A CASH crisis may lead to family doctors coming down a grade in the annual health service star ratings.

Jonathan Himsworth, acting chief executive of the South Huddersfield Primary Care Trust, warned board members that they were likely to lose a star this year.

He said: "The stars will take account of the financial management.

"It's a core target. We may lose a star over that."

The trust, which organises community medical care for patients in the Holme, Colne and Dearne Valleys, earned three stars last year - the highest rating possible.

But the past financial year ended with a £1m cash shortfall, which may impact on its stars in the GP assessments.

On a positive note, the trust noted six projects were underway to improve GP surgeries.

Other achievements included:

* 97% of patients were able to see a family doctor within two working days.

* No patient was waiting more than nine months for hospital treatment at the end of March.

* Only two patients waited more than 21 weeks for an outpatient appointment.