The NHS's plans to meet its multi-million savings targets in Northamptonshire will be among the most difficult to achieve, a national report has found.
It has now been eight months since health chiefs in the county released their Sustainability Transformation Plan (STP) to shake up the way care is delivered by 2020.
The NHS in Northamptonshire needs to change the way it works in order to meet a projected £230 million shortfall from the Government.
But the plans, which include delivering more care from home and reducing A&E admissions were largely criticised for being difficult to understand, for lacking consultation and for the fact consultants were paid £720,000 to help draw them up.
A report by NHS England, looking at the progress of STPs nationwide, states that Northamptonshire's proposals will be among the most difficult to deliver.
It is one of only five STP areas labelled "needs most improvement".
But a spokeswoman for Nene Clinical Commissioning Group, which was behind drawing up the county's proposals, said: "This is the NHS’s first attempt at capturing the combined performance of STP health and care systems. It is not a comment on the performance of STPs to date.
"Rather, it indicates the relative starting points on the road to better care, often driven by a range of historical factors that the NHS and local partners have struggled to resolve."
The report by NHS England rated STP areas on 17 performance indicators from A&E waiting times, to the number of patients waiting 18 weeks or less for hospital referrals to reported cases of MRSA.
NHS England says its STP Progress Dashboard uses a complicated algorithm to give an "initial baseline assessment" of the 44 STPs set up across the country to improve care through collaboration between services.
The report states: "We intend to update the dashboard annually to enable progress to be tracked."