CREWE'S Leighton Hospital has been awarded two stars in a national system to rate hospital performances.
The Mid Cheshire NHS Trust failed to scoop the top three-star status because of the hospital's poor death rate.
Trust chief executive Simon Yates said: 'This rating system is only a start and it is always going to be very difficult to measure performance.
'The question is what do you look at? This is a first attempt to look at a small number of issues and, in fact, it is very cleverly put together.
'It does have an affect on financing but only in the way we can get our hands on it.
'Because we have two stars we have to agree with the regional office of the NHS on how to spend the money to improve performance. Those trusts with three stars do not have to do that.'
At the start of the year Leighton Hospital was reported to have one of the worst death rates in the country. Only six other hospital trusts in England had higher mortality rates.
Mr Yates added: 'We failed to get three stars for two main reasons. We cancelled too many people's appointments on the day they were due to come to hospital.
'That was because the situation is such that we are trying to get more people into hospital than we have beds. That is obviously frustrating.
'The other main area where we are having problems is with death rates, as was highlighted earlier in the year.
'What we are now trying to do is analyse the types of operations that people are having that lead to death to see if there is any underlying cause, such as whether they are end-of-life operations.
'What these ratings do not reflect is the quality of clinical care. I know some of the hospitals with no stars and I cannot believe that it means the quality of care is no good.'
Under the rating system managers of persistently under-performing hospitals will be given a deadline to improve performance. This will be three months for existing managers and a year for recently appointed ones.
If they fail, 'troubleshooting' managers from the best hospitals will compete for the franchise to turn things around.
Vital issues such as waiting times and cleanliness have been key areas in deciding ratings in this first-time survey.
Government Health Secretary Alan Milburn said: 'As every patient knows, there is too much variation in performance between England's hospitals. That is not fair. It must be put right. Every hospital should be a good hospital.
'That is not primarily about money. It is about management and organisation.
'For the first time hospitals are being ranked on their performance, with more freedom and rewards for the best and more help for the worst.
'This is a significant step towards developing a public sector enterprise culture in the NHS to ratchet up performance.'