Editorial Thursday 22 July 2021: It’s speculation, but … there’s some evidence indicating who’s been chosen to run NHSE next

This is speculation. It is not something that I can definitively prove.

I share this with HPI subscribers only on this clear basis: that it is speculation.

I won't be putting this speculation on public media or social media: I ask you, please, to do likewise.

I think that it should stay behind this paywall, and for your personal interest. I say this because it seems unfair to the other known shortlisted candidates: it is not clear that they’ve all been told yet, and I’m certain that some haven’t.

I may also be reaching the wrong conclusion, based on what I've been told, shown and sent over the past 24 hours.

But it’s speculation informed by evidence. I wouldn't share it otherwise.

Here goes: since I tweeted about and published the brief piece yesterday on the decision having been made, a combination of circumstantial, digital and logistical evidence sent to me from multiple and reliable sources points firmly towards NHS England Chief Operating Officer Amanda Pritchard being ‘the next NHS Pope’.

If this speculation is correct, Ms Pritchard will become the third-ever chief executive of NHS England, and the first woman to do the job.

The two more probable candidates of those shortlisted were always Amanda Pritchard and Mark Britnell.

Mark’s successful NHS hinterland, followed by his international experience as Global Head of Health with management consultancy KPMG and his work as an author, would have provided a distinctive and dynamic approach to the role.

However, at the time of writing, it seems as if the appeal of appointing from within the current ‘NHS family’, combined with the virtues of continuity and Ms Pritchard’s strong reputation for operational delivery, swung it her way.

Mark’s formidable curiosity, energy and intelligence will doubtless continue to contribute positively to health services globally as well as locally.

Ms Pritchard is widely admired across the NHS. Her blend of a calm professional approach, upbeat energy and intelligent focus on details have won her many admirers and few enemies (and being the chief operating officer of NHS England does not make the latter straightforward).

Ms Pritchard was appointed as Guys and St Thomas’ chief executive in 2016, having become its chief operating officer in 2015. GSST’s unique physical position directly opposite Parliament always makes its leadership an NHS ‘Big Job’.

Before becoming GSST’s COO, she was deputy chief executive of the well-regarded Chelsea and Westminster Hospital FT.

Prior to that, she led the health team for the Prime Minister’s Delivery Unit working to Tony Blair 2005-6, having been ChelWest’s general manager to director of strategy and service development 2002-5. She joined the NHS through its graduate management training scheme in 1997.

Pritchard’s move to be NHSE COO

Very few NHS CEs get an entire HSJ editorial written about them, but Amanda Pritchard did back in 2019.

It called for her to step down as GSST CE, so as to focus fully on the NHSE COO job.

Here, the context was important: in the merger between NHS England and NHS Improvement (the artists formerly known as the NHS Commissioning Board and Monitor/TDA), NHSE boss Simon Stevens was forced to remove his senior colleague and friend, Matthew Swindells; and in a parity move, NHS Improvement chief executive Ian Dalton was made to step down (the latter was paid off a handsome sum not to challenge this).

When her NHSE appointment was announced, Ms Pritchard sent a note to thousands of GSTT staff saying she “expected to return”.

In a 2020 interview, Pritchard told HSJ’s Dave West, “system oversight and scrutiny will hopefully increasingly be done through, with and by systems, when they’re at that stage of maturity, but at the moment for most of them we would expect that to be done in much more of a joint way between the region and the system.

“It’s the right role for ICSs. If they are only ever going to be at the system transformation end of the spectrum, then the risk is always that we’ll have parallel lines between [the centre and] systems and organisations.

“We’ve tried to be quite clear about what must be in place [to be an ICS]. And the rationale for that is, if we’re going to ask systems to take a greater role in things like distributing the money, supporting bids, and being part of capital decision making etc, then we have to have confidence that the capability, governance and leadership is there to deliver that”.