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Health services in Maidstone and West Kent have been graded as among the lowest in the country.
In the latest health check ratings, published by the Healthcare Commission, Maidstone and Tunbridge Wells NHS Trust (MTW) and NHS West Kent were graded as "weak" for the quality of their services.
Last October NHS West Kent, which was then known as West Kent Primary Care Trust, was rated as "fair" for its quality of services.
When it came to how well the trusts use resources, which includes the financial situation, both organisations improved to get a fair rating, after both were assessed as weak last year.
The information is based on assessments given by every hospital and primary care trust in the UK, for their performances from April 2007 to March 2008.
Maidstone and Tunbridge Wells NHS Trust runs hospitals in Maidstone, Tunbridge Wells and Pembury.
NHS West Kent funds services such as GPs, dentists and some out-patient clinics in hospitals.
This latest grading covered the publication of a critical report into the way patient infections were handled at hospitals run by MTW.
The trust’s management gave itself scores on various elements including safety and cleanliness, standards of care and waiting times, submitting an overall score of weak to the commission, which then checked the self-assessed scores.
Glenn Douglas, chief executive of MTW, said: "What we are seeing today is a reflection of where the trust was for the best part of 2007.
"It is not somewhere we want to be again, but as a new board we felt only the most critical self-assessment of the trust’s performance during 2007 would help us move on."
The trust now has the lowest C-diff rates in the south east, has trebled the number of patients being seen within the 18 week target from GP referral and has employed hundreds of extra nurses.
Eye screening for diabetics, bed blocking in hospitals and waiting times were areas NHS West Kent was told it had to improve.
Steve Phoenix, chief executive of NHS West Kent, said: "We are disappointed by the weak rating, although we were expecting it.
"It is no secret that 2007-2008 was a turbulent year. We are on a journey to improve services."