FOUR out of five primary care trusts in the News Shopper area have been judged among the worst performing in the country by the healthcare watchdog.

The Healthcare Commission's survey of emergency care services assessed the system for delivering urgent and emergency care in each PCT area.

In particular they looked at how easily patients can access services and how efficiently and effectively the different services work together - such as GP out-of-hours-services, ambulance services and A&E departments.

And thirdly, how the services are managed.

Emergency care in the areas covered by Lewisham, Bexley, Bromley and Greenwich PCTs was judged to be in the bottom 18 per cent nationally.

Out of a possible score of 5, Lewisham PCT and Bexley PCT rated 2.55.

Bromley PCT scored 2.6 and Greenwich Teaching PCT scored 2.66.

West Kent PCT was considered to be better performing with a score of 3.11.