The unit was one of the worst in the region in 2011 but four months after Circle took over the running of the Huntingdon hospital in February last year, it was named as the best performing A&E in the East of England. The private company changed processes in the ward so patients would see a senior clinician when they first entered rather than a less experienced member of staff. The change has meant patients and diagnosed and treated quicker and enabled the trust to top the A&E chart for seeing patients within four hours of arriving. Tom Hughes, a Circle partner and clinical lead for the emergency department, said that in 2011 the unit was at risk of losing junior doctor training posts due to concerns raised by the Deanery the body which manages postgraduate medical education about patient safety. He added: The department was also one of two areas the hospital identified as a quality hot spot, posing significant risk of patient harm. Absenteeism and staff turnover were high and medical recruitment was impossible due to the hospitals uncertain future. When Circle took over power was devolved to frontline staff to allow them to have more control of their environment and staff have committed to a model of services for acute patients. A new focus has been placed on the development of skills of medical and nursing staff to be able to work in more than one clinical area. Tom Hughes said: As a result of adopting these new and improved ways of working, in June, the emergency department ranked top in the East of England region and maintained this position for four consecutive months. Last week, the department ranked top nationally for the four hour target. That has never happened in the trusts history. It goes to show that the changes staff have put in place are working. Jim OConnell, Circle chief executive, said: We are extremely proud of our staff in the emergency department for this incredible achievement. However, it cannot be attributed to one department alone. Staff from many other departments around the trust have worked in partnership with the unit to make this possible.