With the ever-turning merry-go-round of NHS leadership, relocation is nothing new as executives regularly move from trust to trust within the organisation.
Few relocations though will have covered such a great distance as that of Lesley Dwyer, the new chief executive of the Norfolk and Norwich University Hospital.
Prof Dwyer previously led the Medway NHS Foundation Trust in Kent, a stint lasting between 2015 and 2018.
However, between her two most recent NHS roles, she was chief executive of the Central Adelaide Local Health Network in South Australia, where she led 18,000 employees across three hospitals.
She has been met with an NHS shaken to its core by the Covid-19 pandemic - from which it is still trying to recover. But she said the difference was not as drastic as one might have expected.
She said: "The biggest difference I noticed is the recovery from Covid seems to be much longer here [than in Australia]. People are really tired and really worn out - but we are asking them to do more again.
"The backlogs are also far more significant than when I left in 2018, but that was the same in Australia and in health systems across the world."
The healthcare system in Australia has similarities to the UK - with much of it funded by the government and made accessible to patients through an NHS equivalent called Medicare.
However, GP access and medication are generally charged for, with Australians encouraged to buy health insurance.
Prof Dwyer said there was a "cultural difference" in attitudes towards private healthcare between the two countries.
She said: "In Australia, there's almost an attitude that if people can afford their treatment and choose to go public, they feel like they are taking a spot away from somebody who can't afford it.
"Here, there is almost a feeling that going private is a vote of no confidence in the NHS - that's a real cultural difference.
"I think there is a real benefit to be had from the public and private sector working closer together and there needs to be an appreciation that the NHS will not always be able to provide services at a higher level than privately."
On putting beds in corridors
A trend Prof Dwyer found on her arrival at the N&N was a controversial approach which saw patients treated in corridors.
Known as "escalation beds" the move was designed to increase ward bed capacity to allow patients to be moved through the emergency department quicker and speed up ambulance handover times - allowing paramedics to spend more time in the community and less in the car park.
While the hospital has managed to keep its ambulance handover times among the quickest in the country - around 24 minutes - Prof Dwyer said she was determined to stamp out treating patients in corridors.
She said: "The most dangerous place for people to be when they need care is in the community waiting for ambulances, so it's vitally important to limit this time.
"But our staff have told us that this approach meant they could not provide the level of care they would want to - and our patients that it is not the care they want to receive.
"We currently have no patients being treated in corridors. There may be times they may have to wait in a corridor when we know a bed in the ward is about to become available, but I'm adamant nobody should ever be in a corridor overnight."
Staff survey concerns
Recent NHS surveys have revealed that staff morale is an ongoing issue at the hospital.
In 2023, its staff reported the lowest morale of any hospital in the country - and although this statistic is no longer true, it remains a challenge.
Prof Dwyer said she was kept well-informed about this after accepting the job and that it was a key concern for her in her new post.
She said: "I was very concerned about the level of tiredness among our staff and concerned by the results of the staff survey.
"But we have got to believe things can get better for them.
"My concern is making sure that not only can our staff feel that they can voice their concern - but that when they do they see action taken to address them.
"We really want our staff to feel that they can do their jobs and provide the level of care they want to."
Five-year plan
Prof Dwyer said she originally arrived with a specific idea of how long she wanted to stay in charge.
While she declined to disclose what this length of time was, she said her plans had now changed and she was working on a vision she expects to take five years to achieve.
Among these ambitions were establishing a major trauma centre at the site, building a closer relationship with Cambridgeshire hospitals and helping to set up a dental college at the University of East Anglia.
And while the hospital currently has university status, Prof Dwyer said she felt this was not being used to its full potential.
She said: "We have the Norwich Research Park on our doorstep which is doing world-leading work and the UEA nearby.
"This should be a place where people come to know there is a learning environment where patients get the very best treatment and have the opportunity to get involved in clinical trials and cutting-edge care.
"What we are about the embark on will likely take the best part of five years."
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