A Sussex hospital trust was today named as one of the 12 worst in England.
Brighton Health Care NHS Trust was awarded no stars in a national list of 170 acute trusts published for the first time by the Department of Health.
The trust, the biggest in Sussex, runs the Royal Sussex County Hospital, Sussex Eye Hospital, Royal Alexandra Hospital for Sick Children and some services at Brighton General Hospital.
Health Secretary Alan Milburn said the rating meant Brighton had shown some of the "poorest levels of performance" in the country.
The trust's chief executive Stuart Welling now has three months to turn the hospitals' performance around or he could find himself out of a job.
If the trust continues to fail, managers from the best hospitals will compete for the franchise to take over and improve performance.
The trust was ranked on everything from waiting times and staff vacancy rates to patient satisfaction and ward cleanliness.
The trust's worst performing areas were in reducing patient waiting times, seeing patients referred to hospital with breast cancer within two weeks and the number of patients waiting on trolleys in A&E for more than 12 hours.
Mr Welling said today he was committed to achieving further improvements during the next few months.
He said: "These new indicators give the trust the chance to further examine certain aspects of our performance.
"I am naturally disappointed in our performance in some areas but I believe that local people can see the staff we employ are excellent and that the care they deliver is high quality.
"I am under no illusions that the performance of the trust and myself as chief executive is under the harshest spotlight.
"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."
Health Secretary Alan Milburn said: "The patient and the public has a right to know how well different parts of the NHS are performing.
"The key thing is that you do as honest an assessment as possible and crucially take action on the basis of that."
Other ratings announced today were two stars out of a possible three for Eastbourne, Worthing and Southlands and Royal West Sussex trusts - which means they are "performing well overall" but have not reached consistently high standards.
Mid Sussex, Surrey and Sussex and Hastings and Rother trusts were given one star - which means there is "some cause for concern".
The two and one star trusts will receive a share of cash from a £155m Government improvement fund - but will have to account for every penny to managers at the NHS Modernisation Agency.
Hospitals awarded three stars have complete independence over how they spend the cash.
Mr Milburn said: "These tables explode the myth that somehow or other poor performance is linking to serving a poor area first of all.
"Secondly, that lack of money is the root of all evil in the NHS because what you have got, quite remarkably, in very similar areas with very similar hospitals is quite different levels of performance."
Mr Welling said recruitment difficulties were part of the problem the hospital faced when it came to providing services.
He said: The South East is an expensive place to live and we have struggled to fill all our vacancies.
"This means that we find it difficult to always have the appropriate numbers and grades of staff to deliver the number of procedures and treatments that would enable us to meet our target."
The trust says shortage of nursing homes beds in the area also leads to problems getting patients out of hospital once they were well.
Mr Welling said the ratings were based on figures up to March 2001 and since then waiting list times and breast cancer referrals had improved.
He said he was confident he would be able to improve the hospital's performance in the time demanded.
A spokesman for Worthing and Southlands Hospitals NHS Trust said: "We welcome the indicators as a way of improving performance.
"There are areas which can still be improved upon such as waiting list times and staff shortages but on the whole we are satisfied with the rating given."
Eastbourne Hospitals NHS Trust spokesman Janine Bell said: "We clearly have some room for improvement but we are pleased with the rating we received."
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