WELL DONE! Mental health service goes from zero to hero but Royal is still a one-star hospital

Worcestershire Mental Health Partnership Trust has gone from no stars to three in just a year.

However, Worcestershire Acute Hospitals NHS Trust has failed to improve on its one-star rating from last year.

The mental health trust blamed last year's rating on an administrative error. Now it has been placed in the top quarter of mental health services in the country.

Worcestershire Royal still languishes in the bottom quarter of the league table after the acute trust could do no better than keep its one star.

Targets for cleanliness, financial management, elective patient waiting lists and waits for cancer patients and elective surgery were met, but inspectors found outpatient and accident and emergency waiting times were too long.

There was bad news for bosses at South Worcestershire Primary Care Trust - which runs GP services and community hospitals. It lost a star and was handed a "cause for concern" one-star rating.

Hereford and Worcester Ambulance NHS Trust fell to two stars, Wyre Forest Primary Care Trust fell from three to one and Herefordshire PCT was downgraded from three to two. There was no change at Hereford Hospitals, which scored two stars.

The biggest success in Worcestershire saw the county's mental health trust improve its score from zero to three stars.

Last year an administrative error was blamed by the trust for its low score but chief executive Ros Keeton was delighted with the outcome of this report.

"It's terrific news for all the staff at the trust and the patients and allows us to have a firm footing to take the service onward and upward," she said.

"This is about organisation-wide commitment, everyone understanding the part they play.

"No one, two or three people can ensure the organisation gets three stars, it takes people at virtually every level to contribute."

However not everyone is convinced by the trust's quality. Richard Hazzard, who receives psychiatric help from the trust for his bipolar depression, was disappointed by the three-star rating.

"There are aspects of the trust that are excellent but the majority are of great benefit to staff, not service users," said Mr Hazzard, of Fort Royal Hill, Worcester. "Serious problems are arising due to staff shortages."

Worcestershire Woman of the Year award winner Christine Morgan - a former full-time social worker and a trustee of mental health charity MIND's Worcester branch - was also surprised at the score.

She claimed the trust had sidelined some patients by changing its focus from offering social to medical help.

"It is providing for people with severe and enduring mental illness but I can't see it giving a good service for those without those labels, such as a one-off breakdown, a need for some counselling or to be with people," said Mrs Morgan.

Ms Keeton responded: "We are a specialist health care organisation and also very focused now on providing opportunities for people with mental health problems so they can benefit from community-based resources, rather than just specialist resources.

"However we take all comments we have from our service users very seriously when we get feedback like that and aim to continuously top what we are doing."

l A top consultant has said patients should not judge the quality of care they receive on the star ratings.

The British Medical Association's consultants' committee chairman Dr Paul Miller said new measures to be used next year will be more useful for the public.

He said: "Clearly, the public has a right to know how well its hospitals are performing but patients should not use the star ratings to judge the quality of care they can expect to receive.

"The BMA has long called for a better system that uses fewer targets and gives patients more useful information.

"We are pleased that the Healthcare Commission is, from next year, introducing new standards to measure hospitals' performance.

HEREFORD HOSPITALS

NHS TRUST

**No change

Improvements included 5,000 more inpatients being treated at Hereford Hospital's accident and emergency department.

Eight per cent more (98 per cent) were dealt with in four hours.

Chief executive David Rose said: "We have reduced the length of time people wait for care and are one of the best performing hospitals in the south Midlands for fast access to emergency care.

"Those who read the Good Hospital Guide will see that we are regarded as one of the most effective hospitals in England in developing day surgery and reducing the length of time people need to spend in hospital.

"Achieving this has been a real team effort.

HEREFORDSHIRE PRIMARY CARE TRUST

**Down One

Weaknesses related to a poor performance in delivering community equipment to patients and in the numbers of staff that have received performance appraisals. Chief executive Paul Bates said: "We are disappointed that even though the PCT achieved all the key indicators and actually achieved higher scores on the balanced scorecard than last year, it has nevertheless been awarded one less star.

This still defines the PCT as an organisation which is performing well overall, but means some slight improvements are necessary to get back to the highest level of performance.

MENTAL HEALTH SERVICES, HEREFORDSHIRE PRIMARY CARE TRUST

**Up one

Chief executive Paul Bates said: "We are absolutely delighted that our mental health service has been awarded an additional star, which now places it amongst the services regarded as performing extremely well overall although not quite at the highest level of performance possible.

"The staff have worked extremely hard over the last year and this recognition of their efforts will be a real morale booster.

SOUTH WORCESTERSHIRE PRIMARY CARE TRUST

*Down one

South Worcestershire failed to meet targets for accident and emergency waiting times and outpatient waiting times and was rated 'low' for improving health and service provision.

PCT chairman David Barlow said: "It is always disappointing to lose a performance 'star' after a year of exceptional hard work and commitment from all our staff and I would like to place my thanks for all their efforts.

The trust has proposed closing the Willows specialist stroke unit and Bredon orthopaedic rehabilitation wards at Evesham Community Hospital and some GP services as part of a £4m cost-cutting initiative.

The suggestion prompted a massive campaign and protest march, and will be discussed at Wednesday's trust meeting.

The service passed all four key targets for response times and financial management, but was rated 'low' for patient focus and capacity and capability focus. The ambulance service's downgrading also came despite an increase in trusts being upgraded to three stars. Thirteen out of 31 ambulance services are now three-star rated.

In achieving the two stars, the trust did meet targets of responding to 75 per cent of life-threatening incidents receiving a response within eight minutes.

Chief executive Russell Hamilton said: "I must recognise the hard work and dedication of every member of trust staff and volunteers. I am very pleased that we hit all of our key targets despite the challenge of a major increase in calls.

"However, I am disappointed that given all of our hard work over the last 12 months we were unable to retain our three-star rating. Despite that we are very proud of our work in all areas."

Wyre Forest PCT lost two stars by underachieving against key targets on access to a GP, access to a primary care professional, financial management and accident and emergency waiting times.

Acting chief executive Eamonn Kelly said the drop came as no surprise but claimed that health care in the area was still improving. "The star rating system is very important actually measuring performance across a range of very important areas but I believe if you look at the overall picture, service has got better over the last 12 months," he said.

"In three of the key target areas we have either got there already or are bouncing back. In financial management the PCT had significant financial challenges and they continue but we are getting much closer to resolving those this year or next year.

HEREFORD AND WORCESTER AMBULANCE NHS TRUST

*Down two

South Worcestershire failed to meet targets for accident and emergency waiting times and outpatient waiting times and was rated 'low' for improving health and service provision.

PCT chairman David Barlow said: "It is always disappointing to lose a performance 'star' after a year of exceptional hard work and commitment from all our staff and I would like to place my thanks for all their efforts.

The trust has proposed closing the Willows specialist stroke unit and Bredon orthopaedic rehabilitation wards at Evesham Community Hospital and some GP services as part of a £4m cost-cutting initiative.

The suggestion prompted a massive campaign and protest march, and will be discussed at Wednesday's trust meeting.

The service passed all four key targets for response times and financial management, but was rated 'low' for patient focus and capacity and capability focus. The ambulance service's downgrading also came despite an increase in trusts being upgraded to three stars. Thirteen out of 31 ambulance services are now three-star rated.

In achieving the star, the trust did meet targets of responding to 75 per cent of life-threatening incidents receiving a response within eight minutes.

Chief executive Russell Hamilton said: "I must recognise the hard work and dedication of every member of trust staff and volunteers. I am very pleased that we hit all of our key targets despite the challenge of a major increase in calls.

"However, I am disappointed that given all of our hard work over the last 12 months we were unable to retain our three star rating. Despite that we are very proud of our work in all areas.

WYRE FOREST PRIMARY CARE TRUST

*Down two

Wyre Forest PCT lost two stars by underachieving against key targets on access to a GP, access to a primary care professional, financial management and accident and emergency waiting times.

Acting chief executive Eamonn Kelly said the drop came as no surprise but claimed that health care in the area was still improving. "The star rating system is very important actually measuring performance across a range of very important areas but I believe if you look at the overall picture, service has got better over the last 12 months," he said.

"In three of the key target areas we have either got there already or are bouncing back. In financial management the PCT had significant financial challenges and they continue but we are getting much closer to resolving those this year or next year.

WORCESTERSHIRE Royal has failed to improve its official star rating over the last year, it is revealed today.

Worcestershire Acute Hos-pitals NHS Trust, which runs the hospital, remains in the bottom quarter of the league table after scoring just one out of three stars.

Inspectors from the Healthcare Commission, who-se job is to rate hospitals, found that outpatient waiting lists and admission times for accident and emergency were too long.

But the hospital passed on six out of eight of the key targets, which the Healthcare Commission said were getting tougher each year. Targets for cleanliness, elective patient waiting lists, maximum two-week waits for cancer patients and outpatient and elective booking were all met. And despite having the third worst hospital debt in the country with a £23.8m deficit, the trust also met financial targets this year, achieving an end-of-year surplus of £2,000.

But the hospital failed to raise its overall score above one star, placing it in the bottom 27 per cent in England, along with 37 other trusts. Another nine acute trusts failed to score any stars.

Anna Walker, chief executive of the Healthcare Comm-ission, made clear that trusts with one star or less would not be tolerated.

She said: "There are still unacceptably wide variations in performance and more one and zero star trusts than there should be.

"More has to be done to bring the poor-performing organisations up to the standards of the best."

Trust chairman Michael O'Riordan said staff were to be congratulated on their efforts of the past year, but warned that areas where action needed to be taken quickly had been highlighted.

"No one should underestimate what we achieved in the delivery of care to our patients, but there is no room for complacency," he said. "It is clear that in the way we deliver some of our services we are letting our patients, and ourselves, down.

"In one area where we fell just short of the mark at the end of March - A&E waiting times - we are now routinely hitting the target of treating, admitting or discharging 98 per cent of patients within four hours of their arrival.

"Unfortunately we did not sustain that performance during the monitoring period.

"Another key target which was missed was maximum outpatient waiting times, following problems with a computer system which resulted in a number of patients not being offered an appointment in time. This too has now been resolved - but it is nevertheless a problem which could have been avoided.

"We have outstanding staff and excellent facilities - we have to look carefully at how our services are provided to make sure that we deliver safe, affordable care of the highest possible standard.

My son was hit but A&E helped him

John Williams was impressed with the care his son Sam received when the 16-year-old was admitted to accident and emergency at Worcestershire Royal Hospital.

The hospital was penalised in the star ratings because A&E waiting times fell short of Government targets, but Mr Williams said Sam's experience was a very positive one.

"He was seen quite rapidly and everything was done within an hour," said John, whose son was punched in the eye during an unprovoked attack.

"It was a Bank Holiday Monday night so I didn't expect it to be too busy but it was quite a good job and was very efficient.

Quality of care will be even better says chief

BOSSES at Worcestershire Acute Hospitals Trust have said work already under way to improve the quality of care will be given even greater impetus following this year's national performance ratings.

As the Healthcare Comm-ission today confirmed that Worcestershire Acute Hosp-itals NHS Trust had maintained its one star, trust chief executive John Rostill said: "The report highlights some of the achievements of our hard-working and dedicated staff - we hit six of the eight key targets.

"I am disappointed that, in what will be the last year of the current rating system, we did not manage to gain an extra star. However, we can take some consolation from the fact that progress had to be made for us to keep our star.

"No one should underestimate the effort that went into balancing our books while at the same time treating record numbers of patients - and delivering that treatment more quickly than ever.

"The new assessment system which the Healthcare Comm-ission is bringing in next year offers a new way of measuring the quality of hospital services. We have now turned our attention to the draft declaration for October.