Hereford Hospitals NHS Trust appeared to be treating people from outside the county rather than its own local patients, it has been claimed.

Concern over the situation was expressed at a meeting of Herefordshire Health Authority, when the trust was asked to explain why it had failed to meet its waiting list target by the end of March.

Assurances were sought that the situation would be put right by the end of June and that targets would be met through the rest of this year.

The sole representative from the hospitals trust was its director of operations and nursing, Dr Jan Stevens, who faced nearly two hours of searching questions from members of the health authority, Herefordshire Community Health Council and representatives of GPs.

Dr Stevens said one of the greatest difficulties for the trust was running an acute hospital service from three sites without extra funding.

Other problems during the year had been the start of building the new hospital on the County Hospital site and the illness and death of consultant staff which had lengthened waiting lists.

She believed the trust could deliver the target figure of 2,280 by the end of June, and possibly three weeks earlier.

And she was more confident this year they would be able to meet the next target, although she could give no guarantees having no means of knowing what contingencies would arise and what could go wrong. Up to 15 per cent of admissions were emergency cases over which she had no control.

As to the claim the trust treated more patients from outside the county, she said there was no ring-fence policy and there were no differential lists.

Dr Stevens said changes were being made to improve the situation. Surgical lists had been introduced on bank holiday Saturdays and Mondays and, as part of their appraisal against job plans, clinicians will be given specific waiting-list targets and performance against these was assessed.

Some members of the health authority claimed they had received repeated assurances from the hospital trust last year that targets would be met. The result was unsatisfactory.

GPs questioned the reopening of a departure lounge at the County Hospital which prepared patients for discharge, saying it was just a way to get people out of hospital beds too early.

It was 'pie in the sky' that things would get easier. GPs were still having difficulty in getting patients into hospital and this had been going on for seven months.

Dr Stevens supported the departure lounge policy saying it gave patients the chance to be counselled and prepared for discharge.

It was far better than them sitting in a chair next to their bed which was then occupied by another patient.

Dr Stevens fielded a wide range of questions relating to the waiting list problems and discharge of people from hospital.

At the end of the meeting it was agreed that the main issues be included in a follow-up discussion at a meeting of the health authority in July and that it would be helpful if Jeremy Millar, the chief executive of the hospital trust, be present with Dr Stevens.