A higher than average mortality rate and missed A&E targets were significant blemishes on Princess Alexandra NHS Trust's annual report.

Released at its annual general meeting on September 25, the report showed the trust's death rate rose from the beginning of 2016 to peak at 121 on the hospital standardised mortality ratio - 21 points higher than the NHS average.

While this decreased slightly in the following months, A&E waiting times remained high, with just 71 per cent of patients being seen within four hours.

In December 2017 Princess Alexandra Hospital in Harlow recorded the worst emergency waiting times of any department in England.

The reports blames "system wide pressures" for the inconsistent performance.

It reads: "The factors influencing our performance have, in the main, been bed pressures resulting in the lack of capacity impacting on the ability to maintain capacity and flow in the Emergency Department.

"There have also been fluctuations in major and ambulance attendances, causing challenges with maintaining flow consistently through the hospital."

The Trust's financial situation is not particularly rosy either, with a £36.7m financial deficit in 2016/17 falling only slightly to £31.6m in a year.

Just shy of £4m could have been saved had elective surgeries not been scrapped in the winter to make sure urgent patients were seen.

More positive points were raised at the meeting however.

In March the Trust was taken out of special measures by the Care Quality Commission, which rated 65 per cent of its functions as good or outstanding.

A rapid access frailty clinic to help cope with the area's growing ageing population was opened as £11m of capital investments were made across the estate.

Lance McCarthy, chief executive, said: "A year after we launched our new Trust objectives to transform and modernise service provision at the last AGM, we have made tremendous strides.

"We have made substantial investment in service improvement while meeting our financial targets.

"Our diagnostics, 18-week referral to treatment rates and 62-day rate for first treatment from referral for cancer are stand-out successes.

"The amazing array of quality improvement projects we have embarked on are proof that all our staff are committed to supporting the Trust to provide the best healthcare in the country for our local population."

To read the report click here.