New league tables rating the performance of NHS trusts in England have been published for the first time, with specialist hospitals taking the top slots.

Number one is Moorfields Eye Hospital NHS Foundation Trust, followed by the Royal National Orthopaedic Hospital NHS Trust and cancer centre the Christie NHS Foundation Trust.

At the bottom is Queen Elizabeth Hospital in King’s Lynn, which has had major problems with its buildings because of structural weaknesses and the need for props to hold up ceilings.

Health Secretary Wes Streeting defended the tables as a tool for helping to inform the public and let them exercise choice, while trusts questioned their usability and the metrics employed.

Trusts in England will be ranked every three months – with the top performers given more power over how they spend their money and those lower down encouraged to learn from the best trusts and receive support from national officials.

The rankings score NHS trusts on seven different areas including waiting times for operations, cancer treatment, time spent in A&E and ambulance response times. Performance levels are calculated based on data submitted by the trusts.

Their finances are also assessed, and it is possible that a hospital rated highly for clinical care will be marked down if they are running up a larger than expected deficit.

The trusts are then sorted into four categories called segments, with the best overall performers in segment one and the worst in segment four.

Trusts experiencing financial difficulties cannot be ranked higher than segment three, even if they are assessed to have a good standard of care.

Within each segment, the trusts are ranked by their average metric scores, and the lower each score, the better the ranking.

The public will be able to use the league tables to check the performance of their local hospital, ambulance service or mental health trust.

Moorfields in London tops the list of trusts with an overall score of 1.39, while the Queen Elizabeth Hospital comes bottom with 3.35.

A spokesperson for the Queen Elizabeth Hospital said: “Our patients deserve the highest standards of care, and we are sorry that in some of our performance areas… we have fallen short. Immediate steps are being taken to address the issues.”

The Countess of Chester hospital, in north-west England, came second to last. The hospital had its emergency services department rated inadequate by the Care Quality Commission last month.

Streeting accused health think tanks of “elitist nonsense” after claims that the new league tables in England would be difficult to interpret.

Another criticism has been that managers will try to game the system to improve rankings, for example on financial performance, which will skew the tables.

Speaking on BBC Radio 4’s Today programme, Streeting said: “Basically what a bunch of very well-informed researchers are saying is they can have access to all the data points, they know what’s going on, they’re qualified to make judgements about these data points, but Joe Public aren’t.

“I’m sorry, that is elitist nonsense. I want patients to know, and staff to know, what is actually going on in terms of the performance of the trust that serves them or the trust that they work in.”

Saray Woolnough, chief executive of the Kings Fund, denied there was elitism.

“These league tables don’t tell you in simple terms if a hospital is performing well or badly,” she argued.

“We are all for more information in the public domain to help people understand how the health service is performing and to make choices about where they receive treatment.

“But it’s not elitist to say these rankings risk confusing people, rather than helping them choose where to get great care.”

NHS Providers, which represents trusts, said there were questions over whether the league tables were accurately identifying the best performing organisations.

Chief executive Daniel Elkeles said: “For league tables to really drive up standards, tackle variations in care, and boost transparency, they need to measure the right things, be based on accurate, clear and objective data and avoid measuring what isn’t in individual providers’ gift to improve.”

He added that anything less could have unintended consequences that might affect patients’ confidence in their local health services.

Thea Stein, chief executive of the Nuffield Trust think tank, said it was understandable that the government was focussed on winning back public trust but there was a risk that trusts would focus only on the measures that immediately boost their ranking, even if it’s not necessarily best for patients”.

“As finances have a particular sway on the rankings, this is of limited use for patients trying to choose the best hospital for their care,” she added.

June Kelly, 63, a retired NHS midwife who used to work for North Staffordshire NHS trust in Stoke, got in touch via Your Voice, Your BBC News, to say the new rankings were “not fair or comprehensive” and felt “demoralising for staff”.

“Specialist hospitals at the top of the list is not surprising at all,” she said.

“They only have limited conditions and diagnosis to deal with. You are not comparing like for like.

“There are so many issues to take into account: size of hospital, demographics, population, wealth, degree of poverty, drug issues, non-English speaking patients, staffing levels.

“It is so much harder to provide excellence for a general hospital who take all and every emergency than for a hospital that concentrates on one specialty with controlled admissions.”

Chris McCann from Healthwatch England said any league table must inform instead of confuse people.

“It will be essential that the new dashboard clearly communicates the information that is most important to patients and that it is as accessible as possible,” he said.

The Department of Health said that from next year the best performing trusts would have more freedom to develop services around local needs while those underperforming would receive “enhanced support” but their bosses could also have pay reduced.

The highest rated leaders would be offered bigger pay packets in exchange for attempting to turn around struggling trusts.

From next summer, the tables would be expanded to cover integrated care boards, which are responsible for planning health services at a local level.

Streeting singled out for praise Northumbria Healthcare NHS Foundation Trust, which was the highest ranking non-specialist NHS trust and ninth overall.

He said the trust had been able to integrate its A&E response with community services so people could receive care at home, keeping appointments free for planned operations and procedures.