MORE than a third of hospital trusts in England are failing to balance their books, an NHS watchdog reported.

The Healthcare Commission, which has just published its annual star ratings, said that about 35% of acute trusts did not meet their target to break even by the end of the financial year.

Overall, a quarter - 138 out of 590 - of acute, mental health, ambulance and primary care trusts failed to meet the key financial target.

The commission said this resulted in a total overspend by trusts of almost £500m - less than 1% of the NHS's total budget of £69.7bn.

Commission chief executive Anna Walker said that despite the overspend accounting for only a small proportion of the NHS budget, the issue was being taken very seriously because patient care was at risk if trust had large deficits.

The 2004/05 star ratings also revealed that hospitals were struggling to meet tough targets in Accident and Emergency departments, which state that patients should be treated in under four hours.