Shadow Conservative health secretary Andrew Lansley said: ‘The government seems unable to turn around poor performers because there is still not enough focus on improving quality in the NHS.

‘That is why a Conservative government would focus on giving patients' real choice and information to drive up quality, make value-based competition between hospitals effective and introduce a system which truly rewards good results.'

However, health minister Mike O'Brien said the report showed that standards were improving.

He said: ‘This is the most rigorous assessment of standards that the NHS has ever seen, carried out by a new independent regulator which we established and tasked with making sure the toughest standards are enforced routinely across the system. This makes it difficult to compare with previous years but is essential as we move towards registration of all NHS services.

‘For the small number of trusts whose performance is weak, we expect immediate action to be taken to remedy this quickly and to prepare for registration with the CQC next year.'

Karen Jennings, head of health for Unison, said: ‘The tough new performance indicators have led to a more mixed picture this year. However, it is important that the NHS aspires to the highest standards and the new indicators are used to shine a light on areas where improvements are needed.'

Dr Peter Carter, head of the RCN, said: 'These figures show that there are a small group of trusts which consistently under-perform and need much more intensive work if they are to improve.'