Heatherwood and Wexham Park Hospitals NHS Trust in Berkshire has been rated both excellent and weak in the latest performance ratings for health care organisations.

The trust in Slough was praised for its services

It got an "excellent" rating for its quality of services - but a "weak" one for its financial management.

The new ratings, compiled by the Healthcare Commission and covering the period from April 2005 to March 2006, replace the old "hotel style" star ratings, and aim to measure trusts against a greater range of issues.

Under the old system, Heatherwood and Wexham Park, based in Slough, was given a top three-star rating overall, after it met key national targets such as waiting times and hospital cleanliness.

And under the new ratings, it was recognised as continuing to meet such targets with the "excellent" rating for its quality of service.

The trust's chief executive Colin Hayton said meeting the key targets was "the reason we have come out so well".

He said, for example, the trust had been ahead and met some targets on waiting lists for 2005 two years earlier in 2003.

New targets

Under new targets, the trust was assessed against 11 of 12 indicators, which include experience of patients based on a 2005 survey and the number of MRSA infections compared with planned reductions.

Hospitals must meet targets on cleanliness and waiting times

The trust was said to have "underachieved" on two of its 11 new indicators - complying with national guidelines on people who had self-harmed, and having the right processes in place to help patients who misuse drugs.

The commission also conducted a series of reviews to see if healthcare organisations were making progress.

Under these reviews, the Berkshire trust was deemed "good" in areas including admissions management and medicines management.

On a review of services for children in hospital it achieved a "fair" result.

Public statement

As part of the new annual health check, NHS organisations are also asked by the commission to make a public declaration on how well they have met basic (core) standards.

Local healthcare partners and groups such as patient and public forums gave their views on the organisation's performance.

It wasn't because we lost financial control or because of our internal running of finances Colin Hayton Trust chief executive

The forum for Heatherwood and Wexham Park hospitals said it had a good relationship with the trust which was "open to constructive criticism".

It said feedback from the public had indicated "increasing confidence" in the trust's services.

Among its suggestions, the forum said the trust should promote itself better, perhaps through its website.

The East Berkshire Cancer Patients' Forum also commented on the trust's performance.

It said some members with a "very recent experience of cancer" found a lack of openness among some professionals on possible treatments.

However, it noted new guidelines within the trust would highlight the treatment options.

Mr Hayton said the new ratings were "much more rigorous" as they considered more criteria and information from patients.

He felt that criteria relating to patient care were the most important, adding that patients were particularly concerned over standards of treatment and cleanliness to prevent infections.

Tough criteria

Based on information from the Audit Commission, the trust did not meet its financial targets for 2005/06.

The Healthcare Commission said in its report: "It is because of this reason alone that they automatically received a score of weak for use of resources."

Mr Hayton said the reason the trust got a "weak" rating over its finances was a "very peculiar one".

He said it was because it had to give up �6 million during the financial year to make up for shortfalls from local primary care trusts.

"It wasn't because we lost financial control or because of our internal running of finances".

He added that, under the new system, "even if you overspend by �1" trusts would get a "weak" rating for use of resources.

Mr Hayton said the trust had appealed against being penalised in this way, but was told that the criteria for exceptional circumstances were very tough, and that trusts should anticipate many aspects which could go wrong when dealing with their budgets.

His trust is planning to get top ratings in both sides of the evaluation next year.