THE boss of Worcestershire’s hospitals has the air of a veteran prize fighter, a little bloodied by recent events but more than willing to pick himself off the canvas and carry on the bout.

John Rostill, the bullish chief executive of Worcestershire Acute Hospitals NHS Trust, is not your typical boardroom suit, befuddling the layman with jargon and glib and trendy phrases.

He talks about patients rather than targets and gives the impression he cares deeply about their fortunes as individuals, not statistics buried in the small print of paperwork.

So when trust chiefs learned earlier this month that their application to become a foundation trust (FT) had been deferred by regulator Monitor for up to 12 months, a disappointed Mr Rostill dusted himself down and responded with his usual tough brand of good humour.

Mr Rostill has blamed the deferment on the recession engulfing public services and questions hanging over whether the trust would be able to deliver its business plan in the harsh economic climate.

But Mr Rostill has not given up.

He now wants the trust to enter a time of “quiet reflection” before the application can be reactivated at the best possible time to ensure success, some time within the next year.

He and colleagues want the organisation to become a foundation trust because they say it will give the county more independence from government and more power to address local priorities, driven from the grass roots up by patients and not top down from Whitehall.

The trust already has ‘shadow foundation trust’ membership of 6,511 people, composed of those who expressed an interest in getting involved in the process, and the shadow public governors, who will represent county patients once foundation trust status becomes reality, have already been elected.

Given that the trust inherited debts of £6.7 million before the merger which formed Worcestershire Acute Hospitals NHS Trust in 2000, it is an achievement that it has even been considered for foundation trust status, Mr Rostill says.

He said; “It’s been a fairly tortuous two-year programme. We launched the FT bid in July 2008, the 60th anniversary of the NHS. We spent the previous three to four years resolving satisfactorily the main financial issues that were peculiar and unique to Worcestershire.

“It has been a remarkable effort to get into a situation where we were even considered for foundation trust status. We were optimistic and we followed the rules. We jumped the hurdles, went through the hoops. An absolutely mammoth amount of information was given to the Strategic Health Authority, to the Department of Health and to Monitor.”

Mr Rostill said part of the reason Monitor deferred the application was because of the need to reduce activity in hospitals over the next three to four years to save money.

Part of this involves trying to get people cared for in the right setting for their needs – smaller ailments or injuries at GP surgeries or minor injury units and more serious, potentially life-threatening situations in acute hospitals and their A&E departments.

Mr Rostill said: “There are people who should not be in hospitals. The situation is further complicated by the current economic climate, particularly in relation to public sector spending.”

Added to this is the general election, which has thrown yet more variables into the mix although Mr Rostill is sure that foundation trusts will be carried forward by the new coalition government.

Mr Rostill has already met five of the county’s six Conservative MPs, including Worcester MP Robin Walker and Harriett Baldwin, MP for West Worcestershire.

While cuts are to be made elsewhere in the public sector, the coalition has pledged to: ● Increase health spending in real terms ● Stop the ‘top-down’ reorganisation of the NHS ● Prevent the centrally dictated closure of A&E and maternity wards ● Give doctors and nurses more freedom to decide what is best for patients ● Strengthen the role of watchdog the Care Quality Commission ● Reform NICE, the body that recommends what medicines and treatments the NHS should use ● Renegotiate the GP contract ● Ensure a stronger voice for patients through directly elected individuals on the boards of their local primary care trust.

Chancellor George Osborne outlined on Monday plans to cut £6.2 billion of what he calls “wasteful spending” to start to reduce the budget deficit but this has been in other areas of the public sector, including cuts to quangos, spending on consultancy and big IT projects and a civil service recruitment freeze.

Mr Rostill said: “What I like is the suggestion we’re moving away from the top-down government and directives. The whole government rationale is to put more power in the hands of local people.

“There are some people who complain there are too many meetings in the NHS. There’s no doubt about it – the NHS is a selfperpetuating bureaucracy. I am absolutely delighted that there’s going to be an effort to cut through red tape and bureaucracy.”

But Mr Rostill knows better than anyone that you can’t disentangle targets and patient welfare so easily – the two are linked and some targets are vital quality controls.

“Targets aren’t all bad. We don’t want to throw the baby out with the bath water. The one that gave us a lot of trouble was the A&E target [98 per cent of patients must be seen, treated, transferred or discharged within four hours of admission] but I personally believe this target is all about patient safety and patient experience.

“I would hate to go back to a situation where people were waiting on trolleys for 36 hours.

Most of the targets were there to improve the patient experience.”

The NHS has improved, of that Mr Rostill has no doubt.

He said: “In 2000 people were waiting 18 months. Now the longest anyone waits is 18 weeks from GP referral to hospital treatment.

That’s a huge difference. People still complain about the time they have to wait. But you can go back to the 1990s when people had to wait four to five years for a hip replacement. The NHS is better than it was 10 years ago.”

His ambition is to see radiotherapy (linear accelerators) developed in Worcestershire so the thousands of cancer patients who need this service do not have to travel outside the county.

Mr Rostill hopes the work can begin in 2012. Other priorities include driving down hospital ‘superbug’ infections such as MRSA and C.difficile and reducing fractured neck of femur (a break at the top of the thigh bone) in elderly people by cutting the number of falls in hospital.