FAILING hospitals, huge debts and controversial service changes are just some of the issues Gina Tiller has had to face during her time in north Cumbria’s NHS.

When she first came in as chairwoman of the Carlisle and Whitehaven hospitals six years ago, public confidence was low, staff morale poor and the national spotlight was shining on them for all the wrong reasons.

But the former nurse, who retired last week, feels she has left North Cumbria University Hospitals NHS Trust in a far more positive position.

The 64-year-old accepts that there is still a long road ahead, but she strongly believes the trust is over the worst and the future now looks bright.

“I do not regret coming. When you work in the health service, most people want a chance to make a difference. I feel that I’ve done that in Cumbria,” she said.

Ms Tiller trained and worked at Newcastle’s Royal Victoria Infirmary and went on to gain many years of experience at NHS board level.

Living in Newcastle, where she had also served as a city councillor, she was the chairwoman of a Primary Care Trust cluster when these bodies were abolished.

After that the position in north Cumbria came up, and she was persuaded to apply - initially thinking she’d only be here for a year. But when she arrived in 2013, she realised the extent of the challenge ahead. Ms Tiller has since been travelling along the A69, helping to steer the trust through some of its most difficult times.

“We had the biggest deficit in the NHS. There were a lot of staff vacancies, so we were spending far too much on locums,” she said. With the hospitals deemed to be failing, the Government sent in its so-called Success Regime to help the local NHS find solutions.

This resulted in the highly-contentious public consultation into proposals to close beds and centralise many services, including consultant-led maternity, in Carlisle.

“It has been difficult. It was a pretty horrible time,” she said. “I went to most of the meetings. Even though I didn’t have to say anything, I felt it was my responsibility to be there, to support the staff.”

There have also been high-profile concerns about the number of never events in the hospitals, and serious fire safety issues at the Cumberland Infirmary due to oversights when it was built.

Ms Tiller - who described the complexity of the fire issues as her “worst nightmare” - said as chair she has had to oversee it all.

On the never events, she said they have worked hard to change the culture.

“What we have done is embedded learning from never events. We encourage staff to report things now. We are very keen on this ‘stop the line’ approach, where any member of staff who isn’t happy with how things are going can speak up,” she explained.

Tackling high-profile staff shortages has also helped. She said: “Our consultant vacancy rate is still quite high. Its just under 12 per cent, but five years ago it was about 25 per cent. We’ve got a better reputation now. That’s all positive.”

Ms Tiller said they have created new roles and trained up staff to take on extra duties. “Out of despair we’ve done some really innovative things. It’s improved quality and reduced our agency and locum spend,” she said.

Bed-blocking rates, which were among the highest in the country, were also a concern. She said: “At its highest point a few years back we must’ve had up to 90 people in hospital who were medically fit enough to be somewhere else. That’s three wards worth.”

But she said things have improved dramatically, largely due to better joint working with social care leaders. “There are much better relationships now. The big change came about when we started to talk about it at the health and wellbeing board. We stopped blaming each other and started to do something about it,” she explained.

Ms Tiller said their wider vision, to deliver more care in the community, is helping to keep people out of hospital and get them home faster.

Key turning points for the trust have seen it come out of special measures, secure national funding for a new cancer centre in Carlisle, and see performance improve.

“Coming out of special measures was a great moment. We are disappointed that we are still ‘requires improvement’, but things are improving. Our A&E performance has been better than some of the hospitals in the north east. That’s incredible. I never thought we’d ever see that. We were always the worst at everything. Now we are the best at some things,” she added.

Ms Tiller is already planning to return for the opening of the new cancer centre - on the site of the old tower block - in two years time. “I’ve been banging on about that tower block for years. I’ve been obsessed. What better reason to pull it down?” she said.

Overall she described her time in Cumbria as a “fantastic experience”

Looking at the trust now, she added: “I think the atmosphere is better. There is more understanding about what we are trying to do. I don’t want to criticise anyone before me, but things are changing.”