Since senior matron Clare Hughes joined troubled the A&E department at Medway Maritime Hospital a year ago she believes she has seen some dramatic improvements.

The number of costly agency staff has been reduced from 65% to 14% and patients are now assessed within 15 minutes of getting to reception.

But perhaps more importantly the controversial “corridor” used to stack patients on trolleys because of a shortage of beds is no longer used.

The emergency department at Medway Maritime Hospital has been criticised over the last few years and remains in special measures.

But Mrs Hughes, who is in charge of 120 nursing staff feels that while there is still some way to go, a remedy is in sight.

She said: “It is busy here and patients are not always in an ideal environment.

“But it is much safer, more organised and more comfortable. The corridor was not acceptable and has not been used for the last six months.”

To free up space, the clinical decisions unit (CDU) which handles acute conditions is now being used for extra beds.

With the unit due to be housed in the extension, the inevitable disruption has meant that bed management has had to be flexible.

Mrs Hughes, who has worked in hospitals in Maidstone and London, said that after a series of damning reports their mindset had to change.

She said: “We temporarily do not have a CDU so we have to be imaginative. Patients go through rapid assessment on the front door to ensure the correct clinical decision is made as soon as possible.

"We we still get complaints of long waits but the public are very supportive of staff and I believe we now have the right number. On average there is one nurse for three patients.”

Mrs Hughes felt that waiting time could be misleading as during this period patients were constantly being monitored with blood pressure and temperature checks, and if needed, X-rays, before seeing a doctor.

She said: “It takes a certain type of person to work in A&E.

“You never know what to expect on the shopfloor. It changes all the time. There is a certain camaraderie in this department because there has to be.

“We do see violent situations but can see them coming. We have a good relationship with our security. There are some nurses who come here from the wards but cannot stick it.

“Morale is good. It’s not like working on the wards where there are 10 people to look after. Here we might have 80 in and we don’t get to close the doors.”

Work on the extension is well under way and is due to be open by the end of the year.

Once the redevelopment is finished, the department will consist of 24 bays in majors, seven bays in resuscitation and 10 bays in the clinical decisions unit (CDU).

The current set-up is 12 majors bays, a 12-bed CDU, which is being used for extra major cases to address current high levels of demand. There are also five resuscitation bays.