How Salford has become the best

The NHS is getting better. Over the last two years the number of NHS trusts getting the top excellent ratings have risen six-fold.

But even amid such achievements one area stands out.

Life expectancy varies greatly from place to place

Salford is one of the most deprived areas in the country.

Average lifespans are about three years below the national average as the local population struggles with high rates of heart disease, mental illness and unemployment.

But the Greater Manchester city is top of the tree for something - its local health services.

It is the only area in England to achieve excellent grades across the board for both its local hospital and primary care trust, which manages community services.

The secret of its success? Partnership work. While the government's reforms of the NHS has encouraged competition, Salford has shunned that for a more friendly approach.

Seven years ago, Salford Royal Hospital and the local PCT set up a joint programme called Shift.

Services

It led to a number of senior managers interchanging jobs to help redesign services.

One of the successes has been an integrated outreach service for people with respiratory conditions such as bronchitis and emphysema.

Hospital consultants and nurses run regular clinics in GP surgeries giving patients a chance to get expert advice if they feel their condition is worsening.

It has led to a 20% reduction in emergency admissions for the conditions.

The two organisations have also set up a GP service in the hospital to help relieve the pressure on A&E which can find itself being deluged with people with minor ailments at weekends and evenings.

It is much better to work together. You can achieve more David Dalton, chief executive of Salford Royal Hospital Many GPs miss wait target NHS ratings 2008 overview

And on top of this, the discharge process from hospital to the community - a thorny issue in many areas - has been revamped.

A PCT team of nurses work on the wards overseeing discharge arrangements into community health services and nursing homes.

"It means no-one is left in hospital beds waiting for their care to be sorted out. It is a seamless process," says Salford Royal chief executive David Dalton.

"Our partnership has been all about trying to understand what each others' needs are.

"You can sometimes see an adversarial relationship emerging between PCTs and hospitals, but that does not benefit patients.

"It is much better to work together. You can achieve more and I think the people of Salford can be pleased with the NHS they have."