York Hospital has lost its place as one of the best-rated hospitals in the country over cleanliness and bed-blocking.

This means that hopes of it becoming one of the Government's flagship foundation trusts have been dashed.

The Healthcare Commission awarded York Hospitals NHS Trust only two stars in its annual performance ratings - the first time York has fallen below three stars in as many years.

The trust needed three stars to press ahead with its bid for foundation status, which attracted the support of more than 14,000 people.

Although eight out of nine targets were met, hospital cleanliness failed to meet its target.

But Mike Proctor, director of nursing at the trust, said poor performance in areas such as bed-blocking, which fell within the targets, had also prevented the trust scoring three stars.

Mr Proctor accepted there was work to be done, but he said there was also much to be proud of. "The standards are harder to achieve every year," he said.

"Patients have a right to expect their hospital to be clean and we don't feel at the moment that the hospital is clean enough for the patients and its staff."

But he said cleanliness was near the top if not at the top of the list for Jim Easton, chief executive of the trust.

"We are performing better in many areas, especially in relation to waiting times. For example, no patient now waits longer than nine months for surgery."

Mr Proctor said the failed bid for foundation status would not affect the trust's commitment to improving services.

"We're disappointed, but not devastated," he said. "There are 14,000 people wanting to take an active role in the hospital and the challenge now is to keep those people interested and involved."

The trust plans to install staff on wards specifically to watch over cleanliness, work closely with contractors and to refurbish.

The NHS performance ratings system places performance into one of four categories, ranging from three stars, reflecting the highest level, to a rating of zero stars, reflecting poorest levels of performance.

Hospitals were tested in key performance areas, including emergency waits in casualty, cancelled operations, financial management, cleanliness, staff working conditions, inpatient and outpatient waiting times, total time spent in Accident and Emergency and waits for cancer treatment.

Selby and York Primary Care Trust scored three stars for the second year running and Tees East & North Yorkshire Ambulance Service gained one star, after scoring nil last year.

Jayne Barnes, chief executive of the ambulance service, said: "We are very pleased, since the latest ratings show we have made a steady improvement. This is most heartening, and something upon which to build. It clearly indicates we are now very much on the right track and it is what we had hoped for."

Health Care Commission star ratings

Last year's rating in parentheses

York Hospitals NHS Trust 2 (3)

Harrogate Healthcare Trust 3 (3)

Scarborough and North East Yorkshire NHS Trust 2 (1)

Craven Harrogate & Rural District Primary Care Trust 3 (3)

Selby and York Primary Care Trust 3 (3)

Scarborough, Whitby and Ryedale Primary Care Trust 3 (2)

Hull & East Riding Community Health NHS Trust 2 (2)

Tees East & North Yorkshire Ambulance Service NHS Trust 1 (0)

Hambleton and Richmondshire Primary Care Trust 2 (1)

Updated: 10:21 Wednesday, July 21, 2004