Hospitals Lose Elite Status

Worth A Look, Healthcare & Welfare, Frontier Centre

The full hospital league tables:

The number of top performing “three star” hospitals in England has fallen for the first time since league tables were introduced because so many are failing to balance their books.

More than 20 hospital trusts achieved “below average” scores for tackling the MRSA superbug, but one in three is running deficits which contributed to the NHS overspending its budget last year by £500 million.

The figures are revealed today by the hospitals inspectorate, which said many hospitals were demoted for financial reasons or for failing to treat patients in accident and emergency within four hours.

Among those which lost the coveted three-star status was King’s College Hospital, London, which fell to two stars for missing financial targets.

It also under-performed on targets which state that patients with possible breast cancer must be seen within two months of a GP referral.

Hospital trusts in West Suffolk and South Warwickshire fell from three stars to one star, while Hammersmith, Bedford and Bromley fell from three to two and Epsom and St Helier from two to one.

Hospitals which received no stars included the Royal Free in Hampstead, north London, which was recently praised for treating 61 casualties after the July 7 bus and train bombings, Mid Yorkshire and North Middlesex.

In a statement, the Royal Free claimed that, if assessed today, it would have two stars. It said the main areas where it fell down were finance, the four-hour target for A&E and “the state of repair of two of the lavatories across our three hospitals”.

Chelsea and Westminster Hospital rose from one star to three stars, after scoring highly on patient and clinical care and financial management, while Mayday Healthcare in Croydon rose from two to three stars.

The league tables show that many hospitals are meeting waiting times for operations and achieving fewer deaths from cancer and heart disease.

But 138 out of 590 NHS trusts failed to break even, 72 out of 303 primary care trusts (GP, dentist and mental health services) failed to balance their books and one in three acute hospital trusts (59 out of 173) overspent.

Anna Walker, the chief executive of the Healthcare Commission, which publishes the tables, said the overspend figure of £500 million accounted for less than one per cent of the NHS’s £69.7 billion budget.

But the issue was being taken very seriously because patient care was at risk if large deficits remained.

She also had particular concerns about the performance of trusts in south-east England – an affluent region with fewer health problems than more deprived areas of the North. One of the hospitals highlighted as among this year’s worst performers was Surrey and Sussex Healthcare NHS Trust, which failed a number of key targets including financial management and A&E targets and was awarded zero stars.

Brighton and Sussex University Hospitals NHS Trust was again given no stars, failing on waiting times and financial management.

Earlier this month the trust’s Royal Sussex County Hospital featured in a Panorama undercover investigation showing a series of failures in care for the elderly.

In one scene, a patient was left to die on her own, and in another a patient was left waiting hours to go to the lavatory.

The league tables show a rise in the number of NHS trusts – as opposed to hospital trusts – with three stars, up 19 from 146 to 165. There was also a fall in the number of trusts with no stars, down 11 from 35 to 24. The number of three-star hospital trusts fell from 61 to 58.

For the first nine months of the year, all hospital trusts met the target of 90 per cent of patients waiting less than four hours in A&E.

But when the bar was raised to 98 per cent for the last three months of the year, 62 out of 159 trusts with A&E departments failed.

Around 28 trusts achieved above average scores for tackling MRSA while 21 achieved below average scores. The number of MRSA cases in hospital fell from 7,684 in 2003-4 to 7,215 in 2004-5.

The star ratings system has been condemned as too simplistic by critics and next year the inspectorate will rate trusts with an annual health check – a four-point scale ranging from excellent to weak.