Mid Cheshire Hospitals trust has praised the efforts of staff in turning around a double 'weak' rating to a double 'good' assessment.
Chief executive Stephen Eames told HSJ: 'Eighteen months ago the organisation was in a very difficult position and it could have gone either way.
'It's been the willingness of the staff to get hold of this agenda that has moved things forward.'
The trust has turned a£10m deficit into a£2m surplus and is on course to become a foundation trust in 2008, he said.
There had been an overhaul of management structures, merging 13 separate clinical directorates into four clinical divisions, each with a consultant, nurse and senior manager at the helm.
All senior staff, including clinicians, had taken part in a leadership development programme. This had delivered significant savings and helped clinical buy-in to service redesign.
Nursing and patient involvement director Tracy Bullock, who joined the trust a year ago, said service redesign had involved clinicians from the outset.
Closures of surgical beds had been agreed in consultation with staff who had also helped design new services such as a surgical assessment unit.
She said: 'When I came here there was a bit of a "No can do" attitude. What I see now is a lot of people up for the challenge and opportunities of the next step.'
They agreed that the ratings had been helpful in 'providing a focus' for change. 'But we would have wanted to do this anyway,' added Ms Bullock.