THE Royal Bolton Hospital has the highest patient death rate in the North-west, new figures reveal.

An independent audit of the treatment of patients in Britain's hospitals has placed Bolton firmly at the bottom of the regional league when it comes to mortality rates.

The rates are described as a crucial indicator of the quality of clinical care in a hospital.

The mortality rate under Bolton Hospitals NHS Trust, which runs the Royal Bolton, has in fact increased since the last published audit in 2001.

A spokesman for the hospital said today it was "constantly striving for improvements".

But he added: "It is a fact that the general health of people in Bolton is not as good as in other parts of the country and many of our patients arrive already seriously ill and with a complex mix of conditions."

The audit was carried out by the Dr Foster organisation, Britain's first independent publisher of healthcare guides. Its ratings appear in tomorrow's Sunday Times Good Hospital Guide.

The Bolton Hospitals NHS Trust has been given a mortality rating of 121. If it had a figure of 100, it would mean the number of deaths was as expected, taking into account factors beyond the hospital's control such as the age and sex of patients, the diagnosis and whether admission was planned or emergency.

Trusts with figures lower than 100 are doing better than expected given their patient mix. But those with figures higher -- including Bolton Hospitals, Bury Health Care (112) and Wrightington, Wigan and Leigh (105) -- are doing worse. In 2001, the Royal Bolton Hospital had a rating of 113 which was then the second highest in the North-west behind Mid Cheshire Hospital which had 114.

The Mid Cheshire has now managed to lower its mortality rating to 101.

A spokesman for the Bolton Hospital's NHS Trust said: "We are both surprised and very concerned about the information from Dr Foster. Clinical care is of the utmost importance to us and we benchmark our performance against a range of standards with other hospitals.

"The Commission for Health Improvement, which inspects the Trust, did not find anything untoward in the quality of clinical care in Bolton. However we are constantly striving for improvement.

"We will be working to further validate the Dr Foster figures and to understand the increase since 2001."