HEALTH chiefs are determined to improve outpatient appointments at west Hertfordshire hospitals, said medical director Colin Johnston.

Dr Johnston, the West Hertfordshire Hospitals NHS Trust's top medic, said after the publication of an outpatients' survey, which ranked it in the bottom 20 per cent of all trusts for 34 out of 40 aspects.

Patients slammed waiting times, hospital cleanliness, lack of information, and said appointment times were often changed at short notice.

The trust, which runs Watford General, did badly on all six questions about patients' encounters with specialists, with responses showing doctors' knowledge of individual cases was poor, and they often did not communicate well with the people they were seeing.

Dr Johnston said: "We were surprised by the results. There are mitigating circumstances but we are not going to talk our way out of it.

"We know we have to do better.

"It is not the clinical side that is being criticised - I am confident that is very good, but clearly patients' experiences are not adequate."

Since the trust has known of the report, it has set up a new outpatients working group, chaired by Dr Johnston and including managers from all three sites as well as senior doctors and nurses.

Initiatives taken so far to improve outpatients' experiences include a card people can use to remind themselves of three key questions for each appointment, and record answers given by the specialist.

New "Can I help you?" name badges will encourage people to ask for help from passing members of staff.

Dr Johnston has identified the recent centralisation of medical records at Watford General as a source of confusion and said it was clear the storage area was not good enough and needed improvement.

He said: "We have to get a major improvement in patient experiences - we will be doing our own surveys and I am confident they will soon be showing better results better than this one."