Hospitals in Oxfordshire have been placed bottom of a league table by Government officials grading teaching hospitals in the UK.
Results of the Department of Health's new hospital rating system - which awards up to three stars to grade Trust's performances - were announced on Tuesday.
The Oxford Radcliffe Hospitals NHS Trust (ORH), which is responsible for Oxford's John Radcliffe, Churchill, and Radcliffe Infirmary, and The Horton in Banbury, received no stars.
Although managers reached five targets out of the nine measured by the Government, they were criticised because they "significantly under-achieved" on three and under-achieved on one.
The rating system compared the performance from January to March this year of 25 'teaching trusts' - large hospitals where doctors are trained.
The ORH was one of only two to receive no stars. The other was United Bristol Healthcare NHS Trust.
The rating system was based on the hospitals' performance in key areas.
The ORH has since implemented a range of measures aimed at improving its performance and conditions inside its hospitals.
Publishing the tables, Health Secretary Alan Milburn said England's 35 best trusts would be given greater freedom to lead improvements across the health service. Hospitals awarded top ratings would be granted a new set of rewards, with fewer inspections from the Government's health watchdog.
They would be allowed to invest in other companies or set up their own ventures, while ploughing the profits back into the NHS.
Those named and shamed as the worst performers, of which Mr Milburn said "there are no surprises", would be given a strict deadline to improve within months.
If they failed, trouble-shooting managers from the best trusts would be able to compete for the franchise to turn them around.
The ORH was commended for the low numbers of people waiting to be admitted to hospital for treatment, and for the short waiting times before they had an appointment. Its pioneering two-week waiting system for breast cancer outpatient appointments, the way it treated its staff and its financial performance were also praised.
But the trust under-achieved on cleanliness, after an inspection team said the hospitals' environment needed improving . It also significantly under-achieved on cancelled operations and on casualty trolley waits - too many patients on trolleys were forced to wait more than 12 hours to be admitted to a hospital bed. The number of people on its outpatient waiting list was also said to be too high.
ORH chief executive David Highton said: "We welcome this exercise, which shows the public where we do well, and where we need to improve.
"It is no great secret that the emergency care system in Oxfordshire has been under pressure for some time and that patients suffer as a result.
"We have seen evidence of this at various times during the past year. We acknowledged at the time that these standards were far from ideal, and have put in place a wide range of both short and long-term measures to improve our services.
"These include a mixture of initiatives designed to increase the number of beds and the way in which they are used. We have also just launched a £20m critical care redevelopment, which will improve conditions for both staff and patients.
"The trust has very skilled and dedicated staff who provide excellent quality of care for patients.
"We are all concerned at our shortcomings, and determined to put things right. I have already seen some signs that we may be turning the corner. By continuing to work hard together, I am confident that we can improve our performance."
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