The Healthcare Commission said standards at York Hospital were 'excellent' in both use of resources and quality of services.

But troubled North Yorkshire and York Primary Care Trust received a damning verdict, being rated 'weak' in both categories during 2007/8.

The report said: 'The PCT provided a weak quality of service to patients, and failed to maintain the adequate standard of performance it achieved the previous year.'

The document revealed the Healthcare Commission downgraded the trust on four out of five ratings after investigating its score declarations during a summer visit.

Financially, the PCT remains 'weak', despite managing to claw back £13 million of its £32 million debt and hitting cash targets during the past two years.

The report added: 'It's financial management was poor. However, the organisation has at least met the basic requirements in all others areas of this category, with it's financial reporting found to be good."

PCT chief executive Janet Soo-Chung (left) quit her role this week, but officials at the cash-strapped trust have refused to comment on whether her departure was linked to the poor performance.

Trust performance director Bill Redlin said the organisation was "disappointed" with the report's findings, but vowed to make improvements during 2008/9.

He added: "While we acknowledge the result, it's important to highlight the ongoing hard work of staff, who are delivering high quality frontline services."

The Local Medical Committee has expressed "deep regret" at Dr Soo-Chung's decision to stand down.

Chairman Dr John Compton said: "Her departure is a loss for health services in North Yorkshire. We believe she showed high levels of insight and integrity, and worked very hard for the area."