Our second Top Chief Executives list contains many leaders who have confronted difficulties in their own organisations which have bested more than a few of their counterparts.

The last 12 months have been something of an annus horribilis for the NHS provider sector with the perfect storm of squeezed income, increasing demand, pressure from regulators and even an unprecedented row over the tariff.

‘Public scrutiny and criticism of these leaders’ actions has never been more intense’

Many well thought of provider chief executives have seen their organisations fall into deficit or rated as inadequate or requiring improvement by the Care Quality Commission.

Public scrutiny and criticism of their actions has never been more intense. There has continued to be a steady stream of departures from the top job at NHS trusts, many deciding now is the right time to retire, others pushed by regulators.

It is in this context that the really excellent chief executives shine.

Our second annual list of the NHS’s leading provider chief executives contains many who have confronted difficulties in their own organisations which have bested more than a few of their counterparts.

20-20 vision

A defining characteristic appears to be a clear vision of what the future will look like - so that even in the most difficult periods their teams always have a sense of mission and hope for the future.

Some have influenced the national scene while others are leading the transformation of their local health economies. Many are doing both.

Our illustrious judging panel are well aware of the challenges facing chief executives. No single criterion ruled anyone in or out of the list - good chief executives can work in problem trusts and are particularly needed there.

‘Good chief executives can work in problem trusts and are particularly needed there’

A third of the chief executives are new entries - which obviously means a third on last year’s list have dropped out.

Some have moved on to new roles while others have run into severe difficulties or simply not shone this year as they had before.

This has left room for some striking new entrants, including Cambridge’s Dr Keith McNeil and Imperial’s Tracey Batten, two arrivals from Australia who have brought new ideas and fresh vision to two large teaching trusts. We have more community trust chief executives included, such as two who have recently led their organisations to foundation trust status. There are also marginally more women than in 2014.

Unlike last year, we have ranked the top 15 chief executives. This elite group is marked by longevity in post - Sir Leonard Fenwick has run hospitals in Newcastle for an astounding 38 years. The top five have all had their achievements recognised by being made knights or dames, and the top 12 are all foundation trusts.

Once again, we thank our judges for giving up their time and providing valuable insight. They and we were full of admiration for the many chief executives who have held things together in this most difficult of years.

HSJ Top Chief Executives 2015