This year will be the last time heath trusts get star ratings

East Midlands Ambulance Service (EMAS) serving Notts, Leics, Rutland and Derbys saw its star rating fall from two to one in tables out on Wednesday.

EMAS said last year it was recruiting 140 extra staff in an �11m investment plan to improve its timings, but 12 months on its service has slipped.

There were better scores for ambulance services in Lincs and Northants.

The Lincolnshire Ambulance Service bounced back from a zero last year up to its score of two stars this time.

Northants patients continue to get the best service in the region as the Two Shires Trust received a top mark of three stars - the same as last year. But the county generally performed worse with GP and hospital rankings.

EMAS hit its targets for the most serious life-threatening response times (category A) and financial management.

It is supposed to reach 93% of category B (such as broken bones and burns) patients within 14 minutes in urban areas and 19 minutes in villages, but it only achieved a 71% score.

Only two out of 31 ambulance trusts in the country gave a worse performance.

'Improved overall performance'

Paul Phillips, EMAS chief executive, said "The fact is we are only now in the second year of a three-year PCT investment programme that, over time, will enable us to hit the national targets.

"The extra investment allowed us to improve performance overall and in particular our response to urgent GP admission calls but came too late in the 12-month period to have much impact on the annual figures.

"The public can be assured that we will be doing everything possible to further improve our services. We are confident of achieving an improved position for 2005/06."

The NHS has rated all hospitals, ambulance services and primary care trusts nationally. No East Midlands service received a zero rating. One hospital, one ambulance service and two PCTs were given a score of one.

HOSPITAL TRUST RATINGS THREE STARS: Chesterfield Royal, Derby, Doncaster & Bassetlaw, Northern Lincs & Goole, Nottingham City, QMC (Nottingham), Sherwood Forest, University Hospitals of Leicester TWO STARS: Northampton General, Peterborough & Stamford, United Lincolnshire ONE STAR: Kettering General

Most hospitals in the region were rated two or the top mark of three. Only Kettering Hospital was given a score of one.

University Hospitals Leicester Trust, running the city's three largest hospitals, scored zero two years ago but jumped to a three last year and has maintained the top mark.

Dr Peter Reading, UHL chief executive, said: "We will now continue with our application to become an NHS Foundation Trust next year and will be consulting the public formally on this between August and November."

Primary Care Trusts (PCTs) were ranked on house services such as GP access, stop-smoking services, flu vaccination, teenage pregnancy rates and financial managements.

Five East Midlands PCTs got a top mark of three - Gedling, Mansfield, Newark & Sherwood, North East Lincs and West Lincs.

And two in the south of the region - Daventry and South Northants plus Northamptonshire Heartlands - scored one. Every other PCT in the region scored two.

Star ratings were introduced in 2001, and critics argue they are too crude in analysing heath services.