Mid Staffordshire hospital chief's tough year

She has one of the toughest jobs in the NHS – but Lyn Hill-Tout is not complaining. She speaks to

about the task ahead.

By her own admission, Lyn Hill-Tout has just completed the most challenging year of her life.

Since taking the reins at Mid Staffordshire NHS Foundation Trust last June, the hospital boss has faced some difficult decisions and daunting diary dates.

The 56-year-old had to confront the toughest of many big calls around five months into her appointment.

"Standing in front of 300 people at a public meeting, telling them you're going to close their A&E overnight after only four, five months in the job – well, that was not the easiest thing to do," she says, through a wry smile.

That extraordinary hospital board meeting, in November last year, confirmed the overnight closure of Stafford's A&E from December 1, 2011.

It remains shut between 10pm and 8am and will until October at the earliest, due to staffing shortages.

That decision was one which was always likely to, and thusfar has, defined Mrs Hill-Tout's tenure.

Accordingly, it is one she fiercely defends. "We took a very difficult and, some would say, brave decision. I don't say it was brave, I say it was necessary. We closed A&E because we couldn't guarantee patient safety.

"What that showed is that we are prepared to take decisions that might not be popular – we will take those decisions, for the benefit of patients."

The inference hangs heavy in the air. It was not always like this. Staff stretched to breaking point, mistakes being made, lives being needlessly lost – that is Stafford's not-so-distant past, and it is a recent history which Mrs Hill-Tout insists is remembered. Never again must the hospital hierarchy lose sight of patient safety.

Regardless of Mrs Hill-Tout's mantra, those painful memories will nonetheless be returned to the public consciousness in October, when Robert Francis QC publishes the findings of his public inquiry. The failure of regulatory bodies to act over poor care at Stafford will draw the sting of his report, but Mrs Hill-Tout is braced for her hospital to take another big hit.

"Like everybody else I have got a lot of anticipation about the Francis report," she says. "Although it's about the regulatory systems which were in place, inevitably we are going to get some criticism."

The scandal surrounding poor care at the hospital not only affected staff but the whole town. There is a general feeling from people that it is time to move on – to be proud in the hospital once again. But the closure of A&E at night is a reminder of past failings and there is a big concern that its reopening will be delayed indefinitely.

Now the Express & Star is highlighting those concerns and, with the support of MPs in Stafford and Cannock, calling for a reopening date to be set and honoured.

Mrs Hill-Tout says:?"The staff have been deeply affected by it all, the community has been deeply affected by it all. There will be people who lost relatives here who will have it all dredged up again. But we are getting support, the community is behind us, and there are things such as your paper's campaign. We are starting to make real progress on mortality rates, and against other targets.

"We have got real, hard evidence that we have moved on.

"What I have said to the staff is it's two steps forward, and one step back. Because we are Mid Staffs, it will make more of a splash. We have to be ready for that."

If the A&E closure has been the defining act of Mrs Hill-Tout's regime, her disarming honesty has set its tone.

The cover-up culture of a few years ago has been swept away, replaced by a new era of openness.

Errors are logged and reported so lessons can be learned, while updates about the A&E situation have been circulated at a series of public meetings.

A veteran of 34 years in the NHS, Mrs Hill-Tout nods knowingly when asked about criticism of the initial three-month deadline to restore round the clock care at A&E. The deadline, and a subsequent revised target in June, were missed.

"The difficulty is, if you set a date people take that as a benchmark," she says. "Yes it was ambitious but if we hadn't set a date that would have set a hare running about A&E possibly closing for good.

Optimistic

"You are damned if you do and damned if you don't."

So will the unit be ready by the new date of October? "I'm optimistic, but as I've said before there's no 100 per cent certainty.

"We won't have left any stone unturned when we get it reopened. When it does reopen we are aware there will still be staff who leave at various points and we have got to make it sustainable for the long term."

Mrs Hill-Tout, who left her job as chief executive at the new Great Western Hospitals in Swindon to come to Stafford, is grateful for the understanding of the public over A&E. It has been almost eight months since it closed overnight.

She adds: "I realise that people have been very patient and understanding of the reasons why and I think some people, although disappointed, have felt safety comes first and this was the right thing to do.

"But there does of course come a time when people do run out of patience and people begin to question whether it is fixable. I am worried about that. However an unsafe A&E is worse than patients having to travel an extra few miles."

Despite the pressures, Mrs Hill-Tout seems genuinely content with her lot.

"It has been the most challenging year I have ever done," she says. "But I wouldn't miss it for the world."

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