CHIEFS of Wyre Forest Primary Care Trust have described a slump in the organisation's star rating as one of the disappointments of the past year of operation.

In the PCT's annual report, chairman, David Priestnall and acting chief executive, Eamonn Kelly, together with professional executive committee chairman, Dr James Goodman, outlined the highs and lows of the trust's year.

The ranking reduction, from the three-star status of the previous two years to just one for 2004-05, was due to factors including under-achievements in performance against targets for access to primary care.

Trust chiefs said that was a "temporary blip". The target of 98 per cent of patients spending no more than four hours in A&E had been achieved since April this year.

The PCT also failed to balance its books, overspending its resource limit by nearly £2 million, out of a total budget of £109 million.

Board members said turning the financial situation around was a "major challenge" but a plan had been developed to allow the trust to hit key NHS service targets and get back in the black by 2006-07.

Notable highlights of the past year included an "excellent" report from the Healthcare Commission, the NHS's external regulatory body, on the quality of the PCT's healthcare and management.

Special mentions were given by the commission to the 24-hour community nursing service and the inclusion of children in the planning and delivery of specialist children's services.

Patient satisfaction, reflected in a survey, was said to remain "high" and that compliments exceeded complaints by 50 to one.

Innovations during the year included the out of hours service, replacing the service previously provided by GPs, last December and the launch of the independent sector treatment centre on the Kidderminster Hospital site.

The centre, which provides a rapid access and treatment orthopaedic service for outpatient appointments and day case operations, will be extended next February to offer joint replacement surgery, covering hips and knee replacements.