BOLTON'S hospitals have been given the worst performance rating in the North-west.

In a new government all-star system, the Bolton NHS Hospitals Trust has received one "star" out of three.

It was penalised for having long outpatient waiting lists for women with breast cancer, a high number of cancelled operations and high staff vacancies.

Bolton is the only trust in the region to be given one star.

In contrast, neighbouring Blackburn, Hyndburn and the Ribble Valley Trust has achieved three stars -- the NHS top rating.

The government is now set to take action to improve badly performing trusts but extra cash directed at the Royal Bolton Hospital will only be handed out under strict financial monitoring.

In the North-west, all trusts were given a rating.

No area was deemed bad enough for zero stars, but Bolton was given bottom place.

The ratings have been described as "fair" by independent health watchdogs, the Commission for Health Improvement.

In a damning report last week, it revealed that patients in Bolton faced long delays on hospital trolleys and high death rates of emergency surgery admissions.

Bolton health bosses expressed their "disappointment" over the rating. They say they have achieved seven out of the nine key indicators.

They are blaming a rise in emergency admissions for putting them under pressure.

A hospital spokesman said: "Our rating has been pulled down by a significant under achievement on "last minute" cancelled operations.

"The Royal Bolton Hospital has seen a very high level of emergency admissions and increased length of stays. This meant that at the time the data was collected beds usually designated for people awaiting surgery had to be used for very ill medical patients instead, resulting in cancellations of some operations."

The trust also admitted that "a small number" of women fell outside the 14 day target for outpatient appointments for breast cancer.

Health secretary Alan Milburn today said the all-star system was far from perfect: "They do not mean that a poorly performing hospital has low standards, is unsafe or does not contain some very good clinical services. Staff are often doing a good job but the assessments show that organisational performance does need to improve."

In summer the trust, which manages three hospitals, including Fall Birch and Hulton Lane, revealed it is facing a £3 million cash crisis due to escalating patient pressures and high numbers of staff vacancies.

Poor trusts could be taken over by managers from some of the successful top-star rated hospitals.

Trust chief executive John Brunt said: "This trust has experienced continuing and exceptional growth in emergency admissions in recent years.

"Despite the hard work of staff at all levels, this has resulted in the pressures on services which are reflected in some of the indicators.

"We are working closely with our partners in the health service and social services to respond flexibly and to plan for the future to tackle key areas."

He added: "It is disappointing that the trust has attained one star because of its poor performance on one indicator when we have so many areas of good practice and performance."