Exclusive: Grant signals global search for 'fresh' chief to replace David Nicholson
The chair of NHS England has underlined his determination to consider people from outside the UK and with no health service experience as candidates to be the organisation’s chief executive.
In an interview with HSJ, Sir Malcolm Grant also revealed all of NHS England’s current national directors had ruled themselves out of replacing Sir David Nicholson.
He emphasised he was beginning a “genuinely open and global search” and saw the appointment as an “opportunity to break from the past and to consider candidates who may not have had any NHS or health related experience”.
Sir Malcolm said NHS England’s board had drawn up job requirements specifically so it was not “confined to [individuals with] a lifetime in the NHS, or even of significant experience in the NHS”.
Sir Malcolm suggested leaders without NHS experience could be successful if they appointed the right staff: “Great leaders delegate quite a lot, keep their eyes on the big picture [and] trust others to have the immediate grip.”
He said success in the role would be “very much a question of values… and actually the freshness that a new appointment can bring to the role”. He added that he was “entirely open minded” about whether the chief executive should be a clinician.
He emphasised the role was different to that of NHS chief executive, to which Sir David was appointed in 2007.
“What we’re doing is recruiting somebody to lead NHS England, the commissioning side,” he said.
Although “candidates will need to demonstrate their ability to have a grip”, he said, NHS England’s leaders “don’t have a responsibility for the provider side”. The NHS system now includes many “largely autonomous bodies over which our new chief executive will not have control”.
“So the new role, I would say, is one of advocacy, inspiration and leadership,” Sir Malcolm said.
“What we need is someone who can really inspire us in thinking about the new models for the NHS.”
He said this meant NHS England was “very much looking for somebody who has a relationship building capacity rather than somebody who is able to command by force of personality”.
Sir Malcolm said he hoped to shortlist candidates in September or October, and appoint shortly afterwards.
The appointment will be made by NHS England’s non-executive directors but must be approved by the health secretary. Sir Malcolm said the Department of Health would be “briefed [throughout] the process” and indicated ministers would have the opportunity to veto candidates.
He said there would probably be “iterative” discussion with the DH to avoid the health secretary rejecting NHS England’s chosen candidate at a late stage.
Asked about the salary for the new chief executive, Sir Malcolm said the “starting point” would be Sir David’s package. His salary is around £210,000, although he was paid benefits in kind of £56,400 in 2011-12.
When asked whether it should be larger, Sir Malcolm said: “We live in an era of austerity.”
He said there may be “outstanding candidates around the world” who would take a “very significant” pay cut for the role, but that if a “truly exceptional candidate” demanded more, “then I’m sure further discussions could be had”.
Sir Malcolm said all of NHS England’s national directors had decided not to apply.
Interim deputy chief executive Dame Barbara Hakin, medical director Sir Bruce Keogh and policy director Bill McCarthy had been considered possible candidates.
The chair himself is retiring after 10 years as provost and president of University College London in September, after which he said planned to spend more time on his NHS England role.