NHS Trust Rankings 2025: Landmark League Tables Reveal Top Performers and Drive Healthcare Reform
Introduction
The NHS has launched a pioneering new system of league tables across England, ranking every trust against clear, consistent standards – from urgent and emergency care to elective operations and mental health services. This new era of transparency and accountability aims to drive up standards, tackle variation in care, and ensure high-quality service delivery.
Top Performers and Rankings
The majority of the top 10 best-performing hospitals were specialist trusts, with Moorfields Eye Hospital NHS Foundation Trust leading the rankings, followed by the Royal National Orthopaedic Hospital NHS Trust and The Christie NHS Foundation Trust.
The Department of Health and Social Care (DHSC) provided three distinct league table rankings – acute trusts, non-acute hospital trusts and ambulance trusts. In the ambulance category, North West Ambulance Trust, East Midlands Ambulance Trust, and Yorkshire Ambulance Trust secured the top positions, while East of England Ambulance Trust ranked lowest.
Performance Measures and Rewards
Trusts are scored on multiple measures including finances, waiting times for non-urgent care, ambulance response times, and patient access. A lower score reflects stronger performance. The trusts are grouped into four segments, with Segment 1 representing the best performing institutions, which receive more autonomy and the ability to reinvest surplus funds.
NHS leaders will receive extra pay incentives to work in challenged trusts and turn them around. Senior managers at persistently failing trusts could see their pay docked, while higher standards will be set for leaders, with pay tied to performance.
Future Developments and Expert Response
By summer 2026, the tables will expand to cover Integrated Care Boards – NHS organisations responsible for planning health services for their local population – and wider areas of NHS performance.
However, some experts have raised concerns about the effectiveness of the ranking system. Healthcare charity The King’s Fund has questioned whether the league tables will be helpful to the public, noting that hospital performance is not as simple as good or bad. A single ranking can hide variations in performance across different departments within the same hospital and across multiple hospital sites run by a single trust.