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A decent performance management framework for the leaders of NHS organisations would do nicely.

It is rare indeed for a CEO or Executive Director to be sacked for poor performance.

A recent Select Committee meeting with England's Chief Nurse was pretty cringeworthy to be honest and clearly demonstrated how people right at the top of the NHS don't really own the problems. It was a study in waffley answers and "not my job" protestations.

Personally I would do away with specialised roles such as directors of nursing altogether. They seem totally ineffective in today's NHS.