Published: 28/07/2005, Volume II5, No. 5966 Page 9

The health secretary's new policy adviser is celebrating after the trust he helped transform jumped from zero to two stars.

When Matthew Swindells took over at Royal Surrey County Hospital trust in March 2003 it had one of the worst-performing accident and emergency departments in the country, with almost eight 12-hour trolley waits a day - some 2,576 a year. The trust was also£3.5m in the red.

But in 2004-05 it broke even and now has one of the top three A&E departments in England, seeing 99.8 per cent of patients within the four-hour target, with no breaches of the 12-hour target.

Mr Swindells, who was appointed to Patricia Hewitt's office last month, said he was 'delighted' to get two stars - though slightly disappointed that the trust had missed out on three stars by the smallest of margins.

He said the first six months of his tenure was spent bringing in a strong management team and sorting out patient flow.

'We did a lot of work re-engaging the staff in the running of the hospital and the clinicians rose to the challenge and were really excited by the idea of being able to turn it around, ' said Mr Swindells.

After just one month at the trust - which he joined after three years at Heatherwood and Wexham Park Hospitals trust - Mr Swindells said he realised there was nothing he could do to avoid a zero-star rating the following year. But he said this enabled the trust to spend an entire year building confidence, strong leadership and proper processes around discharging patients and managing waiting lists.

'It is absolutely critical to get the staff to simultaneously take it very seriously but also not to take it so personally that they give up hope. I was lucky to find a group of staff that were looking for the leadership to get it right.' Mr Swindells said that the star-ratings were 'right for their time', but that the 'next generation' was now needed to focus on patient experience.

'I do not believe that without the star-ratings and the strict performance management we would have turned one of the worst A&E departments into the best in such a short space of time, ' he added.

Acting chief executive Sue Lewis said: 'The turnaround has been amazing. The hard work of staff was not reflected in last year's award of zero stars, but I am delighted their efforts have now been rewarded.'