Patient care could be at risk because health chiefs have managed their finances so poorly in recent years, an alarming report warns today.

NHS Hounslow (formerly Hounslow PCT) scored one out of a possible four points for its overall use of resources in the Audit Commission's annual survey, published on Thursday.

It is the third year running the trust, which is responsible for healthcare across the borough, has failed to meet the 'minimum requirements' when it comes to managing cash.

Michael O'Higgins, chairman of the Audit Commission, said: "Poor financial management can put services for patients at risk. Patients and the public deserve better from the poor performers, who must learn from the strong performers."

NHS Hounslow was one of seven trusts in London to automatically receive the lowest rating in the Auditors' Local Evaluation report because of the historic debt they have built up.

NHS Hounslow began the financial year s22million in the red but a spokeswoman for the trust said it had already wiped s3.8m off that figure over the last six months and was on course to break even this year having agreed a three-year turnaround plan with its bosses at NHS London earlier this year.

A spokesman for the Audit Commission, an independent watchdog for public services, said poor financial management could lead to anything from trusts being unable to afford drugs to hospitals having to close wards.