Reporter John Harrison talks to West Hertfordshire Hospitals NHS Trust’s ‘Mr Fix It’, Jan Filochowski about his first year as chief executive.

T is no exaggeration to say October 2007 was one of the darkest months in the histoy of the health trust which runs St Albans, Watford and Hemel Hempstead’s hospitals.

A damning health report had just rated quality of services and financial management at West Hertfordshire Hospitals NHS Trust as “weak” – the lowest possible rating.

It was the second consecutive year the trust had received a “double weak”, leaving it among the worst in the country.

Burdened by a huge deficit, with hospital infections rampant and the trust in disarray, chief executive, David Law, resigned.

Twelve months on and under the leadership of “Mr Fix It”, Jan Filochowski, the trust has undergone a remarkable turnaround.

This year’s Healthcare Commission report, released last Thursday, rated the trust as “fair”.

The result is particularly pleasing because the commission conducts its reviews between April and March, meaning Mr Filochowski had just five months to “cure” the crippled trust.

Next year’s report promises to be even better.

Shortly before meeting him last Wednesday, I asked whether the new chief executive was pleased with the results.

“Jan doesn’t really do pleased”, his director of communications told me.

During my chat with him it emerged that he was “delighted”.

The message, however, is that while the tide may have turned, Mr Filochowski will not be content until standards are consistently among the best in the country.

Last week, almost a year to the day since taking the job, Mr Filochowski revealed he was advised to “not touch Watford with a barge-pole” such was the mess.

The trouble-shooter was told to “park” the health campus and “forget” about becoming a foundation trust.

His brief, in short, was to “just sort it out”.

He said: “It was a scary experience to begin with. I felt I had to say that to people.

“We were doing very badly.”

Faced with the prospect of a third straight “double weak” rating, he spent the first two months getting to grips with the trust’s failings, a period that was “very hard, very stressful and very lonely”.

“First of all, we had a very long history of substantial deficit.

“Then we had a lot of problems with waiting lists in casualty – we probably had some of the worst waits for inpatients and outpatients in the country.

“The third, big problem was infection.”

Since getting to grips with the organisation, Mr Filochowski and the hundreds of doctors and nurses at Watford, Hemel Hempstead and St Albans hospitals have made a big difference.

Waiting times in A&E are now hitting national targets.

Twelve months ago, two thirds of patients requiring an operation had to wait longer than the Government’s 18-week target. Now just ten per cent are waiting that long.

In the last financial year, the trust made a surplus. It will make a bigger surplus this year.

Crucially, infections in our hospitals have all but disappeared.

Last August, 86 cases of clostridium difficile (Cdif) were found in Watford and Hemel.

This August, there was just one case while no patient in West Herts has had MRSA for more than eight weeks.

So why are fewer people catching “superbugs”?

“It is very simple things.

“It is about giving it a high priority, it is about creating infection control areas and we have massively reduced the prescribing of two antibiotics.

“We have also had a huge publicity campaign for both staff and patients.

“Now, if staff do not wash their hand they will be spoken to and if they still don’t, it will become a disciplinary matter.

“I think on one or two occasions we have disciplined people.”

But it would be wrong to see him as a clunking fist, Mr Filochowski argues. He hopes to have empowered staff, while making them more accountable.

He has also been more realistic about the pressures of cost-cutting.

“I think previously there was a requirement to cut and cut costs and so people were told you had to cut costs come what may.

“They did that and they damaged services and once you damage services it costs you more to put them right.”

Instead the trust now aims for “reasonable” savings that are deliverable.

Last year, it aimed to save £20 million, then cut services across the board and ended up saving just £5 million.

This year, an £11 million saving should be met.

The trust is now moving towards achieving foundation status, while the business plan for the Watford Health Campus is again a priority.

Mr Filochowski adds: “I want people to say Watford is the place that leads the country.

“We have got great ideas, realistic ideas that have national support and I think we have every chance of providing something people are going to come from around the country and say: ‘That’s the way to do it’.”