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The hospital chief who came in from the cold

She was the youngest ever NHS hospital chief executive when appointed. Alison Stacey finds out why Birmingham Children's Hospital boss Sarah-Jane Marsh turned down the chance of becoming a spy to get into the business of saving lives.

Sarah Jane Marsh, CEO of Birmingham Children's Hospital, and (inset) husband NHS boss Sir David Nicholson
Sarah Jane Marsh, CEO of Birmingham Children's Hospital, and (inset) husband NHS boss Sir David Nicholson

When Sarah-Jane Marsh left university she was offered the chance to join MI5’s graduate training scheme.

She passed the initial tests and embarked on full training – being presented with tough undercover scenarios.

But it was the trauma of her father falling ill shortly after she left Lancaster University in 1999 and her appreciation for the treatment he received from the NHS which set her on the path into the health service.

Ms Marsh, who is the daughter of a Dudley coal merchant, said: “I knew I wanted to do something in the public sector. I wasn’t interested in joining a private sector company and making profits for shareholders.

“I went down two paths simultaneously. The civil service put me in the MI5 recruitment pool – and so I thought – you don’t get many chances like this.

“I passed all these initial tests and started going off on all the training. There were simulation exercises that were very difficult.”

But as her applications reached a stage in both processes, her father Geoff, who runs the family coal business, fell ill with heart problems.

He would undergo a quadruple heart bypass at Walsgrave Hospital in Coventry.

“I think I saw it as a bit of a sign” admits Ms Marsh. “I felt like I had a moment of clarity when it coincided with my dad being in hospital. I was there, and thinking that you can make a difference.

“The set-up in Coventry was really well organised.

“I thought that there is a lot more to organising healthcare when you look at it through a patient’s eyes.

“Plus I found the idea of not being allowed to go to the toilet for eight hours a bit of a turn-off during MI5 training,” she adds jokingly.

Ms Marsh, who is now married to outgoing NHS boss Sir David Nicholson, did a management training scheme and as part of her first assignment was placed at the former Castle Street Hospital in Worcester.

Her role included managing medical secretaries and tackling the outpatients’ surgical waiting list, which was spiralling out of control.

She admitted: “It was quite a basic first job – but it was actually really scary.

“You come in and you’ve not long left university, and you’ve been asked to do things and manage people who are very experienced.

“When you work with some leading surgeons – to come into management at 23-years-old with established careers, it is a big thing to do.”

Ms Marsh rose quickly through the management ranks and by 2005 was promoted to director of planning and productivity at Walsall Hospitals.

During her tenure waiting lists were cut dramatically, and the hospital was cited as an inspiration to others.

In December 2007 she made the move to Birmingham Children’s Hospital as chief operating officer, putting her in charge of the day to day running of the things.

But after a damning report by the Healthcare Commission published in March 2009, chief executive Paul O’Connor resigned from his post, and Ms Marsh was promoted to chief executive in an interim position – aged just 32.

“The message that rang out loud and clear was that there was a real lack of ambition for the hospital” said Ms Marsh.

“Children were turned away when we were full, rather than responding to their needs. The theatres were not organised in the right way.

“I felt part of the problem was when you went to the board meeting and executive meetings people there seemed to be talking to a different organisation to the one I had experienced when I arrived.

“They seemed to be disconnected. The staff had all the answers, it was just a question of getting them heard.”

After a few months in the interim role, Ms Marsh was made permanent chief executive in June 2009. Since then, she said, the trust no longer turns away sick children.

The capacity has increased from 280 to 360 beds, with a rise of intensive care beds from 20 to 31 and the number of staff has increased by 25 per cent from 2,800 to 3,500.

In the last Care Quality Commission report carried out in November 2013, inspectors praised the hospital for its adequate staffing levels, care and record keeping.

But what does the future hold for the hospital?

Demand for hospital resources is one the rise. Not only is the hospital having to cope with an increase in population but also with developments in medicine as many children are surviving diseases and living longer than they would have just five years earlier.

“Just when you think that we may be getting on top of things the demands for our services will take another leap” said Ms Marsh.

“Even though we have done an amazing amount we still need to do more.”

The long-term plan is to strengthen ties with the QE Hospital and hopefully, one day, to be part of the University Hospital Campus.

But in the meantime, there are proposals to build a new facility on the city centre site, which has already seen a £35 million investment, for possibly the development of a cancer centre and new operating theatres.

“We are still in the development stage at the moment, so we don’t know exactly what will be in the new build, but we have an idea.”

As a chief executive, Ms Marsh said that she tries to spend as much time as possible at the hospital – avoiding attending events and conferences where possible.

But she admits that being female did make her peers sometimes ‘hold back’.

“I think the NHS have started to crack it. I do feel when I go outside that, I get that sense that some people actually hold back.

“I had a few breakthrough moments and realised I just had to be authentic and be myself.

“I did a talk at Cambridge University a couple of years ago. I never thought about being a woman. I think I worried about my Dudley accent. I thought ‘they’re not going to understand anything I’m talking about.”

In recent years Ms Marsh has come under criticism in the press for her marriage to NHS boss David Nicholson, with some newspapers even insinuating her relationship helped her climb the ladder.

“I feel that’s unfair. It has been nothing but hard work.

“What message does that send out to other people? The message that I think that comes through loud and clear is that you can only be successful as a young woman if you’ve got the patronage of somebody else. And that’s just a crap message.”

But for now Ms Marsh is going nowhere, and is looking forward to a bright future with the hospital.

“I honestly can’t think of a better job in the world.”

 
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