21 hospital trusts fail value for money test

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But overall, the report said the NHS in London has made major financial improvements since last year, recording a £92 million surplus.

Steve Bundred, chief executive of the Commission, said: "There is a worrying gap between the top performers and those still failing to meet their duty to balance the books."

Investigators looked at value for money, financial management and debt before awarding a score between one and four, where one is "inadequate".

Six of these, including Barking, Havering & Redbridge NHS Trust where the chief executive resigned after debts reached £34million, were failing on all three measures.

Mike Penning, Tory health spokesman for London, said: "Londoners simply won't believe that after putting billions of pounds into the NHS so much is still failing financially.

"Part of the failure is because they are getting a very bad deal on funding, but others are failing because of useless management."

Nationally, the health service is projecting a £1billion surplus after a year of aggressive cuts reduced a debt of £547million.

Among the London trusts rated "inadequate" were Barnet and Chase Farm Hospitals Trust, Bromley Hospitals NHS Trust, Whipps Cross University Hospitals Trust and Hillingdon primary care trust, which faced the highest deficit in the country at £53m.

The report also showed trusts performing well above expectations, including Barking & Dagenham primary care trust and Bromley primary care trust.

HEALTH AUDIT

Worst in London*

Barking, Havering and Redbridge Hospitals NHS Trust - £16.8M (Deficit 06-07)
Bexley Care Trust - £8.65m
Enfield Primary Care Trust - £10.67m
Hillingdon Primary Care Trust - £52m
Hounslow Primary Care Trust - £12.9m
Kingston Primary Care Trust - £21m

Best in London**

Barking and Dagenham Primary Care Trust - £4.67m (Surplus 06-07)
Bromley Primary Care Trust - £315,000

*Among 27 nationally scoring lowest on three key financial measures inc value for money
**Among only five trusts nationally given a top "four" overall

Source of figures: Department of Health