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Last Updated: Tuesday, 20 July, 2004, 23:14 GMT 00:14 UK
Flagship hospitals lose top stars
This is the fourth year the ratings have been published
Four of the government's flagship hospitals have lost their three star status in this year's NHS ratings.

Another 11 hospitals, which were in line to join them as foundation trusts in October, also failed to secure the top rating.

But the NHS watchdog the Healthcare Commission, which awards the stars, said overall the health service in England is improving.

Critics said the hotel-style ratings were meaningless.

The commission assessed every hospital, ambulance and primary care trust in England.

It examined how well they are doing against key government targets, such as waiting times and cleanliness.

The commission told the NHS in December which targets would be used to draw up this year's star ratings.

Each trust was awarded between zero and three stars - the worst received zero while the best received three.

Overall, more trusts have been given three stars than in previous years. These include 74 acute hospitals, 10 ambulance trusts, 15 mental healthcare providers and 44 primary care trusts.

Foundation trusts that slipped
Addenbrookes Hospital
Moorfield's Eye Hospital
Papworth Hospital
Peterborough Hospital

However, 35 organisations received zero stars. These include 10 acute hospitals, four ambulance trusts, seven mental health providers and 14 primary care trusts.

The trusts lost a star if they failed to achieve the government's key targets.

Hospitals, for instance, lost stars if they didn't balance their books or were unable to treat patients quickly enough.

Ambulances were docked marks if they failed to respond to 999 calls quickly enough, while primary care trusts were downgraded if patients were unable to see a GP within 48 hours.

Commission concerned

The commission said it was concerned that more than one in three mental health trusts had just one star or less.

"This area is a significant cause of concern," said Anna Walker, its chief executive.

The ratings show that NHS performance varies across the country.

England's zero star trusts
Barnet & Chase Farm Hospitals
Brighton & Sussex University Hospitals
Maidstone & Tunbridge Wells Hospitals
Mid Staffordshire Hospitals
Mid Yorkshire Hospitals
Royal Surrey County Hospital
Surrey & Sussex Healthcare
West Hertfordshire Hospitals
Weston Area Health

In the north of England, 86% of primary care trusts have two or three stars. In London, no PCT has three stars.

The decision to strip four of the government's flagship hospitals of their three star rating has sparked controversy.

Addenbrookes Hospital and Papworth Hospital in Cambridgeshire, Peterborough Hospital and Moorfields Eye Hospital in London became foundation trusts this year.

Only three star hospitals are eligible to become foundation trusts. These hospitals have greater freedom from government control. They also have much more control over their finances.

However, three of the hospitals lost their top-rating partly because of concerns over their financial management. Moorfields Eye Hospital lost one star partly because of concerns over the way it manages its staff.

The hospitals will not necessarily lose their foundation trust status. However, the government's foundation trust regulator has written to each hospital to ask them what action they intend to take to rectify problems.

And their failure to retain three star status raises doubts about whether the government will achieve its target of all hospitals attaining three stars by 2008.

Health Secretary John Reid welcomed the ratings, saying they showed the NHS is improving.

"Today's ratings are indicative of the improvement that is happening across the whole NHS, such as falling waiting times and reductions in mortality rates of the biggest killers, heart disease and cancer."

Under fire

However, opposition parties were critical. Shadow health secretary Andrew Lansley said: "This has got to stop. Star ratings do not give an accurate reflection of a hospital's performance. They are extremely misleading for patients."

Liberal Democrat health spokesman Paul Burstow said: "Hardworking NHS staff are being forced to run around chasing government targets instead of getting on with the job of treating patients. "

Stars are a good way of rating hotels but don't work so well for complex organisations like hospitals
Niall Dickson,
The King's Fund

Niall Dickson, chief executive of the health think tank The King's Fund said: "Stars are a good way of rating hotels but don't work so well for complex organisations like hospitals."

Frances Blunden of the Consumers' Association said the ratings were "inadequate and meaningless".

Sophie Corlett of the mental health charity Mind called on the government to improve mental health services.

"It is time for some action now, instead of the rhetoric we have been fed so far," she said.

The Healthcare Commission said it planed to overhaul the way the ratings are compiled in time for next year.

"We will try to assess a broader range of things next year," said its chairman Sir Ian Kennedy.

NHS Star Ratings 2004
Type of trust 3stars 2stars 1star 0star Total
Acute & specialist hospitals 74 60 29 10 173
Ambulance 10 11 6 4 31
Primary care 44 182 63 14 303
Mental health 15 38 23 7 83
Overall 143 291 121 35 590
Source: Healthcare Commission

The BBC's Vicki Young
"It is embarrassing for the government that hospitals are being downgraded"

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