It has been a year since Duncan Selbie took over as head of the largest hospital trust in Sussex. Here he tells health reporter Siobhan Ryan about the changes he has seen, what improvements still need to be made and his plans for the future.

Ask most patients to highlight grumbles about their hospital and the chances are that most will include mentions of MRSA, dirty buildings, how long they’ve had to wait for an operation and having to spend ages in the accident and emergency department.

A year or so ago, Brighton and Sussex University Hospitals NHS Trust had recorded high numbers of MRSA cases, had numerous patients waiting longer than 18 weeks for a routine operation and had the fifth worst rate in the country when it came to patients spending longer than four hours in A&E.

But things have been improving.

Changes in working hours, shift patterns and a drive to reduce bed blocking across the trust has led to A&E performances significantly changing, with the trust now routinely ensuring almost all patients are routinely dealt with within four hours.

Last weekend the Royal Sussex County Hospital in Brighton dealt with a record 841 A&E cases, mainly down to the large numbers visiting the city for Pride, and every one of them was seen on time.

At the end of March last year the hospital recorded 105 cases of MRSA.

At the end of March this year the figure had fallen to 66 and the aim is to have 43 by next March. The trust has been stepping up its infection control campaign through targeting atrisk areas such as intensive care, changing its staff dress code and restricting visiting hours.

It is also on target with cases of inpatients and outpatients waiting no more than 18 weeks for an operation, with eight out of ten patients being seen on time.

So far so good, but there is still one major stumbling block.

The older buildings at the Royal Sussex are more than 100 years old and are showing it.

They may basically be kept clean but no matter how hard staff try, they are never going to make the place look pristine.

The answer? Pull it all down and create a new hospital that will not only provide all services for locals in Brighton and Hove but also highly skilled specialised services for the rest of Sussex, Surrey and Kent.

Health officials at South East Coast Strategic Health Authority have given approval for the trust to press ahead with its redevelopment plans, at a cost of more than £300 million.

All being well, says chief executive Duncan Selbie, work could start by the end of next year. He said: “We have spent the last year stepping up in those areas where we needed to improve in particular the patient experience.

“We were not paying enough attention to those. However, we are now and we will continue to do so.

“But the buildings are a big constraint. The wards may be clean but that is not good enough.

“At the moment if a patient is admitted to a medical ward it is not anything like it should be.

“Our long-term aim is to provide specialist services for the South East region including children’s, cancer, renal, major trauma and neurosciences.

“Patients are often having to go up to London for treatment but we want them to stay here.

“This hospital is the fourth safest in the country clinically when it comes to mortality rates and the best when it comes to neonatal treatment.

“We want to strengthen and build on that but we need to get the environment sorted.”

There are plans to continue to develop the trust’s links with Brighton and Sussex Medical School and its teaching hospital status. Mr Selbie said: “We have just had the first set of graduates from the school and this week, for the first time, we are having junior doctors starting work with us who trained with us.

“It makes a huge amount of difference.”

And what of the Princess Royal Hospital in Haywards Heath?

A year ago its future was looking uncertain because of plans by West Sussex Primary Care Trust (PCT) to downgrade hospital services.

The position is better than it was when it comes to A&E services but the future of its maternity unit is still unclear.

Mr Selbie said: “We are in a better position now but in terms of maternity that is still an issue. All we can say is that we will continue to reinforce and develop our maternity services.

“The Princess Royal is very important to the trust. We operate as one hospital over two sites and will continue to do so.

“There are a lot of changes ahead at the Royal Sussex and it will seem like a building site – but at the end of the day we will end up as a teaching hospital that actually looks like a teaching hospital.”