Studying health ethics on her weekends off has equipped the NHS's new director of performance for the battle to deliver the NHS plan's targets, she tells Paul Stephenson

You are a director of clinical services at an acute trust in the process of closing down its accident and emergency department. When you finish your week's work, what better than a nice relaxing weekend, far away from the world of medicine?

Alternatively, how about spending a year of your Saturdays studying for a diploma in the philosophy of medicine? That is precisely what the new NHS director of performance, Margaret Edwards, did. 'I saw it advertised one Saturday morning, and I was fascinated by medical ethics. I am just sad. How can I justify doing that?' she says.

Actually, the justification is an integral part of the make-up of someone who freely admits she didn't really understand what the Department of Health was all about and, more particularly, what performance management was all about, when she was a trust chief executive.

'I am dyslexic. I was in remedial class at school, ' explains Ms Edwards, who says these personal challenges have been a major factor in pushing her on to ever greater positions, and have spurred her on to continual study.

The remit of the post Ms Edwards has recently taken up had not been clarified when she spoke to HSJ, and relations with other organisations were still being put in place. The overall responsibility is clear, however.

'My role is to have overall responsibility that the NHS delivers key targets set out in the NHS plan.

The [staff of the] Modernisation Agency are the experts in how to do it. Part of my role will be to identify where we need to develop.

'David [Fillingham, Modernisation Agency director] will advise me on targets. I do not have staff who go into trusts, but I have overall responsibility.'

She says her directorate, with around 50 staff, will have responsibility for planning priorities. 'We should be seen as giving clear and consistent messages as to what organisations should deliver, but not telling organisations how they do it, allowing some innovation and development.'

So does she believe that the plan's targets can be met? 'Yes and no.Where targets have been set, it is ultimately a ministerial decision. Clearly that is something we will be able to talk through, but the NHS plan is the template.'

Ms Edwards says her role involves telling ministers what the reality of achieving the plan targets is. So will she be able to hold her ground? She says: 'One of my staff said to me: 'What are you nervous about? If you can manage the surgeons, you can manage the ministers.' I think part of my role is to brief ministers on targets and achievability.'

So what about the financial situation? 'It looks very tight.'

At the time she took up her new appointment, hospitals were being told how many stars they were being awarded.

So how should the ratings system work? She says: 'It has got to be supportive.What we are looking for is some progress and action plans.'

She says trusts need clarity, and uses her own experience as a chief executive to show it should work.

'What I want to develop is a sense that there are no surprises. We need to be very clear about what organisations can do.

'Which are the real top priorities?

What will you be judged on? We would like to share the performance rating criteria in advance.We have to be honest with people, trusting people.

'I had 3,500 staff. I could not know what they were doing.

It was about setting the agenda.

We had 10 key objectives in the organisation.'

Whether she will be able to bring ministers the news they want to hear remains to be seen.

When she left her last job, she was given a life jacket as a leaving present.

It was for safety, in case it all went wrong, her staff said. Then again, perhaps they were not talking about her new job; just her passion for water-skiing.

Margaret Edwards' CV

Sept 2001: NHS director of performance

May 1998-Sept 2001: chief executive, Heatherwood and Wexham Park trust

Sept 1995-May 1998: director of clinical services, Heatherwood and Wexham Park trust

Aug 1994-Sept 1995: director of corporate development and contracting, Bournewood Community and Mental Health trust

May 1992-Aug 1994: contracts director, Plymouth and Torbay health authority

1984-92: a variety of management roles, Plymouth HA

1983-84: finance officer, Norfolk family practitioner committee