Published: 28/07/2005, Volume II5, No. 5966 Page 7

A trust that went from two to zero stars said it fell down on finance, accident and emergency targets and the state of two toilets.

Royal Free Hampstead trust said it had been working hard to improve, and believed that if it was assessed on today's performance it would still have two stars.

A trust statement: 'The three areas where we fell down were finance, the four-hour A&E target and the state of two lavatories across our three hospitals.' North Middlesex University Hospital trust also fell from two stars to zero. Chief executive Clare Panniker said the trust had 'gone through an unprecedented time' and was hoping demands would 'slow down'.

She said many financial problems would have been resolved if payment by results had not been delayed. 'If payment by results had been fully implemented this year then our reference costs would have rectified this issue.' Ms Panniker said the trust had faced a series of 'unprecedented' challenges, with the consultant contract and the European workingtime directive. 'What We have achieved is phenomenal, and soon some of these demands will slow down'.