Watford General’s Accident and Emergency rating worsened slightly last month as the key four-hour wait stats deteriorated – and ambulance turnround times lengthened.

But Lister Hospital in Stevenage did even worse on A and E as both Hertfordshire acute hospitals struggled to meet their targets.

At Watford General, only 43.8% of the most urgent (Type One) cases were admitted, transferred or discharged within four hours in November. The official target is to achieve a 95% figure. The average last month in England was 55.4%, so Watford is well below average.

That means that West Herts  A and E comes about 109th out of 122 in England on that four-hour measure, a bit lower than last month.  But the Lister did even worse, with just 41.1%  of the Type One cases within the four hours. And below the Hertfordshire strugglers come a number of desperate cases, with Hillingdon dealing with just 29.6% of Type Ones within four hours.

Ambulance handover times at Watford also got worse in November, with 86.4% of handovers taking over 15 minutes, against 79% in October.

Overall, not a good picture – with three local trusts at or near the bottom of the four-hour table on a regular basis.

Yet Homerton Hospital in Hackney, dealing with some of the poorest areas in the country, manages to deal with 81.7% of Type One cases within four hours. What is wrong with our little group of trusts that they fail to match a hospital which is facing so many challenges? Maybe our managers should visit Homerton – they might learn a thing or two.