City hospitals are failing

Brighton and Sussex University Hospitals NHS Trust has failed to hit Government targets on 12 hour waits in accident and emergency departments, cancelled operations and bed-blocking patients.

The trust has been given one star out of a possible three in the annual Government star ratings published today.

This means the Commission for Health Improvement (Chi), which has carried out the audit, feels the trust is showing some cause for concern regarding particular key targets.

The main problems for the trust, which runs major hospitals in Brighton and Haywards Heath, is getting patients admitted to hospital wards from A&E departments.

This is mainly because of bed blocking patients who are ready to be discharged but no care or nursing home place can be found for them.

This has a knock-on effect on cancelled operation rates and finding beds for patients waiting in A&E.

The trust was formed in April 2002 following the merger of the former Brighton Health Care and Mid Sussex trusts.

Brighton was given two stars last year while Mid Sussex had a one star rating.

Sussex Ambulance Service dropped from two stars last year to one.

Primary Care Trusts, which are responsible for managing NHS budgets, GP and dental services and public health, were rated for the first time this year along with South Downs Health NHS Trust, which is responsible for mental health and community services.

Brighton and Hove City PCT was given two stars while Sussex Downs and Weald, which is responsible for services in the Lewes District and north Wealden area, got one.

South Downs Health kept its two star rating from last year.

The annual ratings are based on a range of performance indicators including financial management, clinical care, patient access and care and staff relations.

Targets for ambulance trusts include response times while PCTS are assessed in areas including waiting times, smoking cessation services and access to GPS.

Brighton and Sussex chief executive Stuart Welling said: "The first year of a brand new organisation is bound to be difficult. I would have liked us to have achieved two stars but the pressures on our hospitals have been significant.

"An increase in the number of seriously ill patients and the high number of delayed discharges has made achievement of some of the targets difficult.

"The rating doesn't reflect all the many efforts that our staff made in this first year. However, I know that local people are very appreciative of those efforts.

"I believe that we will continue to improve as the new trust develops and I would like to see us achieve three star status in the next two years."

The trust managed to hit its financial targets and got the highest possible rating for its hospital food.

Earlier this year the trust introduced a meet and treat initiative at the Royal Sussex County Hospital A&E department in Brighton as part of a drive to improve waiting times.

The successful pilot scheme involved all patients not arriving by ambulance being seen within 15 minutes by a senior nurse who would either treat them, refer them to a hospital or send them to their GP.

Two stars for Brighton and Hove City PCT means that the organisation is meeting the majority of its targets set by the Government to improve services, such as ensuring that waiting times for treatment or appointments are falling and that minimum standards of care are being met.

Further improvements need to be made in a number of areas, particularly in cutting waiting times for accident and emergency.

PCT chief executive Gary Needle said: "It is excellent news that CHI has recognised the effort that is being made to improve health and care services for the city and to improve the overall health of the population too.

"Being awarded two stars means we have achieved a lot, but we must not be complacent. There is much more to be done, and the challenges will get tougher year after year.

"People in Brighton and Hove have said time and again that long waits for treatment and for appointments are the most important issue to be tackled. For inpatient surgery or appointments with consultants or GPs these are getting shorter.

"We now need to keep up that momentum, particularly in A&E and in ensuring that patients dont spend longer than they need to in hospital. There wont be an overnight solution to these issues, but we are making progress."

South Downs Health performed well in areas including better hospital food and meeting standards of privacy and dignity but does not have a fully operational assertive outreach team for people with the most severe mental health problems.

There have been mixed fortunes for other hospitals in Sussex.

The specialist Queen Victoria Hospital in East Grinstead has kept its maximum three stars which means it can continue its plans to achieve controversial foundation hospital status and have more freedom from Whitehall.

East Sussex Hospitals was given two stars along with St Richard's Hospital in Chichester while Worthing and Southlands and Surrey and Sussex Healthcare, which runs Crawley Hospital, were given one star.

Health Secretary John Reid said: "The purpose of this exercise is not to condemn or shame those trusts who fail to make the grade on any particular indicator but to help them overcome local difficulties and offer better services for patients in the future."

British Medical Association chairman James Johnson said nobody should use star ratings to judge how well a hospitals was doing and was unfair on low-rated trusts as it affected public confidence in them.