PATIENTS waiting on trolleys and staff shortages are among the concerns highlighted in a report on the Bolton Hospitals NHS Trust today.

The report by the Commission for Health Improvement also revealed the high number of emergency surgery deaths is above the national average.

A lack of clear leadership in improving services was a major concern.

Bolton performed poorly in clinical effectiveness, experiencing 5,710 deaths among emergency patients within 30 days of surgery at the hospital in 1998/99.

This compares to a national average of 3,867.

Bolton had 12,357 deaths in the same year -- 3,000 higher than most average hospitals.

The CHI said the figures did not necessarily "imply poor clinical performance", saying that the health of people in the town may be partly to blame.

Investigators revealed the trust had "serious difficulties" in meeting waiting list targets.

One patient told the CHI they had to wait 63 weeks before being seen by an orthopaedic doctor.

The CHI also discovered that, at the time of inspection in May, there were 53 patients who had suffered a stroke in hospital -- but there were only 13 specialist beds available.

The report said: "The trust needs to take action to ensure adequate provision of this service for patients."

The CHI found facilities were inadequate when patients were forced to wait without privacy on trolleys in the Accident and Emergency department.

Staff told inspectors that, on one occasion alone, there had been 16 patients left waiting for beds on trolleys in the medical admissions unit.

The CHI said the bed capacity problem "affected all areas of the hospital".

Problems with recruiting nursing and radiography staff were also raised with the trust assuring CHI they were working to address the problem.

The hospital was noted for using high numbers of bank and agency staff.

Some nurses told inspectors they worked through lunchtimes and extra shifts to ensure "adequate" staffing.

However, the CHI did commend the trust for bringing in additional intensive care beds and two high dependency beds to reduce transfers of acutely ill patients outside Bolton.

The hospital's "innovative" diabetes nurse consultant is highly praised and being held up as excellent practice.

The chaplaincy service and its multifaith team and the stroke co-ordinator were commended.

A spokesman for the Trust said: "We are delighted the CHI found many areas of good practice in the Trust.

"There are some areas where there has been much worthwhile progress had been made but further work is needed and we agree.

"We will complete an action plan within six weeks and start putting it into place immediately after that.

"The trust has already taken many steps to reduce staff shortages and strengthen its recruitment campaign.

"Thius includes supporting different ways of working, flexible retirement packages and a very successful return to practice programme."

John Brunt, chief executive of the trust, said: "The whole assessment process has been one we welcome as it is helping us to build on our strengths and to identify and improve any weaknesses."

Peter Homa, chief executive of the CHI, said: "Bolton Hospitals NHS Trust has demonstrated both examples of good practice and areas that need improvement." PATIENTS waiting on trolleys and staff shortages are among the concerns highlighted in a report on the Bolton Hospitals NHS Trust today.

The report by the Commission for Health Improvement also revealed the high number of emergency surgery deaths is above the national average.

A lack of clear leadership in improving services was a major concern.

Bolton performed poorly in clinical effectiveness, experiencing 5,710 deaths among emergency patients within 30 days of surgery at the hospital in 1998/99.

This compares to a national average of 3,867.

Bolton had 12,357 deaths in the same year -- 3,000 higher than most average hospitals.

The CHI said the figures did not necessarily "imply poor clinical performance", saying that the health of people in the town may be partly to blame.

Investigators revealed the trust had "serious difficulties" in meeting waiting list targets.

One patient told the CHI they had to wait 63 weeks before being seen by an orthopaedic doctor.

The CHI also discovered that, at the time of inspection in May, there were 53 patients who had suffered a stroke in hospital -- but there were only 13 specialist beds available.

The report said: "The trust needs to take action to ensure adequate provision of this service for patients."

The CHI found facilities were inadequate when patients were forced to wait without privacy on trolleys in the Accident and Emergency department.

Staff told inspectors that, on one occasion alone, there had been 16 patients left waiting for beds on trolleys in the medical admissions unit.

The CHI said the bed capacity problem "affected all areas of the hospital".

Problems with recruiting nursing and radiography staff were also raised with the trust assuring CHI they were working to address the problem.

The hospital was noted for using high numbers of bank and agency staff.

Some nurses told inspectors they worked through lunchtimes and extra shifts to ensure "adequate" staffing.

However, the CHI did commend the trust for bringing in additional intensive care beds and two high dependency beds to reduce transfers of acutely ill patients outside Bolton.

The hospital's "innovative" diabetes nurse consultant is highly praised and being held up as excellent practice.

The chaplaincy service and its multifaith team and the stroke co-ordinator were commended.

A spokesman for the Trust said: "We are delighted the CHI found many areas of good practice in the Trust.

"There are some areas where there has been much worthwhile progress had been made but further work is needed and we agree.

"We will complete an action plan within six weeks and start putting it into place immediately after that.

"The trust has already taken many steps to reduce staff shortages and strengthen its recruitment campaign.

"This includes supporting different ways of working, flexible retirement packages and a very successful return to practice programme."

John Brunt, chief executive of the trust, said: "The whole assessment process has been one we welcome as it is helping us to build on our strengths and to identify and improve any weaknesses."

Peter Homa, chief executive of the CHI, said: "Bolton Hospitals NHS Trust has demonstrated both examples of good practice and areas that need improvement."