent in A&E, ambulance response times and financial performance, meaning clinical ratings can be reduced if a trust is running larger than expected deficits. Health Secretary Wes Streeting told the Daily Mail the measure was intended to show "where urgent help is required" and that every patient "deserves top of the table care".

The Queen Elizabeth Hospital King’s Lynn NHS Foundation Trust was ranked lowest overall, placed 134th out of 134 trusts. The Norfolk trust was flagged for poor A&E and cancer wait times and was rated "requires improvement" by the Care Quality Commission (CQC) after an inspection last year. NHS target figures cited in the rankings showed just 52.1 percent of A&E patients were admitted, transferred or discharged within four hours in July, compared with the 95 percent standard. Only 53.4 percent of newly diagnosed cancer patients referred for urgent treatment were seen within two months, below the 85 percent target, and 86.9 percent of patients started treatment within 31 days of booking in June, against a 96 percent goal. The trust also missed the target for communicating suspected cancer results, meeting it for 70 percent of patients rather than the 75 percent threshold. Interim executive managing director Chris Brown said the trust was "sorry it had fallen short" and that immediate steps were being taken to address the issues.

Inspectors and the published data also drew attention to long-standing building safety problems at the King’s Lynn site. The trust remains affected by reinforced autoclaved aerated concrete (RAAC) and reportedly requires more than 1,500 temporary props to support ceilings. RAAC, used widely in construction between the 1950s and 1990s, has been judged structurally weaker than traditional concrete and the trust is one of seven hospitals prioritised for a rebuild under the national New Hospital Programme.

Other trusts at the bottom of the tables include University Hospitals Coventry and Warwickshire NHS Trust, ranked 132nd and identified as the lowest-ranked teaching hospital. The trust has faced legal action from more than 20 patients who allege excessive long-term use of the chemotherapy drug temozolomide, including cases where the drug was reportedly prescribed for years rather than the usual six-month course. The trust said it was carrying out an internal review. Performance measures published with the tables show 60.4 percent of A&E patients were seen within four hours and 64.2 percent of urgent cancer referrals were treated within two months.

North Cumbria Integrated Care NHS Foundation Trust, ranked 130th, was cited for failures in emergency and medical care and multiple concerns in maternity services. CQC reports referenced staff shortages, infection control lapses, delays in timely pain relief, gaps in life support and safeguarding training, and a workplace culture in which some staff said they did not feel able to raise concerns without fear of reprisal. The trust was also recorded as being in a deteriorating financial position, with a deficit of £34.71 million as of December 2024.

Mid and South Essex Foundation Trust, ranked 123rd and the lowest among large teaching and general hospital groupings, is one of ten trusts subject to a "rapid national investigation" into maternity and neonatal services. The CQC in January rated some maternity services as "requires improvement" and inspectors noted gaps in staffing and fetal monitoring equipment, as well as delays in completing investigations into incidents. NHS figures show the trust met the 18-week referral-to-treatment standard for only 49.58 percent of patients in June 2025.

At the community hospital level, Birmingham Community Healthcare NHS Foundation Trust was placed last among community trusts (61st of 61) and is ranked "requires improvement". The CQC cited low staffing levels for health visitors, high caseloads, low morale and inconsistent systems and processes. Board papers published in June also flagged failures to meet required digital security standards and a risk of a severe cyber attack.

The published rankings underline a geographic and urban-rural disparity in performance. The analysis found more than half of the 20 worst-ranked general hospitals are in the North of England, while trusts in London occupy many of the top positions, reflecting what the government and campaigners have described as a "postcode lottery" of care.

Regulators and ministers said the public publication of the league tables is intended to provide transparency and direct resources and oversight where they are most needed. The CQC continues to inspect and report on individual services, and some trusts identified in the tables are already the subject of targeted national reviews, rebuilding programmes or internal inquiries. Trust leaders have said they are taking steps to address the issues, including safety improvements, staffing recruitment, equipment checks and financial plans.

The tables combine performance against clinical standards with financial outcomes to provide a composite view of trust performance. Health sector leaders and patient groups cautioned that the rankings capture a snapshot in time and that local factors such as ageing buildings, workforce shortages and surges in demand can influence results. Government officials said the new transparency will help pinpoint urgent interventions and track progress over time as trusts implement improvement measures.