New NHS trust league tables name Moorfields top and Queen Elizabeth, King's Lynn, bottom

The first national league tables rating NHS trusts in England have been published, placing specialist hospitals at the top and naming Queen Elizabeth Hospital, King's Lynn, as the lowest-ranked trust.

Moorfields Eye Hospital NHS Foundation Trust was rated highest, followed by the Royal National Orthopaedic Hospital NHS Trust and the Christie NHS Foundation Trust. Queen Elizabeth Hospital, King's Lynn, was placed at the bottom amid widely reported building problems that have required props to hold up ceilings.

Health Secretary Wes Streeting said the tables will help identify where "urgent support is needed" and give the public a way to check the performance of their local hospital, ambulance service or mental health trust. The new ratings place trusts into four categories every three months. Top performers will be given greater discretion over how they spend money, while those judged to be struggling will be expected to learn from better-performing trusts and receive targeted national support.

The Department of Health said that from next year the highest-rated trusts will have more freedom to develop services around local needs, while trusts facing challenges will receive "enhanced support". It added that leaders of poorly performing organisations could see reductions in pay, and that the most highly rated leaders will be offered larger pay packages to help turn around struggling trusts.

The rankings are drawn from a range of metrics, including patient waiting times for planned treatments and emergency departments and financial performance. That combination means a trust with strong clinical outcomes could be downgraded if it is running a larger-than-expected deficit.

A spokeswoman for Queen Elizabeth Hospital, King's Lynn, said: "Our patients deserve the highest standards of care, and we are sorry that in some of our performance areas... we have fallen short. Immediate steps are being taken to address the issues." The hospital has previously reported structural weaknesses in parts of its buildings.

NHS Providers, which represents trusts, warned there were questions about whether the league tables accurately identify the best-performing organisations. Chief executive Daniel Elkeles said league tables must "measure the right things, be based on accurate, clear and objective data and avoid measuring what isn't in individual providers' gift to improve." He added that anything less could risk "damaging patient confidence in local health services, demoralising hardworking NHS staff and skewing priorities."

Thea Stein, chief executive of the Nuffield Trust, said it was understandable the government wanted to win back public trust but cautioned that trusts might concentrate on measures that immediately boost their rankings rather than on wider patient needs, noting the particular influence of financial metrics. Chris McCann of Healthwatch England emphasised that the new dashboard "must inform and not confuse people" and should clearly communicate the information that matters most to patients.

The publication of the league tables marks a new phase in efforts to increase transparency and tackle variation in care across England. Trusts will be re-ranked quarterly, and officials say the system is intended both to reward high performers and to target resources and accountability where services are failing. Observers say close attention will be paid to whether the chosen measures accurately reflect quality of care and whether incentives shape trust behaviour in ways that benefit patients.