Feature: Pivotal moments as retiring hospital chief reflects on five years in charge

A junior doctor working 100-hour weeks hears the call come in, jumps out of his dormitory bed and dives out the door into total blackness.

It took the young Sir Jonathan Michael a minute to realise that he had not, as intended, run out of the door into the corridor, but had in fact climbed inside the wardrobe.

The outgoing chief executive of Oxfordshire’s hospitals laughs across the conference table in his office, remembering the anecdote fondly, but it all could have gone so differently for the doctor of 45 years.

Sir Jonathan was brought up in Bristol, attending the city’s grammar school and achieving A-Levels in English, French and History and had a place at university to study social sciences.

But the course of his life changed one day when he went to see a film, the name of which now escapes him, set in a hospital in America.

He told the Oxford Mail: “I don’t know why, but I think in reality I went to some awful film about hospitals – it was an American film – but it just triggered something in me, and I remember coming back from the cinema and saying to my parents ‘I want to do medicine’.”

So Sir Jonathan wrote to a number of medical schools and was invited to an interview at St Thomas’ in London.

He qualified in 1970 and has since risen through the ranks and has worked as a chief executive for nearly 20 years since being appointed to the top job at Birmingham’s Queen Elizabeth Hospital in 1995.

Sir Jonathan said: “I was asked to work alongside the chief as a medical director to try to make sure the financial recovery didn’t crucify clinical care.

“That was a difficult period, but it was in one sense a really good learning experience in that I knew what a bankrupt health organisation looks like and how painful it is to pull it out.”

He then moved to London to become chief executive of Guy’s and St Thomas’ Trust for seven years, steering it through its bid to become a foundation trust.

After a three-year break working with BT Health he was made chief executive of the then Oxford Radcliffe Hospitals Trust.

Remembering his arrival in Oxfordshire, the self-confessed car buff said: “An organisation in Oxford ought to be like a Ferrari, everyone knows it is absolutely the top.

“When I arrived here it looked like a Ferrari but was not firing on all cylinders.

“I hope I have played my little part in actually moving the academic health system in Oxford to a slightly higher plane.

Sir Jonathan said that when he took the reins in April 2010 he wanted to improve the relationship between clinicians and senior management, drive up the “poor” operational performance and escape the financial deficit he inherited.

• Welcoming Prime Minister David Cameron and his wife Samantha in 2013

He added: “That’s one of the advantages I find of being an ex-consultant, I have been there and done that, and got the T-shirt and got the blood stains.

“I understand the pressures and the strains the staff face, but I also understand what happens as an organisation if you don’t control the finances and operational performance.”

Since then the trust has merged with the Nuffield Orthopaedic Centre NHS Trust, achieved the status of academic health science centre in 2013 for its work with Oxford Health and the city’s two universities and gone from a financial deficit to a surplus.

Sir Jonathan said he was very proud of the improvement in relations with Oxford University, which culminated in the trust being renamed the Oxford University Hospitals Trust in 2011.

He added: “That was also a reflection on the very significant improved relationship with the university which jealously guards the term ‘Oxford University’.

“When you have one of the strongest medical sciences faculties in the world and a very academic university hospital what you can do together is enormously greater than what you can do separately.”

He also introduced a clinical management structure, bringing clinical staff into the management team, devolving clinical decisions and accountability to clinicians.

Sir Jonathan added: “As chief executive I may be the senior manager, but all the care is given by my 11,500 colleagues.

• Sir Jonathan Michael applauds all the dedicated and hard working staff the OUH at the Staff Recognition Awards in 2013

He said his proudest moment was when the trust was given a good rating by the Care Quality Commission following an inspection in February last year.

He added: “That was a really pivotal moment for me because it was a reflection of the quality of the services and staff.”

But he said one of the biggest changes he has overseen is a shift in culture, getting staff to create a set of values for the trust, then introducing them across all the hospitals and clinics.

He added: “You have to have the right devolved management and clinical structures – organisations where every decision has to go all the way to the top never work.”

Sir Jonathan will step down from the role at the beginning of next month and said he looks forward to spending more time at his family home near Godalming, Surrey.

The father-of-three, who has a step-daughter with his wife of 10 years Karen, said he has already bought himself a golf membership.

But he stressed he is not going to stop work completely and will continue to act as a trustee of the King’s Fund.

Although he said he would not dream of giving his successor, Dr Bruno Holthof, advice he hopes the trust will continue to go from strength to strength.