The failing trusts

Ashford & St Peter's Hospitals NHS Trust Barnet & Chase Farm Hospitals NHS Trust Brighton Health Care NHS Trust Dartford & Gravesham NHS Trust E & N Hertfordshire NHS Trust Medway NHS Trust Oxford Radcliffe Hospital NHS Trust Stoke Mandeville Hospital NHS Trust Portsmouth Hospitals NHS Trust United Bristol Healthcare NHS Trust Walsgrave Hospitals NHS Trust (now University Hospitals of Coventry & Warwickshire NHS Trust) Epsom and St Helier NHS Trust

Health Secretary Alan Milburn said that within the NHS, there were few surprises among the bottom-ranked hospitals.

He said: "Very many of these problems in the poorly-performing hospitals have been very well known for very many years, at least in management circles.

"The very people who have known least have been the patients who have had to use those services."

But Stephen Thornton, head of the NHS Confederation which represents trusts and health authorities, told the BBC: "I'm sure each (of the 12 hospitals with no stars) has a story to tell of their own that explains some of the situation they find themselves in."

Many of the managers who run them are voicing their disappointment at finding themselves at the foot of the table - some said that the figures were old, and that their hospitals were doing much better now.

Hit squads

These management teams are now under threat - they have to turn around their failing hospitals within months or stand back as a "hit squad" is brought in.

Medway NHS Trust in Kent, which runs Medway Hospital in Gillingham, failed to reduce outpatient waiting times and for keeping patients waiting longer than two-weeks for a breast cancer appointment.

Jan Filochowski is disappointed

But Chief Executive Jan Filochowski welcomed the publication of the star rating assessment system saying it was an effective way of driving up performance.

He said: "I am, of course, disappointed that we received a low performance assessment but this relates to the year ending last March.

"Over the past year we have made tremendous strides towards improved patient care and I am absolutely confident we will improve our position further over the coming year.

On the basis of our current performance I am sure we would be assessed as a two or three star trust."

It is no great secret that the emergency care system in Oxfordshire has been under pressure for some time and that patients suffer as a result

David Highton Chief Executive of Oxford Radcliffe NHS Trust

Oxford Radcliffe NHS Trust fell short of targets for reducing outpatient waiting lists, the number of cancelled operations, the number of people waiting on hospital trolleys and also failed in hygiene and catering standards.

Chief Executive David Highton, said: "It is no great secret that the emergency care system in Oxfordshire has been under pressure for some time and that patients suffer as a result.

"We acknowledge that these standards are far from ideal and have put in place a wide range of both short sand long term measures to improve our services.

"These include a mixture of initiatives designed to increase the number of beds and the way in which they are used.

"We have also just launched a �20 million critical care redevelopment which will improve conditions for both staff and patients."

'Particular Challenges'

Stoke Mandeville Hospital NHS Trust significantly underachieved, or underachieved in nine categories.

Chief executive Fiona Wise, who was seconded to the trust in April this year, said: "The trust recognises that the results of today's star ratings reflect poor performance in a number of areas of the hospital.

"But we have already taken a number of important strides forward in improving all but one of the key areas of the hospital's performance in a number of areas in recent months."

The United Bristol Healthcare Trust (UBHT), which runs the Bristol Royal Infirmary, also failed to gain any stars in the ratings.

The trust's biggest failure was not reducing the length of time people waited for breast cancer operations and the number of patients waiting longer than 12 hours on trolleys in A&E.

Chief Executive Hugh Ross said: "It is important to remember that we received this rating on the basis of a very small number of aspects of our overall performance.

"UBHT is one of the largest Trusts in the country.

"As the Secretary of State has personally highlighted, we face particular challenges and issues which are being addressed, but which need long term solutions."

Brighton Healthcare Trust, responsible for the Royal Sussex County hospital, was also criticised for the length of waiting times.

Chief executive Stuart Welling said: "I very much regret that some patients have not been able to access care as quickly as they or we would wish.

"My colleagues and I have been working to address these issues with some success and are committed to turning this situation around."