The credibility of the government's foundation hospital plan is under question, after a number of trusts saw their performance slip considerably over just 12 months.

Three of the new foundation trusts saw their ratings fall from three stars to two for allegedly poor financial management.

A further two trusts went from no stars a year ago to three stars today, while one fell from three stars to none.

"How can anyone have confidence in a system of measurement where hospitals oscillate from one end of the table to the other over a 12-month period?" asked professor of health management at Durham University, David Hunter.