HOSPITAL boss John Brunt fears that the Bolton Hospitals NHS Trust will not be able to meet stringent new government targets.
And the chief executive, who heads the Royal Bolton Hospital, will now be pushing for extra funding for a new ward.
From March, the Royal Bolton Hospital will no longer be allowed to cancel ANY operations on the day.
In September, it was penalised by the Government and given just one star because of its bed management system.
The range of new government targets also means that the town's hospital -- crippled by massive demand on its accident and emergency unit -- will have to find patients a bed within four hours.
As highlighted in the BEN,, many Bolton patients have spoken of waiting more than 11 hours in casualty on trolleys in corridors.
It is the first time that hospital bosses have spoken in public about the one-star rating, awarded to the Bolton Hospitals NHS Trust by the Government in September.
The news caused staff morale to plummet at the Trust.
Mr Brunt has revealed that the hospital will use £325,000 to bring in a range of measures to ease the pressure.
Four beds will open on B4 ward to cope with the winter pressures and there are also plans to set up extra beds in the accident and emergency unit.
The hospital is still to hear what slice of a £50 million government grant it will receive towards reforming A&E and reducing the number of cancelled operations.
Mr Brunt also revealed that they were looking to employ a trauma nurse to get patients through the system quicker.
Mr Brunt told members of the hospital trust board: "In my experience, these measures won't be efficient to achieve the four-hour government target and allow us to hit the target of no cancellations on the day for surgery. These targets are very, very demanding.
"It is my gut feeling that we will need an extra ward."
From October 25, the hospital was banned from allowing any patient to wait more than 12 hours for a bed.
Ann Schenk, service development director for the Trust, said 1,317 patients waited longer than four hours to be admitted into hospital last year.
This figure is expected to be higher this year due to a rise steep rise in demand from outside Bolton.
And it is predicted the demand will worsen after Fairfield Hospital and Bury General Hospital merged last month.
Mrs Schenk said that in order to cope, 104 extra beds would be needed at the Minerva Road hospital over the next five years.
Mr Brunt also called for a reduction in the number of bed-blocking patients waiting to be discharged.
The hospital can have up to 40 patients waiting to leave hospital on an average day, but have nowhere to go, blocking a bed needed for an emergency or surgical admission.
Mr Brunt said: "We have bought 40 places in Millview nursing home but to meet targets we will have to reduce the number of patients who are waiting to go home after treatment into the low teens."
Chairman of the Trust, Peter Liptrott, spoke of his disappointment of the star rating system.
He said: "It doesn't assess the clinical excellence of the hospital. Unfortunately, the demand exceeds our funding. But we are stuck with this criteria and we have to live with it."
Mr Brunt said that news of the one-star rating -- the lowest in the North-west -- had badly affected morale among hospital staff.
The hospital noticed a steep rise in the number of nurses leaving the Trust in September, according to human resource managers.
Mr Brunt, worried about the Trust's performance in next year's league table, said: "There is so much pressure in the system."
New criteria for next year's star rating system is also expected to include patient and staff satisfaction.
Mr Brunt added: "The rhetoric around the importance of the achievements of the targets get sterner. We want some head room and some space." Cash crisis
may block
new projects SEVERE cash flow problems are continuing to cause a headache for finance bosses at the hospital, who are now £898,000 in debt.
Beverly Peacock, director of the Trust's finances, predicted in autumn a £3 million overspend by April 2002.
But, due to stringent cutbacks, this prediction has been considerably reduced.
Mrs Peacock said: "We are still under pressure to get back on track, but action plans are now beginning to bite."
However, the trust's financial situation for April 2002 could mean an end to various health projects because of a lack of money.
The Trust board agreed that their capital programme for 2002 was "over committed" and were looking at ways to slimline their wish list.
They currently want £670,000 for a new renal dialysis unit, an MR scanner and a long list of repairs and ward renovations.
Bosses claim it is still too early to say what schemes, if any, will be axed and are hoping to secure extra funding from the Government before making any decisions. Audit highlights bed-blocking DESPITE meeting financial targets last year, the Trust needs to address its current cash flow problems, according to the Audit Commission.
Following an inspection, auditors are urging the hospital to reduce the number of patients and their length of stay by better planning.
They said that there was a "clear need" for the hospital to work closer with social services to reduce costly bed-blocking.
The hospital could also make savings of £100,000 next year by having greater control on its catering budget.
It revealed that 20 per cent of meals were being wasted each day at the hospital.
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