BOLTON NHS Foundation Trust has been singled out as one of the worst five in the country by health watchdog Monitor.

The health watchdog listed 18 trusts that had breached their licence and named five — including Bolton — as the ones with a “history of non-compliance or very severe issues have been ordered to put right the breaches”.

Monitor also named Bolton, the University Hospitals of Morecambe Bay and Tameside Hospital as the three trusts who had been given “legally binding” instructions to rectify their breaches within an agreed timescale.

The other two trusts in the worst five are Sherwood Forest Hospitals, and Kettering General Hospital.

Bolton must create plans to rectify its breaches by the end of July.

The other 13 trusts have been given legally binding undertakings that they will rectify breaches as soon as possible.

Mid Staffordshire NHS Foundation Trust was not included in the 18 worst performing trusts as it has been put under special administration and subject to separate regulatory scrutiny.

Monitor released the information as it announced changes which came into effect from April 1.

Bolton has breached its licence in four main areas — 18-week referral to treatment time targets, C Difficile targets, financial planning, and governance breaches.

It has been given several deadlines to complete different plans and by May 31, must submit a three-year plan to Monitor, which has to include the turnaround plan.

Stephen Hay, managing director of Provider Regulation at Monitor, said it was “not new action”.

He added: “It follows a period of engagement with trusts in which we reviewed their representations and then decided on the appropriate action to take.

“Although the legal basis for our regulatory scrutiny has changed, Monitor continues to apply consistent and robust principles to ensure that foundation trusts are well led and able to provide good quality services for patients on a sustainable basis.”

A spokesperson for the foundation trust added: “Nothing has changed and we will continue to work towards the targets agreed with Monitor.”

Bolton was placed in breach in April last year after failing A&E and 18-week targets.

In August, its risk rating was moved to the most serious level for financial failings and poor governance, after inaccurate reporting left £3.8 million “unaccounted for” and Monitor stepped into the Trust.

Since then, there have been numerous changes in leadership at the Trust, which is currently being led by interim chief executive Antony Sumara — the man who was brought into Mid Staffs to turn the scandal-hit hospital around.

There have also been several independent investigations at the Trust and consultancy firms Deloitte, KPMG and PwC have all carried out reviews.