It would be simple to look at John Gilham's arrival at Southend Hospital as an easy move for him.

With a three-star rating, university and foundation status, Southend is one of England's most successful general hospitals.

It is no wonder the job of chief executive was a tempting prospect for Mr Gilham who spent the past four years at the other side of Essex - at Princess Alexandra Hospital, Harlow.

While Southend has been consistently praised, Princess Alexandra Hospital has been battling to balance its books and to improve its rating, which has now risen from one to two stars.

Southend's former chief executive David Brackenbury, who retired earlier this month, had been at the helm for 15 years and always kept Southend's finances in the black.

Mr Gilham, 48, hopes to be another safe pair of hands, but said that doesn't mean there's no room for improvement.

"The difference between David's time and mine is that the healthcare environment is changing," he said. "Patient choice is now a key factor."

Some might think a man who ran a less successful hospital is not the best person to take over at Southend, but Mr Gilham said things are not always that black and white - a one-star hospital might be doing some things better than a three-star one.

"You can never rest on your laurels," he said. "I have experience of having to bring organisations back in line so have experience in changing healthcare. And there needs to be continuous change."

Southend is a bigger hospital trust than Harlow with about 3,500 staff, compared to 2,300, and a budget just under £200million, compared with £130million at Harlow.

But Mr Gilham will still apply the same principles - reliability, safety and effectiveness, all pledges which he believes keep patients and accountants happy.

When Mr Gilham left school in Stratford and began a job analysing blood samples, he never dreamed one day he'd be running a hospital. He studied biology, worked in pathology and gained a biomedical science fellowship.

He then worked in private hospitals, took management qualifications and become deputy lab manager.

In 1986 he became general manager of Rush Green Hospital which later became part of Havering Hospital NHS Trust, where Mr Gilham became director of operations and deputy chief executive.

He took the same role with the Mid-Essex trust, before he was approached to join Princess Alexandra Hospital which was attracted by his interest in introducing change.

It suited him as it was a new challenge and was close to his home in Upminster. It meant he did not need to uproot his wife Bernadette and their sons Christopher, Michael and Ian, now 24, 23 and 15.

Of his time at Harlow, he said: "The ratings have improved and the financial situation has been, not resolved, but addressed and this year the trust is generating a surplus."

He said his background in pathology makes it's easier to understand what happens on the ground in hospitals and his time in private hospitals gave him another perspective on healthcare.

"They were pretty clear about what they needed to do," he said.

Now he hopes to make changes at Southend to improve the already successful hospital, but wants to make sure staff and patients are involved.

"We will constantly look to challenge ourselves," he said.

"David did an excellent job here. The hospital is now moving into a new era, driven by the way the NHS itself is changing, but also by becoming a foundation trust.

"I'm pleased to be the chief executive who will lead things."