Doctors attack `misleading' hospital ratings

NHS evaluated: League tables spark row as two famed centres are ranked as `worst performers'
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Medical Editor

Angry doctors poured derision on the Department of Health's new hospital league tables published yesterday, dismissing them as misleading and unhelpful.

The new NHS Performance Guide 1994-95, which gives star ratings on more than 40 standards and operations for hospitals and trusts in England and Wales, relegates some of the country's most prestigious hospitals to the "worst performers" category.

Addenbrooke's NHS Trust, Cambridge, and St James's University Hospital NHS Trust - "Jimmy's" - in Leeds both score badly.

In response, Addenbrooke's said an infection had closed wards last year, affecting its performance. It also experienced pressure on its accident and emergency department when neighbouring hospitals were forced to close their own accident and emergency units due to high numbers of patients.

St James's said outpatient input had risen by 11 per cent and that it had treated an extra 2,500 in-patients.

While Virginia Bottomley, out-going Secretary of State for Health, congratulated NHS staff on "another year of achievement" yesterday, doctors at the annual meeting of the British Medical Association in Harrogate held an emergency debate.

James Johnson, chairman of the BMA consultants' committee, said the league tables were "pointless and misleading. It only serves to stigmatise certain hospitals on an inaccurate and unfair basis."

Mr Johnson questioned the value of measuring hospital performance by the number of patients treated as day cases, one of the standards used. "The decision to keep a patient in overnight is determined by clinical and social considerations. It would be wrong to send people home inappropriately, but a good way to score high points in the league tables.''

Describing the tables as a "ridiculous and farcical exercise", Dr David Wrede, a registrar at St Mary's Hospital, central London, said his hospital had come low in the tables, but its own figures showed constant improvement in "waiting times, patients seen and operations achieved".

The tables show hospitals' performance in waiting times for first outpatient consultations; for times waited in outpatient and accident and emergency departments; for the amount of day surgery provided; and for waits for admission for common operations and procedures.

Performance is measured against targets laid down in the Patients' Charter. This year's tables show that 93 per cent of patients were assessed within five minutes of walking into an accident department compared with 88 per cent last year, and that 88 per cent of patients are seen within 30 minutes of their appointment time compared with 84 per cent last year.

The tables show that more than half of the hospitals admitted 95 per cent or more of their patients in the eight main surgical specialities listed within 12 months of going on to a waiting list. In general surgery, urology and gynaecology, 95 per cent or more were admitted within a year.

A new category for time patients wait to see a consultant when they have been referred by their doctor showed that 82 per cent were seen within 13 weeks and 95 per cent within 26 weeks.

The NHS Performance Guide 1994-95 , free from Health Literature Line, 0800 555777, or BAPS, Heywood Stores, Manchester Road, Heywood, Lancs, OL10 2PZ.

Polly Toynbee, page 17