Figures out today paint a revealing snapshot of the North's NHS service. The independently compiled survey shows that there is still a wide disparity between services. Barry Nelson reports

POOR financial management at one of the region's ambulance services has helped to earn it a zero score in this year's extended NHS performance ratings.

The shock demotion of Tees, East and North Yorkshire Ambulance Service (Tenyas) from a satisfactory two-star rating last year to a zero score was one of a small number of under-par performances in the region's NHS services, which otherwise performed well.

Apart from financial problems, the ambulance trust, which is based in York and covers much of Teesside and North Yorkshire, was also penalised for narrowly missing a performance target.

Tenyas reached 74 per cent of category A life-threatening calls within eight minutes, missing the 75 per cent target.

In contrast, the North East Ambulance Service, which covers County Durham, Tyneside and Wearside, retained three stars.

Tenyas trust chief executive Jayne Barnes said paramedics are now reaching 74.8 per cent of category A call-outs.

Mrs Barnes said extra cash had been needed to meet a "sharp rise" in the trust's activity, and work was in progress to resolve the problem.

A one-star rating was given to Prime Minister Tony Blair's local primary care organisation in Sedgefield, County Durham, the only single-star Primary Care Trust (PCT) in the region other than the Hambleton and Richmondshire trust.

Sedgefield PCT was marked down because only 58.4 per cent of patients could get an appointment with a GP within two working days, well under the target of 87.5 per cent.

Alan Gray, chairman of Sedgefield PCT, said local GPs are taking action to improve access to doctors.

While more English hospitals than ever before have achieved a three-star rating, which entitles them to be considered for controversial foundation hospital status, at least one major North-East hospital has slipped back to two stars.

The flagship Newcastle trust, which includes the Royal Victoria Infirmary, Newcastle General Hospital and the Freeman Hospital, was rated as three stars last year, but has been penalised for readmitting too many patients as emergencies.

Last night, the Newcastle trust's 22 clinical directors challenged the ratings assessment, and said they had been penalised because of their insistence on treating patients in order of clinical need.

One trust, which was at the centre of a controversy about manipulation of waiting lists, Scarborough and North-East Yorkshire, dropped from two stars to one.

Three-star performers among the region's PCTs included Durham and Chester-le-Street, Craven and Harrogate, and Selby and York. All other PCTs were given two.

Three-star trusts, which stay on course to become foundation hospitals, include Gateshead, Harrogate, York, and North Tees and Hartlepool.

South Tyneside has joined the ranks of three-star trusts. After going down to two stars last year, the trust has regained its coveted third star.

The Middlesbrough trust, which includes James Cook University Hospital, received a two-star rating, along with the County Durham and Darlington trust.

Three-star ratings were given to mental health trusts in Teesside and North Yorkshire, the rest received two stars, apart from the Newcastle mental health trust, which received one.

The ratings were compiled by the Commission for Health Improvement, an independent body set up by the Government to monitor performance within the NHS.