There have been major changes at the trust

BBC News Online looks at how one trust made the jump from zero to three stars in just two years.

Two years ago, Dartford and Gravesham NHS Trust in Kent was ranked among the worst hospitals in England with a zero-star rating.

This year, the hospital finds itself with three stars and a coveted place among the top-rated trusts in the country.

It has been a long journey. In 2001, the trust was found to be failing two out of six of the government's key targets.

It was cancelling too many operations. Too many patients were dying in hospital within 30 days of surgery.

Lagging behind

In 2002, the trust was assessed on even more targets. Things had improved but it was still lagging far behind other hospitals.

There has been a significant reduction in waiting times Sarah Dunnett, Trust chairman Click here to find out how your local trust scored

Consultants at the trust were failing to see patients with suspected cancer within two weeks, in line with the government's target.

Patients were waiting too long in A&E - and too long for operations generally. There were also too many emergency readmissions.

This year, the picture is dramatically different. The trust is meeting all of the key government targets on patient waiting times.

Its rates of emergency readmissions are in line with the national average. It cancels fewer operations than many other hospitals and waiting times are falling steadily.

"The outstanding result reflects the sheer determination and professionalism of the staff," says Sue Jennings, the trust's chief executive.

It also reflects a concerted strategy by management. The trust has seen some major changes over the past couple of years.

Major changes

Its A&E services have been overhauled. A new management team has been appointed and a new "see and treat" policy was introduced earlier this year after a successful pilot.

We will not rest on our laurels Sue Jennings, Trust chief executive

Patients are now treated when they are seen rather than having to wait hours. Waiting times have fallen as a result.

The trust also established a dedicated surgery unit with 10 beds for routine operations. This has led to a sharp reduction in the number of cancelled operations.

Additional clinics are now running at weekends to ensure that patients are not waiting longer than 21 weeks to be seen.

Staff are using new systems which flag up patients who are running close to maximum waiting times.

"There has been a significant reduction in waiting times for both admission to hospital and for outpatient appointments," says Sarah Dunnett, the trust's chairman.

"We are looking forward to building still further on these successes during the year ahead."

That view is backed by Sue Jennings.

"We will not rest on our laurels, as we know there is still much to do to ensure we do provide the very best care at all times."