AFTER months of hitting the headlines for all the wrong reasons, Worcestershire's health service is starting to fight back.

The county's acute trust came under fire earlier in the year following a critical report from the Commission for Health Improvement.

It was also attacked by the Audit Commission for falling into such a huge amount of debt.

However, two pieces of news have come to the aid of the trust's beleaguered chiefs.

Against the odds, the organisation has managed to hit all the Government's key clinical targets for the past financial year.

These targets are all-important, having an effect on the trust's star rating and future funding.

More importantly, as the trust's acting chief executive Graham Smith was quick to point out, it means patients are getting a good service in Worcestershire.

This is supported by The Sunday Times Good Hospital Guide, which shortlisted Worcestershire Royal Hospital for its Hospital of the Year award.

The news came as a shock to many people, not least Wyre Forest MP Dr Richard Taylor, who confessed to being "speechless".

The hospital has had long-standing problems with parking, Accident and Emergency admissions and bed availability, with Mid-Worcestershire MP Peter Luff convinced its capacity is too low.

However, the guide is well-respected and comprehensive. The hospital may not be perfect, but it clearly has an outstanding team of doctors and nurses to compensate for its deficiencies.

The publication describes Worcestershire Royal as a "centre of excellence", and it is bound to stop many of the hospital's critics in their tracks.

However, there would be something seriously wrong if a one-year-old hospital was not one of the best in the country.

It is bound to have good, modern facilities. It cost £96m, has nine operating theatres and good scanning facilities and boasts a £4m training centre.

It's reassuring to know that such impressive facilities exist in the county, but there are still serious problems that need to be addressed.

The full extent of the past mismanagement is now starting to become clear.

Mr Smith is using his considerable troubleshooting experience to rectify the situation.

Within a month of taking up the post, he has identified 50 superfluous management jobs within the trust.

If Mr Smith is right, it means the trust has been wasting £1.7m a year on unnecessary bureaucracy.

It's no wonder the organisation has been found to be the most expensive in the West Midlands.

The reason for the trust's debt, which is now in the region of £8m, has always been given as the high cost of employing agency nurses.

However, there is a national shortage of nurses, and not all trusts have managed to run up such large debts.

Mr Smith's assessment of the situation reveals the truth of the matter. Somehow, his predecessors have managed to employ 50 more management staff than is necessary.

The acting chief is having to make some difficult decisions in a short space of time. However, despite identifying £9m worth of savings for this financial year, Mr Smith still expects the trust to run up another £4m of debt.

This will bring its total deficit to £12m, which will have to be repaid within three to five years. The debts are rising rather than falling, despite the expected cutbacks.

The county's three primary care trusts, the main purchasers of services from the trust, have financial problems of their own and are paying the acute trust several million pounds less than they had anticipated this year.

The organisation is looking at ways of paying back the loans to the strategic health authority, but it has no definite plan at present.

Unlike the primary care trusts, it has very little land to sell off.

Mr Smith says he is not even thinking about paying off the debt at the moment, but it is not going to go away.

The recent good news is extremely welcome, but nobody should be fooled into thinking that the acute trust's problems have disappeared.