The Healthcare Commission has once again identified record keeping as one of the weakest areas of NHS performance in its annual health check.

CO9, which requires organisations to have a “systematic and planned approach to the management of records”, is identified as one of the core standards with the lowest rates of compliance in the overview of organisational performance, published today.

Just 85.2% of organisations met the standard. This is barely changed from the first health check in 2006, when 19% of organisations said they were not complying with the standard or could not be sure whether they were complying or not.

Although all trusts were supposed to meet the core standards from their introduction, the Commission notes that one in three are still not complying with all of them. Also in the compliance bottom five were standards relating to training and to minimising the risks associated with the use of medical devices.

Overall, the Commission is keen to stress that standards continue to improve. The number of trusts rated “excellent” or “good” for both the quality of their services and their financial management have continued to increase, while the number rated “poor” or “weak” have declined.

However, the regulator’s findings in some areas have been affected significantly by the increased use of patient information.

The Commission called for more patient views to be taken into account when assessing organisational performance in its annual report last year – a recommendation taken up by the Darzi report and endorsed by health secretary Alan Johnson at the Labour Party conference this summer.

But there has been a dramatic decline in the number of primary care trusts meeting the target that every patient should be able to see a GP within two working days in this year’s health check, as a result of surveys of patient views being included alongside information from GP surgeries.

Just 31% of PCTs met this target this year; down from a stated 80% last year. Surprisingly, Mr Johnson appeared to question the Commission’s methodology when commenting on the results on Radio 4’s Today programme.

“I think we have to look very hard at how the Healthcare Commission has produced its figures because we have an independent survey of patients asking them about these things and we found in our latest survey that 87% could book 48 hours in advance,” he said.

“The Healthcare Commission has changed the way it assimilates figures and we will have to look very, very carefully at the disparity between the Healthcare Commission figures and the independent survey.”

Meanwhile, only 16% of PCTs met the target for giving patients choice and providing them with convenient services, which includes use of the Choose and Book electronic booking system. Just 16% of PCTs met the target – although the Commission notes that just 2% met it last year.

NHS organisations in London performed particularly badly on access. Indeed, the Commission notes that “for the first time” a clear gap can be seen between NHS performance in the capital and the rest of the country.

The number of NHS organisations rated “excellent” for the quality of their services fell from 55% to 48% between last year’s health check and this year’s. The Commission says PCTs need to work together to improve the commissioning of services, including GP services, and that the results provide support for pushing ahead with the Darzi reforms.

“Three years into this assessment, the public is entitled to expect urgent action at trusts which are still performing poorly,” said Commission chair Sir Ian Kennedy. “The primary sector has improved, but more is needed in areas such as access to GPs and provision of choice. [And] the NHS in London continues to face significant challenges.”

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The Healthcare Commission