An increasing number of hospital trusts are moving further away from the Department of Health's high-profile accident and emergency waiting time target.
Department of Health figures for the first three months of 2007-08 reveal trusts are dealing with as few as 86 per cent of patients in major A&E centres in four hours far below the target of 98 per cent.
Three trusts failed to make it into the 90-100 per cent bracket between April and June. During the same period last year all trusts were above 90 per cent. Eight fell within the 90-95 per cent performance range compared with three the previous year.
In the last quarter of 2006-07 this figure was even higher, with 19 trusts seeing 90-94 per cent in four hours.
However, the overall average waiting figure in England is down just 0.1 per cent, to 97.6 per cent, compared with the same period last year. This figure is for major A&E units and does not include minor injuries units and walk-in centres.
NHS Confederation deputy policy director Jo Webber said she did not see the results as a slide towards poor performance.
'There are individual reasons why it is the way it is. It's far better to look at the overall figures, and overall the service is improving,' she said.
Surrey and Sussex Healthcare trust performed worst at 86 per cent. A spokeswoman said the trust's 'throughput of patients' had been improved and last week's figures showed it was at 98.4 per cent.
A Department of Health spokeswoman said: 'If NHS trusts are not delivering the operational standard, it is for the local NHS to ensure performance is addressed.'