Since 2002 the number of healthcare organisations across the Midlands awarded a three or two star rating has almost doubled.
Back then primary care services were struggling while acute hospital trusts were basking in the glory of their three star ratings.
But the last round of performance ratings published by the Healthcare Commission today has revealed services and facilities at all levels have continued to improve.
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How did Midland hospitals fare? Click the link below to view the ratings:
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This system will be replaced by a new annual "health check", a four-point scale from excellent to weak, which the Healthcare Commission said would be less target driven.
Nine hospital and primary care trusts were awarded three stars - the highest level of performance - and 14 received two stars, while five were named as one star organisations within the Birmingham and Black Country Strategic Health Authority region.
The top rated hospital trusts are Birmingham Children's Hospital, Dudley Group of Hospitals, Heart of England NHS Foundation Trust, Royal Orthopaedic Hospital and University Hospital of Birmingham NHS Foundation Trust.
Other success stories included Wolverhampton City PCT's mental health services which have improved from zero stars to attaining three star status.
The Royal Wolverhampton Hospitals NHS Trust was stripped of a star, to make it a one-star organisation - which means it has not performed well across key targets. It has accumulated debts of nearly #8 million, which could top more than #30 million by 2008, even if it makes projected savings of #20 million.
Tom Taylor, deputy chief executive of the SHA, said other trusts were demoted as a result of "tiny deficits."
He said: "The two trusts whose results I'm disappointed with are West Midlands Ambulance Service and the Birmingham Women's Hospital, because their tiny deficits have resulted in them losing a star.
" Royal Wolverhampton Hospitals have got their problems, but they've got their new board and management, and we've told them to concentrate on getting back into recurrent balance rather than focus on their historic deficit.
"Despite losing a star, in all other clinical areas the trust is in the top band nationally."
He added: "However, we would not describe one-star trusts as failing trusts, because we want them to recover.
"At the same time we would like to see more three star trusts, which could go forward to apply for foundation status. But we have no zero star organisations this year, which I think shows significant improvement."
Today's figures revealed that University Hospital Birmingham NHS Foundation Trust retained its top flight status for a fourth successive year.
John Charlton, the trust's chairman, said: "This is a pleasing result and it is further testimony to the skill and dedication of our 6,550 staff.
"We managed to achieve the highest ranking in each of the key target areas and we were placed in the top band of performance in each focus area."
Heart of England NHS Foundation Trust, which runs Heartlands and Solihull Hospitals, retained its three-star rating for a third consecutive year - after reducing its MRSA rates.
It is welcome news after an undercover Panorama reporter highlighted how contract cleaners were not doing their job at Heartlands.
Clive Wilkinson, the trust's chairman, said: "We've worked hard to reduce our MRSA rates and meet national targets.
"However, we're not going to be complacent and we're looking at areas where we can make further improvements."
