The white paper represents a seismic shift in policy and operational form, perhaps the biggest since the inception of the NHS.

The coalition has signalled a determination to reshape services to create a clinically led and patient centred approach. This represents a bottom-up drive to change how services are commissioned. But will this change in direction lead to NHS boards encouraging clinicians to take up leadership roles?

Only a small number of clinicians have made the transition to become managers, with varying degrees of success. But this year’s HSJ100 illustrates that clinicians are on the rise, as demonstrated by Hamish Meldrum, Barbara Hakin and now Clare Gerada at the Royal College of GPs.

It is vital that clinicians have a strong relationship with service managers to support the provision or commissioning of high quality care for their local population. Clinicians need to be empowered to take responsibility not only for patient care, but the performance and finances of their organisation.

Clinicians are responsible for the majority of expenditure within the service and are often the ambassadors of the NHS to the local population; patients base their opinions of their local trust or practice on how they are treated by clinicians.

We need a philosophy that seeks to connect clinicians better with the needs of their populations from the ground up. Given the difficulty in recruiting medical directors or encouraging clinicians to become chief executives, the NHS and its partners need to manage and develop this scarce talent in a far more coherent way.

We all have a part to play in actively encouraging clinicians to come forward and giving them access to training and mentoring schemes so that the “leadership bug” can spread throughout the clinical community. This is critical if future clinical leaders are to progress to board positions and provide the clinically led approach that Andrew Lansley is seeking to embed - and to which clinicians are starting to respond.

Frank McKenna, group director of healthcare, Harvey Nash, and former NHS HR director