The head of Ealing Primary Care Trust said he feels disappointed the health authority has not performed better in this year's health check.
The Healthcare Commission has released its annual survey of every health trust in the country and this year awarded Ealing with a 'fair' rating, the same as last year and the year before.
But chief executive Robert Creighton (pictured) said the trust had made a genuine effort to improve its peformance.
He said: "We had taken the view that we were going to aim for a good rating the next time round. We are disappointed not to have acheived a 'good' rating for this year.
"We are pleased to have confirmation of the fact that the services we commission for Ealing residents continue to be satisfactory. It remains our ambition to get a good rating and to keep on moving up."
Mr Creighton said he was proud of the trust meeting targets for reducing MRSA and a 12 out of 12 score for safety and cleanliness.
"These are things that really affect people. We've put a huge amount of effort into these and I'm proud of our acheivements."
The trust peformed less well in its attempts to get people to give up smoking and reduce underage pregnancies.
"We need to put more effort and energy into our overall sexual health strategy. Along with smoking, I would say those are two areas in which we've got strong measures in place. I would be even more disappointed if we did not get a 'good' rating for those next year."
Mr Creighton acknowledged that the trust had failed in meeting targets for patients who had a satisfactory experience with their local health service, but added that particular part of the health check was based on a survey of 403 patients.
"We recognise there is evidence that people are not satisfied with the survices that they are being offered by their GPs. This is something that we need to understand better and address."