Wiltshire Ambulance Service NHS Trust failed to answer 75 per cent of Category A emergency calls within eight minutes.
The ambulance service met only one of the four key targets set by the Government.
West Wiltshire Primary Care Trust failed to meet three of the nine key targets.
Bath's Royal United Hospital failed to meet five of the nine targets.
Kennet and North Wiltshire PCT failed to meet four of the key targets.
Of the 304 PCTS in England 45 were awarded three stars; 22 received no stars.
Ten out of 31 ambulance trusts received three stars. Five were given a zero stars rating.
Fourteen out of 88 mental health trusts received three stars. Three received no stars.
Four trusts were downgraded from three stars to two.
Fourteen hospitals received a zero stars rating an increase of four from last year.
Fifty-three out of 176 acute hospitals were awarded three stars, up from 45 in 2002.
Figures were compiled by the independent watchdog, the Commission for Health Improvement (CHI).
Ratings were first published in 1999.
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