Health Secretary Alan Johnson has warned that the four worst-performing NHS Trusts identified in a Healthcare Commission report face "radical action" - including a takeover - unless they improve.
Mr Johnson said he has asked David Nicholson, chief executive of the NHS, to "urgently meet" the four trusts to "assess what action they are taking to remedy the situation".
He said: "If this is not satisfactory, we will consider more radical action. Stringent assessments would need to be made regarding the most appropriate course of action but one of the options could be takeovers by well-performing trusts."
He continued: "I have also asked strategic health authorities to publish and implement action plans within 30 days for trusts who are weak on both categories. This helped improve poor performers last year."
The four trusts affected are those judged to be "weak" in both parts of the commission's performance ratings - for quality of services and use of resources - in 2006/07 and 2005/06. They are: the Royal Cornwall Hospitals NHS Trust, Northern Devon Healthcare NHS Trust, Surrey and Sussex Healthcare NHS Trust and West Hertfordshire Hospitals NHS Trust.
Mr Johnson said the Healthcare Commission's report on the NHS Trusts "was the toughest and most comprehensive assessment of the NHS ever".
"Our expectations are high and we expect NHS Trusts to improve every year. That is why we set up the Healthcare Commission to assess every NHS organisation, carrying out inspections where necessary to ensure they meet high standards and deliver for their patients," he explained.
"This independent verdict on the NHS shows clear improvement, with more trusts getting an excellent rating, more trusts improving on last year's performance and fewer in the lowest category."
The commission's report found over a quarter of NHS trusts in England were failing to meet new infection control standards to tackle superbugs such as MRSA and Clostridium difficile. It expressed "concern" that 111 of the 394 trusts assessed - 44 of them acute and specialist trusts - had not complied with one or more of three Government hygiene standards.
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But the commission found trusts' performance was in general improving, with more scoring "excellent" and fewer scoring "fair" and "weak" when judged on quality of services and use of resources, or financial management.
