Boss Jan Filochowski has told how the challenge of turning around West Herts Hospitals NHS Trust took so much out of him his wife feared for his health.
He has described how the first two months in the post of chief executive, as he tackled the trust's massive failings, left him 'emotionally and mentally' exhausted.
The task was so great he originally told his superiors – and his wife - he would s
tay for just six months.
Now a year later things are improving and, with the permission of his other half, he is still in the top job with no plans to leave just yet.
"For the first two months it was incredibly demanding. By Christmas I was exhausted. It was emotionally and mentally exhausting," he said.
"I made a promise to my wife because she was worried about the time it would take."
Mr Filochowski is known as an NHS troubleshooter and he previously fixed two other failing trusts in Medway and Bath, but the problems in west Herts had become of national significance.
Within weeks of arriving he had been summoned to see the chief executive of the NHS to give assurances he would get the job done.
The trust had just been rated as 'weak' by health watchdogs for the second year running, leading to the departure of Mr Filochowski's predecessor David Law, and it was plagued with debt, long waiting lists and infections.
"The problems of west Herts had become of such significance that they were national problems," he said.
"When you go into a place that's clearly in trouble, I think it's fair to call it a failing organisation, you have people who are demoralised and you must have poor performance.
"When you arrive you don't know what's wrong and you have to find that out.
"If I gave a reasonable account of the problem and gave a way forward, that was the main thing."
Mr Filochowski quickly identified three key areas that he would focus on, which were finances, infection control and waiting times.
He says they are on track this year to pay off £7million of an £11million debt, infection rates have plummeted and they are 'within a smidgeon' of achieving waiting time targets.
The trust has just been rated 'fair' by the Healthcare Commission, but Mr Filochowski says this does not truly reflect its achievements.
"This organisation is full of good people. If things go wrong that is management responsibility," he said.
"That was my central diagnosis, that the organisation didn't follow through on issues.
"It didn't have the culture to push things through and implement them to the end.
"It became the victim of events.
"I'm a great believer that bad things don't just happen, you let them happen.
"What's surprised me is how quickly we have been able to show quite dramatic improvements in some key issues."
Part of the reason the chief executive has stayed on is to see through the shift of services from Hemel Hempstead to Watford.
Next March A&E will close in Hemel Hempstead along with all acute services, leaving an urgent care centre, outpatients department and diagnostics.
Mr Filochowski says the urgent care centre, which is expected to treat around 65 per cent of people who currently use A&E, will be staffed by highly-trained nurses and GPs.
A controversial GP-led health centre, offering the services of a GP surgery, is also planned.
"The move of services from Hemel to Watford had not been thought through and was at risk of not going through properly," he said.
"If I had left then I would have left the organisation at some risk."
Regarding the future Mr Filochowski points to the new £300million hospital destined to replace Watford General Hospital.
"It's very good for Watford. I realise not so good for Hemel," he said.
"I would like to see the hospital in 2015 - about seven years."
He says the building will incorporate the latest architectual thinking and eco technology.
"We're going to create the greenest hospital there has ever been," he said.
