Mixed diagnosis

Last week, the Healthcare Commission rated each of the 570 NHS bodies in England as excellent, good, fair or weak for quality of services and how they handle their finances.

For Haringey residents, the results have been mixed. The Whittington and Royal Free hospitals both received a good' score for quality of services, while the two trusts - Haringey Teaching Primary Care Trust (TPCT) and the Barnet, Enfield and Haringey Mental Health Trust (BEHMHT) - were only given a fair' rating.

The quality of services score reflects whether the hospital or trust is providing the basic level of care required by the Government and looks at the care and treatment a patient receives by looking at areas such as GP referral times and safety.

The use of resources rating takes into account how the hospital or PCT plans and reports on its financial performance, how it monitors the money it spends, and how it makes sure the services it offers to patients represent good value for money.

While financial assessments might seem like something only of interest to accountants, they are becoming increasingly important as the Government clamps down on overspending trusts - many of which have had to cut services to balance budgets.

The Royal Free and BEHMHT scored weak' in this category, while the Whittington and Haringey TPCT did only slightly better with fair' assessments.

The Haringey TPCT report also highlighted that it has failed to progress with the Government target to reduce cancer mortality by at least 20 per cent in people under 75, by 2010.

Lynne Featherstone, Liberal Democrat MP for Hornsey and Wood Green, said: "Worryingly, this report has flagged up several areas where the trust is clearly underperforming, such as supporting people in their own homes, helping people give up smoking, tackling childhood obesity and substantially reducing deaths from cancer."

Maureen Dewar, chairwoman of the Haringey TPCT Patient Public Involvement (PPI) forum, would like to see the hospital improve its quality of services.

She said: "We will be monitoring the areas in need of improvement and continuing to work with the trust to ensure that areas such as equality are adequately addressed, particularly in relation to older people's and children's services."

There has also been criticism of BEHMHT, which the Healthcare Commission said had failed to demonstrate that it has adequate arrangements for managing its use of resources'.

Councillor Richard Wilson, Haringey Liberal Democrat spokesman for health and social services, said: "We are particularly concerned about the fact that BEHMHT received a weak' rating for use of resources, placing it in the bottom 15 per cent nationwide."

A spokeswoman for the trust said it had met its financial duties over the past two years and forecasted a surplus for next year, but a weak score in the value for money' category had brought its overall score down.

It scored better for its quality of services with a rating of fair but underachieved' in meeting national targets to reduce smoking. However, it did manage to increase staff levels in child and adolescent mental health services.

The weak financial management score for the Royal Free, in Hampstead, did not come as a surprise to the hospital due to the difficult financial position the trust was in at the end of last year.

Chief executive Andrew Way said: "We have made huge progress on the financial side, which is showing through now month on month."

While the Royal Free did fare better for the quality of services it provides, receiving a good' overall ranking, there are areas for improvement. It scored weakly for the experience its patients had in its care - this includes whether they were admitted to the right bed or ward and whether they had to stay longer in hospital than necessary.

Government guidelines state that patients admitted to A&E should be seen in four hours or less and the Royal Free has achieved this target. However, it failed to make sure cancelled operations were rescheduled within 28 days and it also failed to comply with national guidelines on treating people who have self-harmed.

The welfare needs of children is of particular interest to the Healthcare Commission and the Royal Free scored a good' in this area. And while its inpatient care was ranked as excellent', the outpatient care was weak'.

The Whittington Hospital NHS Trust achieved a good' overall score for quality of services by achieving the planned reductions in adult smoking and recording fewer pregnancies in girls under 18.

David Dawson, vice chairman of the Whittington Hospital PPI forum, believes the review offers a largely positive view of the hospital.

"I would say 80 to 90 per cent of the review says we did very well," he said. "You cannot expect to get 100 per cent in everything but I think the hospital is on the right track and I am encouraged by the results."

Whittington chief executive David Sloman said: "I am delighted that the ratings reflect on the commitment and hard work of our staff to offer services in line with our strategy to become the hospital of choice for local people."

The hospital scored fair' for the way it manages its finances but, with 51 per cent of trusts in the country with the same score, Mr Dawson said: "Most hospitals have problems with this but I believe the Whittington is dealing with it and trying to get out of that end of year deficit and is doing a good job."

Haringey TPCT declined to comment.