The Healthcare Commission's report on West Wiltshire Primary Care Trust (PCT) highlights good practice and suggests areas for improvement.

The report praises the PCT's staff, but adds that "a lack of leadership and decision-making has led to an uncoordinated approach."

Maternity services were commended and an action plan has been drawn up.

"The PCT also needs to... do more work to ensure involvement of patients, the public and contractors such as GPs and pharmacists in service delivery and development," the report continued.

The Commission said the PCT needed to address: Developing clinical governance Strengthening internal and external communication Patient, service user, carer and public involvement Managing operational risks, especially the "unsuitable" environment for patients in Bradford-on-Avon Hospital Structures and strategy for clinical audit and effectiveness HR, education and training, information management and technology services

"They highlight areas where we have not provided the level of service our patients have the right to expect and where we really need to improve.

"Since the review seven months ago, we have made a number of significant changes. Many of these address the issues raised by the report."

Anna Walker, chief executive of the Commission, said: "Our inspections give patients and the public an independent assessment of whether an NHS organisation is doing all it can to ensure good patient care.

"Staff at the PCT are committed to providing a quality service and many patients, who spoke to the Healthcare Commission, said they were happy with their care."