HOSPITAL bosses today defended their performance after they were labelled amongst the worst in the country.

According to a new Good Hospital Guide produced by the Mail on Sunday, Blackburn Royal Infirmary, Queens Park Hospital, Blackburn, and Burnley General Hospital are in the bottom 17 in the UK, at 202nd, 214th and 205th respectively, and only receiving a one-star rating.

Factors taken into consideration include death rates over the last six years, as well as waiting times, rates of day case surgery, provision of services -- such as having a paediatrician on site 24 hours -- and whether the hospital has a specialist stroke unit or teams to care for patients with common cancers.

But Blackburn, Hyndburn and Ribble Valley NHS trust acting chief executive John Dell, said: "The guide is upsetting to staff and causes concern to our patients. We do not believe this is a fair representation.

"The Trust welcomes publications which open the NHS to public scrutiny, however, we are disappointed that the methodology used to derive the ranking system within the Dr Foster Guide appears to be heavily weighted against hospitals within socially deprived areas like East Lancashire, which have levels of poor health which are well above the national average.

He added the principal factor in determining the 'star rating' was the hospital mortality rate.

He added: "Clearly hospitals such as ours, operating within areas of nationally recognised high social deprivation with acknowledged high mortality rates, can only expect to reflect those factors within hospital mortality rates."

"One serious concern we have in respect of the Dr Foster Guide is its potential for creating anxiety in our patients.

"Within Blackburn, we are very proud of the high clinical standards in place within our hospitals. We were recently awarded the highest rating of 3 stars in the Department of Health Performance Ratings and achieved high rankings in the recently published NHS Performance Indicators."

According to the guide, Blackburn Royal Infirmary is currently struggling due to cramped facilities, but is due to be closed by 2005 when services will be centralised at Queen's Park Hospital in the town.

Statistics show the Accident and Emergency Department deals with 94 per cent of patients within four hours.

The overall mortality rate for the Trust is 10 per cent above average, with the death rate for emergency stroke admissions also high as there is no stroke unit at the hospital.

Staffing levels show there are currently 28 doctors and 120 nurses per 100 beds and nearly nine per cent of consultants posts vacant.

Of Queen's Park Hospital, the guide recognises it is undergoing a £70 million scheme to consolidate all the Blackburn, Hyndburn and Ribble Valley Healthcare Trust's services by spring 2005, with plans to build a new £86 million super hospital in the town.

Its mortality rate is 106, compared to the national average of 97, and there is a high mortality rate for emergency stroke patients.

It says Burnley Health Care Trust does not perform well on mortality measures with a high overall mortality rate, of 106 compared to the national average of 97, and death rates for emergency hip fracture admissions are above average.

"There are dedicated stroke facilities, but not all stroke patients receive a CT Scan within 48 hours of admission."

In Burnley there are 26 doctors per 100 beds and 102 nurses per 100 beds.

The guide found 74 per cent of inpatients were seen within six months and 71 per cent of outpatients seen within three months.

Backing the Good Hospital Guide, Health Secretary Alan Milburn MP said health chiefs should not "reach for the excuse manual" if they are criticised.