HSJ100 2013 (mobile friendly)

• View the HSJ100 in full – interactive version
• Hunt fills the power vacuum – while Stevens knows that England expects
• Simon Stevens rated second most powerful man in healthcare

1 Jeremy Hunt

Health secretary, Department of Health

2013 Although he was a surprise appointment as health secretary last year, 2013 has seen Mr Hunt grow more confident in the role. It’s obviously been a testing time: the past 12 months saw the roll out of the health reforms which have been a key plank of coalition policy, and Mr Hunt had the perhaps unenviable task of overseeing a process which he hadn’t actually created. There was also the not inconsiderable challenge of the Francis report and concomitant calls for change, and for heads to roll. Mr Hunt took his time responding fully to Sir Robert’s findings, waiting until November to accept the majority of the recommendations, and to fully unveil his plans. Other high profile challenges this year have included the fallout from the late Jimmy Savile’s NHS connections, reports of “failing” trusts, and, of course, the ongoing A&E pressures. All these - along with the transition to the new system - have meant it’s been a challenging year.

2014 Mr Hunt now has a firm grip on the health service agenda - impressing even those who dislike his ideas through his ability to combine a focus on the details with a feel for the big party political and media picture. His close involvement in winter planning means the NHS’s performance during this period will be crucial for his future prospects. Operating like the 21st century businessman he is - and therefore wrong-footing many civil servants used to a more formal approach - Mr Hunt will continue to move at pace, banging the patient experience drum and positioning himself as the public’s champion.

2 Simon Stevens

Chief executive (incoming), NHS England

2013 When Simon Stevens’ appointment as chief executive was announced, Jeremy Hunt spoke of his “extraordinary reputation in the UK and abroad as a reformer and an innovator”. “We’re lucky to have him,” added Mr Hunt. HSJ agreed, welcoming the announcement as “a cause for celebration”. The former health adviser to Tony Blair knows the NHS inside out, although he has been working abroad for some time. His nine years working in the NHS during the eighties and nineties convinced him things had to change. He was one of the architects of the Labour government’s health plan, which combined unprecedented investment with sweeping reform. His role at United Health has allowed him to develop commissioning experience that will stand him in good stead. His work has also given him a near unparalleled understanding of which incentives work - and which do not - when trying to create a safe, effective healthcare system. He has been in the lower reaches of the HSJ100 in past years while abroad, illustrating how influential he is - now he’s right back up at the top.

2014 Four months before he even begins his new job, the anticipation around Mr Stevens’ impact on the NHS is already close to fever pitch. He is likely to initially focus on building a good relationship with Mr Hunt - both are political operators par excellence - and refreshing the top team at NHS England. He will use his considerable intellect to deal with the level of expectation (expect him to dampen it) and the challenge of stepping back into the bear pit of NHS public debate (expect him to be ubiquitous, persuasive and challenging).

3 Sir Mike Richards

Chief inspector of hospitals, Care Quality Commission

2013 Sir Mike Richards’ appointment as England’s chief inspector of hospitals ensured him a high placing in this year’s HSJ100. Perhaps best known in his role as cancer tsar, he is widely seen as having transformed services across the country. Interestingly, he decided to become involved in national policy when he found out that services were not as uniformly high quality as he experienced at Guy’s and St Thomas’s. In his new role, he is taking his considerable influence beyond cancer services to the hospital sector in general. He is a heavyweight whose presence can only add lustre to the troubled Care Quality Commission in which he and his team sit. In July, HSJ reported that Sir Mike was planning a “small army” to inspect hospitals in the first wave. He did, however, say that existing CQC inspectors would remain integral to the process. The second wave was announced in October. Before he took up his new job, Sir Mike was director of improving mortality at NHS England. The role of chief inspector of hospitals was created by the government in response to the Francis report. David Cameron said it would ensure a hospital was “clean, safe and caring”.

2014 The process Sir Mike is leading as chief inspector is unprecedented in the NHS. Expert, rather than generalist, teams are due at every trust before the election. Jeremy Hunt’s plan for an inspection regime similar to Ofsted has already turned up one major scandal in Colchester and Sir Mike’s role will keep him in the news. The process is not cheap but the former oncologist’s work could evolve into something unique: a peer inspection system for the acute sector - another first for the NHS.

4 David Flory

Chief executive, NHS Trust Development Authority

2013 The NHS Trust Development Authority took on its full responsibilities in April 2013. Former director general for NHS finance, performance and operations, David Flory has two decades’ experience at board level in the NHS, which will stand him in good stead in his new post. Part of his task this year has been building alliances: in September it was announced that the TDA and Care Quality Commission had pledged to work together to support NHS trusts that fail to meet national standards of quality and safety. The idea is that, while the CQC is the quality regulator, the TDA will be the quality improver. The organisations aim to work together to identify problems, improve information sharing and reduce duplication - and trusts will presumably be pleased that there is an attempt to cut the number of inspections. The TDA has been supporting the five trusts it has put into special measures. In September, Mr Flory said the TDA had met senior leaders to make sure they recognised the gravity of the problems they were facing.

2014 The former DH money man has half of the biggest job in health, steering an acute sector that is stuffed to the gunnels through two winters without busting the budget. Although the TDA has a responsibility to get its charges - half of all trusts - to foundation status, it must also perform a role familiar to Mr Flory: intensive performance management. Complaints from hospitals about micro-management show the seriousness with which winter performance is being taken. The government is committed to staffing and safety transparency. Mr Flory will provide the intelligence on financial and clinical performance that will hopefully avoid this new openness revealing a hospital system buckling under pressure.

5 Sir Jeremy Heywood

Cabinet secretary

2013 Sir Jeremy Heywood’s job has included some perhaps less than usual duties in 2013. In August, Nick Clegg’s spokesman confirmed that the cabinet secretary had been tasked by David Cameron with warning The Guardian to surrender or destroy the NSA documents leaked to the paper, a move described as “unprecedented” by Labour’s Keith Vaz. The incident does, however, serve to emphasise just how important to the inner workings of government Sir Jeremy is. Last year’s HSJ100 described him as the civil service’s “top fixer”, a statement which now seems rather prescient. He is seen as key to Number 10’s efforts to neutralise the NHS as an issue ahead of the next election - no easy job as winter pressures and other issues, such as Mid Staffs, have kept it in the headlines over the year. Having worked as a private secretary in Numbers 10 and 11 Downing Street he has been right at the centre of successive health reforms, which gives him a longer view than most. His Treasury experience, his stint at the International Monetary Fund in Washington, and banking credentials all mean he is well placed to see the financial challenges and potential solutions.

2014 With the prime minister, along with the chancellor, excluded from the HSJ100, Sir Jeremy’s rise up the rankings manifests Number 10’s ever increasing focus on the NHS. It will be Sir Jeremy, along with Nick Seddon (9), who will guide that interest. Mr Heywood’s time as Tony Blair’s principal private secretary between 1999 and 2003 - the period which gave birth to the NHS Plan penned by Simon Stevens (2) - gives him a good understanding of the NHS England chief. They are likely to speak often on an informal basis to ensure alignment of the government’s overarching objectives and Mr Stevens’ plans.

6 Sir Bruce Keogh

Medical director, NHS England

2013 Sir Bruce Keogh has been one of the highest profile figures on the health landscape this year, and has made the headlines many times over hot issues from A&E to patient safety. In November, he revealed controversial plans to redesignate emergency services, with fewer than 40 of them offering a higher level of staffing and expertise. This came out of the first stage of his review of urgent and emergency care in England, a process which is likely to have far reaching consequences. He has also spoken out in favour of seven-day working. In July, it was announced that 11 of 14 hospital providers investigated because of high mortality ratios in the so-called Keogh Review had been placed in special measures. A broad thinker, in July he suggested (in an interview with The Independent) that the NHS could learn from high street retailers such as PC World where people expect more but pay less.

2014 With reforms of NHS working hours, emergency care, and cardiology all on his plate, the medical director has placed himself centre stage. He has avoided becoming NHS England chief executive, but for many Sir Bruce will be the public face of his organisation, at least until the arrival of Simon Stevens (2).

7 David Behan

Chief executive, Care Quality Commission

2013 In 2013, David Behan faced what must have been one of the toughest years of his professional life. The Care Quality Commission - never a quiet backwater - was rarely out of the news, and little of the coverage was positive. His predecessor as chief executive did not go quietly, telling The Independent that she had been “hung out to dry”. The big issue facing the CQC was the alleged cover-up of failings in the inspection process at Morecambe Bay Hospitals where 16 babies died, allegedly due to poor care. Mr Behan, who only took up his post in 2012 (previously he was DH director general for social care, local government and care partnerships) had to face the Commons health committee - never fun - at a session on the CQC. Nevertheless, health secretary Jeremy Hunt described him as an outstanding public servant in June and, in October, he was one of three senior figures called in by Number 10 to be consulted on winter planning.

2014 With the CQC set to start rating NHS providers and judging the quality of senior leaders, the regulator becomes ever more powerful. Mr Behan will ensure the much expanded ship steers a reasonable course that maintains the increased respect the regulator has earned over the past year.

8 David Bennett

Chief executive, Monitor

2013 In October, David Bennett returned to his old stamping ground at Number 10 (where he had been a non-political chief policy adviser to Tony Blair), this time to advise on winter planning. It is a mark of how respected the former partner at McKinsey & Co is by government - he is frequently consulted by Jeremy Hunt too. At the start of 2013, the new style Monitor had started to take shape and look at its new responsibilities as health sector regulator. By May, Mr Bennett felt able to write in HSJ that Monitor would be a “fair and pragmatic” regulator that would use its new powers in a rigorous and evidence-based way. He said that the regulator would be proportionate and pragmatic in how it enforced the rules. He accepted, however, that getting the balance right would not be easy. By July, he was warning on the NHS funding gap and, by November, the regulator was fearlessly putting trusts into special measures.

2014 Mr Bennett’s fall to No 8 illustrates the way quality has dislodged finance from the top of the NHS’s priorities list post-Francis. However, this belies the huge expansion in Monitor’s role and size in the past year - expect him to have more, not less, influence on providers’ lives in 2014.

9 Nick Seddon

Prime minister’s special adviser, No 10

2013 Nick Seddon’s appointment as policy adviser at Number 10 back in May instantly elevated him to one of the most influential positions in UK health. The former deputy director of the pro-market think tank Reform (previously head of communications at independent healthcare provider Circle) has written for HSJ on issues ranging from innovation to culture change. Just a month before his appointment was announced, he said the NHS had to break the habits of the past to spread innovation. He said the government could create a system that rewarded those who created value by innovating - and said the health service should learn from international examples. He also said that commissioners needed to be open to “big and bold risks” such as using prime contractor models.

2014 Mr Seddon is wise and pragmatic enough to know that his boss’s interests will be best served by turning down the volume on the NHS. However, any radicalism in coalition health policy during 2014 is likely to emerge from Mr Seddon’s office. He will be on the lookout for vested interests in the NHS exerting undue influence, and for any retreat from the idea that patients are best served by the widest possible range of quality providers.

10 Sir David Nicholson

Chief executive (outgoing), NHS England

2013 Sir David announced in May that he would retire in March 2014, giving rise to inevitable speculation about why he was going and who his successor would be. We have an answer to the second point but perhaps not yet the former. Sir David had faced calls for his resignation over Mid Staffs, but is not the type to bow to media demands. It seems more likely that he felt the time was right to retire from such a high profile and demanding - some might say thankless - task, although he would have been aware that continuing criticism of him would prove a distraction.

2014 While he may not be prominent in public ahead of his departure, Sir David has told staff he will remain clearly in charge and does not intend to reach for his pipe and slippers. He will speak up on long term NHS strategy, reconfiguration and concern about competition rules. His role in guiding the NHS through the winter will also be crucial.

11 Danny Alexander

Chief secretary to the Treasury

2013 Speaking on the Today programme during this year’s Lib Dem conference, Danny Alexander repeated his leader’s pledge to protect the NHS budget in real terms beyond 2015. But nobody should assume it is immune from Treasury pressures. Indeed, in September it was reported he had warned hospital trusts using short term contracts to avoid tax that they should put their house in order. Mr Alexander is one of the “Big Four” or “Quad”, along with Lib Dem leader Nick Clegg, the chancellor and prime minister.

2014 Parts of the NHS are showing real financial strain and the general election’s looming. Mr Alexander’s rise to 11 suggests judges feel the DH may need to ask for more money, or more freedom to spend the money it has been allocated.

12 Richard Douglas

Director general, finance, DH

2013 With much health service funding now flowing through NHS England, Richard Douglas will have spent much of 2013 ensuring the new body and Treasury are on roughly the same page - no small ask when the latter wants efficiencies from the former. He is, however, a trusted figure whose experience ensures he is listened to by both sides. The public spending review, NHS staff pay and pensions will have been in his inbox. In March, he indicated a new target, saying that, while staff costs and pay restraint were showing efficiency savings, efforts to improve procurement processes were not going so well.

2014 Reforms have left financial responsibility in the NHS more fragmented and it’s Mr Douglas’s task to protect the DH’s bottom line. He is aided by his credibility and deep understanding of NHS financial flows, but it remains to be seen how powerful the levers available to him are in the new world.

13 Professor Steve Field

Chief inspector of general practice, Care Quality Commission

2013 The former chair of the RCGP took up this new post in 2013, saying he was “thrilled” at being the first person to be appointed to the role, and adding that he saw it as a wonderful opportunity to highlight what was good in general practice and dentistry and, importantly, “to shine a light on what isn’t”. Moving from NHS England, where he was one of the two deputy medical directors and responsible for health inequalities, he intends to carry that interest forward into his new role. Described by CQC chief executive David Behan as being “known and respected” across healthcare, and an “ideal person” to lead the organisation’s work in primary medical and dental services, he is clearly not one to shy from a challenge.

2014 Expect the focus on clinical quality to broaden post-Francis. Professor Field is a longstanding critical friend of primary care, and will want to hold substandard GPs to account as never before. In particular, he will give no quarter where he finds shortcomings on equality of access - a well established personal cause.

14 Stephen Dorrell

Chair, House of Commons health select committee

2013 The former secretary of state for health continued to hold the NHS to account in a way he possibly dreamed of being able to do when he was at Richmond House. In his committee role, he has greater freedom to criticise all parts of the system - and is not afraid of taking the opportunity. In 2013, he turned his mildly voiced fire on the CQC, in particular revealing concerns over its relationship with the health service ombudsman (over Morecambe Bay). In July, he warned that the discipline of the Nicholson Challenge would have to stay in place as it would be “unwise” for the NHS to rely on any significant net increase in funding in 2015-16 and beyond.

2014 The work of Mr Dorrell’s committee will continue to attract significant media attention to sensitive issues, and the chair himself is in constant demand to advise and mentor a wide range of policy makers. Ahead of the game on integrated care, the urbane Mr Dorrell is influencing policy across the political spectrum.

15 Norman Lamb

Minister of state for health, Department of Health

2013 Norman Lamb continued to push hard at the integration agenda in 2013. Last month he warned that the DH would be monitoring its “integration pioneers” - and that they could be stripped of their status if they lost their way. More positively, however, he said the 14 were leading a “quiet revolution” in the delivery of health and social care in England. In September, the minister warned that individual directors on boards of healthcare providers could face the threat of prosecution for neglect or abuse of patients. He also questioned whether increasing roles for competition authorities could end up blocking integration.

2014 With an election little more than a year away, Mr Lamb will want to build a positive and distinctively Lib Dem story on the NHS over the next year. That will include making sure his integrated care pioneers lead to tangible improvements across the service, and convincing the system that mutual ownership structures can benefit the NHS.

16 Dame Barbara Hakin

Deputy chief executive, NHS England

2013 October brought the presumably welcome news that the GMC had cleared Dame Barbara Hakin of acting in a “bullying and unprofessional manner” during her time as chief executive of East Midlands SHA in 2009. Although the year-long investigation might have distracted lesser mortals, it did not stop Dame Barbara agreeing to take on her new post with NHS England (then the Commissioning Board) in March. In this role, Dame Barbara - who is a GP by background and who has strong expertise in clinical commissioning - is taking responsibility for overseeing the development of NHS England’s “operations architecture”.

2014 Though she is very close to the outgoing NHS England chief executive Sir David Nicholson (10), Dame Barbara also worked with his incoming replacement Simon Stevens (2) in the early 2000s. She will remain a valuable conduit to the Department of Health, and hold the reins on critical performance delivery issues, as well as primary care and commissioning.

17 Tim Kelsey

National director for patients and information, NHS England

2013 Tim Kelsey has pressed on with his grand plan of bringing the NHS into the digital age. He is a massive advocate of transparency and open data and his pleas for the health service to be more tech savvy seem to be bearing some fruit. Throughout the year he has spoken out on the need for innovation and partnership with for-profit and not-for-profit entrepreneurs and has been open about the need for change. Speaking in July, he warned that the NHS was facing a financial shortfall and said that significant service change was needed. He has also continued to push for more patient feedback.

2014 NHS England’s energetic national director for patients and information has launched numerous policy initiatives to ingrain “transparency and ‘customer’ participation” into the health service’s DNA. The former Cabinet Office transparency tsar continues to oversee some of NHS England’s most pioneering projects including care.data, which aims to link patients’ GP and hospital data.

18 Dame Sally Davies

Chief medical officer for England, Department of Health

2013 Dame Sally Davies has had a high media profile this year and has not minced her words. She has said the country should be profoundly ashamed of the “worrying picture” of child health, in particular the return of rickets, and has called for children to be given free vitamins. She also caused surprise in some circles by her confession (as part of a radio programme) that she had used cannabis - but took the opportunity to press her point that drugs were a medical rather than criminal issue. Apart from anything else, as HSJ’s Michael White pointed out, Dame Sally’s candour has served to bring her to the public attention - and also given her the opportunity to raise the public health issues she holds dear.

2014 Dame Sally has impressed with an understated operational style and continues to raise the profile of medical research as chair of the UK Clinical Research Collaboration. Included in HSJ Inspirational Women 2013, she recently set up a mentoring scheme for female academic clinicians at King’s to address the gender gap in senior academia.

19 Earl Howe

Parliamentary under secretary of state for quality, Department of Health

2013 Earl Howe entered 2013 as the longest lasting minister in the coalition government’s health team - and with an expanded remit too. The hereditary peer and former banker played a significant role in pushing the Health Act through the House of Lords last year, and has been on hand throughout its implementation. This year his duties have included responsibility for the foundation trust pipeline and economic regulation. In September, he called for a little moderation in the way that the government talks about NHS “failures” in an effort to counter a fall in public confidence. He said ministers had to take the opportunity to celebrate the “excellent and the good”.

2014 With little legislation to pilot through the house, Earl Howe’s influence has waned slightly, but the quiet man of Tory health politics still carries a big stick. As Conservative party election planning moves into top gear, “Freddie” will be regularly consulted on how ideas will be greeted by the Lords, the NHS and Tory party faithful.

20 Andy Burnham

Shadow health secretary

2013 Before this year’s Labour party conference there were strong rumours that Andy Burnham was to be shuffled away from the health portfolio he clearly loves. In the event he remains, to continue his policy of being a thorn in the side of health secretary Jeremy Hunt, while laying out his own plans for the health service should Labour win the next election. At the conference he said he would put forward legislation to repeal the Health Act - although he told HSJ afterwards that he intended to keep the bits of it that he liked. He also pressed the idea of health and social care integration, saying that some local authorities had already signed up to the vision of becoming “whole person care innovation councils”.

2014 Next year looks like it will be make or break for Mr Burnham. Win the battle with Jeremy Hunt and land his radical ideas for healthcare reform and the former health secretary could very well be occupying a top cabinet post or the opposition leader’s office in 2015. However, the Tories have his past record firmly in their sights.

21 Bill McCarthy

Policy director, NHS England

2013 Mr McCarthy has moved up four places in the HSJ100, recognition of the importance of his role at NHS England. As lead director for establishing the organisation, he has had his work cut out and also has to work closely with the Department of Health on big policy decisions. In an exclusive interview with HSJ in April, he pledged to extend the current QIPP savings programme beyond 2015, and said this would involve strategic change, including reconfiguration.

2014 Mr McCarthy should help smooth NHS England’s change of chief executives. He is overseeing his organisation’s all-important long term strategy and will be charged with morphing it into something that fits with Simon Stevens’ (2) priorities.

22 Ian Dodge

Director, policy support unit, Department of Health

2013 In his relatively new role at the DH, Ian Dodge balances advising ministers on their stewardship of the NHS while leading on NHS policy, stakeholder engagement and delivery. His job includes managing the government’s relationships with bodies such as Monitor, and the NHS Trust Development Authority. As if that was not enough, he is now also adjunct professor at the Centre for Health Policy, Institute of Global Health Innovation at Imperial College London - and yet still has time to keep his LinkedIn profile bang up to date and very thorough.

2014 In perhaps his last full year with the DH, Mr Dodge will nevertheless remain the conduit for translating Mr Hunt’s ideas into policy.

23 David Prior

Chair, Care Quality Commission

2013 It has been another difficult year for the Care Quality Commission and, as the man at the helm, David Prior has had to demonstrate that he has broad shoulders. He came out fighting, however, admitting in an exclusive HSJ interview in June that the CQC should have published the names of those implicated in the alleged cover-up over Morecambe Bay. In October, he laid down the gauntlet to clinicians, saying they had to make their voices heard to end poor practice and wide variations of care in the NHS.

2014 The outspoken chair appears more comfortable on camera than his chief executive and there will no doubt be plenty of opportunities for public appearances as the CQC’s new inspection regime gets going in full during 2014. A key role for Mr Prior will be ensuring the CQC has the necessary resources to cope with increasing demands from ministers.

24 Dr Mark Porter

Chair, BMA

2013 Dr Porter is a respected figure in the health service and he has needed all his skills this year to counter what the BMA sees as a continuous barrage of attacks on the profession. Doctors across all branches of practice fear that their terms and conditions are under attack and, despite last year’s doctors’ strike, virtually no progress has been made on protecting pensions. At the BMA’s annual representative meeting in June, Dr Porter said the government was making the NHS unsafe for patients through spending cuts.

2014 A big drop marks the BMA’s tactical mistakes over pensions, which he could not prevent. But the sensible Dr Porter is steadily regaining lost ground.

25 Dr Chaand Nagpaul

Chair, GP committee, BMA

2013 Chaand Nagpaul has long been a senior player in the BMA’s GP committee, particularly on commissioning, but was perhaps not the front runner to take over from former chair Laurence Buckman this summer. Nevertheless, he hit the ground running, with an immediate pledge to take a “positive, constructive and fresh” approach with government to help deliver improvements to patient care. In September he criticised “unnecessary” changes to GPs’ contracts and said that GPs were getting fed up, were overworked and were tied up in red tape.

2014 GP reform is one of Jeremy Hunt’s favourite themes - the BMA will as ever be central to the bargaining process.

26 Dr Maureen Baker

Chair, Royal College of General Practitioners

2013 The new chair of the RCGP looks set to continue Clare Gerada’s policy of outspokenness. In her first major interview as chair-elect, she told HSJ in September that she had reservations about government plans for general practice. In particular, she said the prime minister’s £500m accident and emergency bail-out plan was “voodoo med-economics” driven by political imperatives. She was also dubious about proposals aimed at improving the care of older people by making GPs accountable clinicians.

2014 While employing a different style to her predecessor, Dr Baker will not shirk from robust and public battles over GP funding, workforce and independence.

27 Paul Baumann

Finance director, NHS England

2013 A new entrant to the HSJ100 last year, Paul Baumann has the tough job of overseeing the £80bn NHS commissioning budget. The former Unilever finance director is bringing private sector know-how to NHS financial decisions. In July, he spoke out about the huge challenge of making savings to create a pooled budget for health and social care commissioning, calling it a heroic undertaking, and saying it could not be achieved by “business as usual”.

2014 With NHS England due to decide imminently on clinical commissioning group allocations, Mr Baumann’s actions will be significant for the immediate and long term financial outlook of every health economy in England.

28 Peter Carter

Chief executive, Royal College of Nursing

2013 Peter Carter has remained the loudest voice in nursing in a tough year for the profession. As expected, the Francis report did not pull its punches in raising serious issues with the nursing at Mid Staffs, and more widely, and the RCN had its work cut out to make a credible defence. Nevertheless, Mr Carter won a standing ovation at 2013’s RCN congress when he upped the ante on staffing numbers - an issue that is likely to rumble on.

2014 Mr Carter has made the RCN highly efficient, meaning he will have plenty of time to intervene in the increasingly heated debate over nursing ratios.

29 Sir Malcolm Grant

Chair, NHS England

2013 Finding a successor for Sir David Nicholson (10) was just one of the challenges facing Sir Malcolm in 2013, and he was resolute in broadening the search beyond the usual suspects, saying that it was time for a fresh approach. As chair of NHS England during its formation, he has been prepared to stand up to the Department of Health - for example, warning that the government’s proposed refresh of the NHS England mandate threatened to push the NHS back towards “command and control”.

2014 Sir Malcolm keeps a relatively low public profile but is not afraid to make waves when the time comes to speak out.

30 Professor David Haslam

Chair, National Institute for Health and Care Excellence

2013 David Haslam took over as chair of NICE this year at a time when the organisation’s remit was expanding to take in social care. Professor Haslam pointed out that his work at the Care Quality Commission and Healthcare Commission (where he was a senior clinical adviser) meant he appreciated the cultural differences between health and social care “even down to the language”. A former GP, he said his main priorities in his new role would include developing NICE’s work on people with multiple conditions, and responding to the funding squeeze.

2014 Professor Haslam has maintained a lower profile than predecessor Sir Michael Rawlins but the well regarded clinical leader continues to make sound progress.

31 Dean Royles

Chief executive, NHS Employers

2013 Dean Royles has jumped another few places this year, a reflection of the ongoing importance of staff pay and terms and conditions. It has not been an easy time, with continuing rumblings over changes to the NHS pension scheme and trying to get the unions on side with pay modernisation. Hot topics for Mr Royles and NHS Employers in 2013 have included seven-day working, recruiting staff with the right values and exploring extended working hours - the last being a particularly hard sell.

2014 Mr Royles is an increasingly prominent voice and should be pleased with his 2013. Key workforce contract challenges lie ahead in 2014.

32 Bob Alexander

Finance director, NHS Trust Development Authority

2013 A big leap up the list for Bob Alexander - in recognition of the importance of his role at the NHS Trust Development Authority. While care quality and clinical standards are understandably the watchwords for the TDA, it is the financial situation of trusts seeking foundation status that is the nitty gritty issue. Previously, Mr Alexander was director of NHS finance at the Department of Health from 2007 - leading on financial policy and performance, as well as being responsible for the national tariff programme.

2014 With a record number of hospital trusts predicting a deficit this year, the TDA’s money man is going to be more important than ever.

33 Duncan Selbie

Chief executive, Public Health England

2013 Public Health England has obviously been a challenging place to be in 2013, having formally taken on its responsibilities from April. The organisation is dealing with a new landscape with the shift of public health to local authorities, and the transition period will doubtless be bringing its challenges. A man with NHS DNA - he joined the service on 1 January 1980 - Mr Selbie has a tough job to embed public health values in the new system.

2014 Mr Selbie faces difficulties convincing financially challenged councils to invest in illness prevention, rather than use public health funds to plug gaps.

34 Sir Andrew Dillon

Chief executive, National Institute for Health and Care Excellence

2013 NICE’s remit has expanded this year to include setting quality standards for social care as well as health, broadening its influence and bringing new challenges to Sir Andrew - now is his 14th year in the role - and his team. The organisation has also got a new chair following the departure of the equally long-serving Sir Michael Rawlins early in the year.

2014 Sir Andrew is overseeing a critical period in which NICE must develop guidance on safe staffing levels and support the work of clinical commissioning groups.

35 Stephen Hay

Chief operating officer, Monitor

2013 It has been a year in which Monitor has sought to prove it really means business, with the redoubtable Stephen Hay on the front line of the action. In May, the regulator was given extra powers to deal with failing healthcare providers. Throughout 2013, Mr Hay has been the public face of the organisation as it forced changes at poorly performing trusts from Dorset to Norfolk and called for foundation trusts to ensure they had effective investment plans.

2014 With the new government emphasis on regulation, increasing financial strain on foundation trusts, and plans to extend Monitor licensing to private providers, expect him to have a busy year.

36 Jane Cummings

Nursing director, NHS England

2013 The big question facing Jane Cummings this year was how to galvanise a demoralised nursing profession, reeling from criticism that it had lost some of its sense of purpose. Her response was the 6Cs campaign, which championed the values of “care, compassion, competence, communication, courage and commitment”. She has also been at the forefront of the debate over nursing staffing levels - insisting that patients have the right to expect that enough staff will always be present to provide quality care.

2014 Down nine places, the chief nurse will want to embed the nursing strategy and prove a leading voice on staffing levels and quality in 2014.

37 Ciarán Devane

Chief executive, Macmillan Cancer Support and non-executive director, NHS England

2013 Mr Devane continues his ascent of the HSJ100 following another successful year. As an important player in the Richmond Group, he is a voice for 17 million patients. In 2013, he led a striking campaign for patients with terminal cancer to be able to die at home rather than in hospital. At the same time he has made an outspoken call for the NHS to embrace branding as a way to ensure that core values are embedded in all it does.

2014 His dual roles make him both a leading advocate for patients and an influential voice at the centre of NHS power.

38 Professor Chris Ham

Chief executive, The King’s Fund

2013 As chief executive of the mighty King’s Fund think tank, Professor Ham helps direct informed debate across every area of healthcare. As an avid blogger, Tweeter and accomplished speaker, his personal contribution is considerable. This year has seen him take on a role which could result in much more than discussion. Health minister Norman Lamb put him in charge of a review to establish whether staff engagement and patient outcomes would be improved by turning acute trusts into social enterprises and mutuals.

2014 Expect Professor Ham to be highly influential in helping shape the next set of health reforms post-election.

39 Bob Ricketts

Director of commissioning support strategy and market development, NHS England

2013 Better commissioning is a foundation stone of government healthcare reforms, making Bob Ricketts’ job one of the most significant in the NHS. Having gone full-time in April, his big ambition has been to create the efficient support structure clinical commissioning groups need if they are to succeed. He has abandoned the notion that the commissioning support units need to be “free standing enterprises”. They now just have to be “autonomous” - perhaps as co-ops or joint ventures with the private sector.

2014 Much of the future success of the commissioning sector depends on Mr Ricketts’ work building a market for support services.

40 Lord Ara Darzi

Chair, Institute of Global Health Innovation

2013 A year of changes. As his term as UK global ambassador for health and life sciences ended, he was wooed by Boris Johnson to head (his second) clinically led investigation of London’s healthcare. Lord Darzi’s status is such that when he speaks, governments really take notice - so his suggestion that CCGs are ill-equipped to press big beast providers to reshape services will have had an impact. What remained constant in 2013 was his top table position among British healthcare’s great and good.

2014 Lord Darzi will want his review to result in a greater focus on population health and establishing the capital as a healthcare research centre to rival Boston.

41 Dr Charles Alessi

Chair, National Association for Primary Care

2013 Dr Alessi has continued to build up his position as cheerleader in chief for the new commissioning system and has lauded “the incredible work” of CCGs. January saw him appointed as senior adviser to Public Health England, reinforcing his reputation as someone whose opinions are well received. However, Dr Alessi has been critical of a “flat-lining” in funding which could lead to poorer provision. He has also called for a period of calm, free from “externally imposed disruption and centrally-driven reorganisation”.

2014 This longtime advocate of clinical commissioning carries clout in Richmond House and Downing Street on the subject of primary care reform.

42 David Dalton

Chief executive, Salford Royal Foundation Trust

2013 Last year, HSJ predicted that we would be hearing more from David Dalton as pressure grew for the sector to innovate - and so we have. He was on the reference panel for a report which condemned the DH procurement strategy as a missed opportunity. Mr Dalton has also been critical of patient safety, warning the NHS Confederation conference of the “huge danger” of failing to recognise that hospital care is not as safe, reliable and cost-effective as it could be.

2014 Hospitals around the country are already being encouraged to follow Salford’s example on nurse staffing levels and Mr Dalton is likely to be consulted by Jeremy Hunt on other quality issues.

43 Professor Keith Willett

Director, domain 3 (acute care), NHS England

2013 As the leader of Bruce Keogh’s urgent and emergency care review, Keith Willett has been tackling some of the knottiest issues in healthcare politics and practice. He wants solutions that will enable staff to be rested, alert and safe. He simultaneously insists that seven-day working can be a reality. Bold statements are a trademark - as is shown by his widely reported comments that due to consultant shortages he would have concerns if a relative was admitted to hospital at the weekend.

2014 As reform of urgent and emergency care becomes an increasing policy priority, Professor Willett is likely to emerge from Sir Bruce Keogh’s shadow.

44 Christina McAnea

Head of health, UNISON

2013 Christina McAnea shows relentless energy in upholding the interests of UNISON members and NHS patients. She has been campaigning for fixed, safe nurse-patient ratios and is demanding better protection for whistleblowers - following allegations that staff who complained about the falsification of data about cancer patients were “pressured or bullied”. While she has been quite prepared to speak of industrial action when terms and conditions are threatened, she is more than willing to accept change - having recently broadly welcomed proposals to reshape emergency services.

2014 A huge union voice for NHS staff. The next 12 months could herald further talks on pay, terms and conditions, making Ms McAnea a key player.

45 Sir Robert Naylor

Chief executive, University College London Hospitals Foundation Trust

2013 Early in the year Sir Robert unveiled a far reaching service reorganisation under which UCL would take a greater role in urological cancer services while specialist cardiac work would go to Barts. From May he served a term as chair of the Shelford Group, which represents England’s 10 leading academic teaching hospital trusts. The group has been lobbying hard for extra cash to compensate for higher costs and falling tariff prices - with members outside the capital demanding parity with London for education finance.

2014 Chief executive of England’s most successful hospital trust and the man the politicians turn to for informed counsel on acute issues.

46 Liz Kendall

Front bench spokesperson on older people and social care, Labour Party

2013 Now a regular at shadow cabinet meetings, Liz Kendall’s star is rising. Her portfolio really matters to Labour as it embraces perceived coalition weak spots. Ms Kendall recently launched an assault on the government’s care costs cap, claiming that six out of seven pensioners were dead before it was reached. Her attacks on the “depressingly unambitious” integrated service pilots and deep cuts in adult social care have also been sharp. By contrast, her outlining of Labour’s alternative approach can appear woolly.

2014 Most informed commentators now believe Ms Kendall, rather than Andy Burnham, would be the health secretary in any Labour government.

47 Geoff Alltimes

Chair, Local Government Health Transition Task Group

2013 A noted high flier in local government, he has spent this year helping councils and the DH chart their way through choppy waters as authorities take on new public health responsibilities. It followed January’s decision - a clear vote of confidence - to extend the group’s life by a year allowing the transition to be sector rather than government led. Mr Alltimes asserted that his aim would be to ensure that the group got the very best out of integration.

2014 Mr Alltimes will be a leading player in trying to ensure health and social care integration does not run out of steam at the pilot stage.

48 Dame Julie Moore

Chief executive, University Hospitals Birmingham Foundation Trust

2013 Dame Julie is a woman of profound influence and authority. She was among those touted as a potential successor to Sir David Nicholson as chief executive of NHS England. With a strong interest in the care of older people, she has been loudly ringing the alarm bell over the failure of the NHS to come up with a realistic approach to ensure better care.

2014 Dame Julie will continue her campaign for improved service provision as the chair of the commission on the hospital care of frail older people launched earlier this year by HSJ.

49 Dr David Geddes

Head of primary care commissioning, NHS England

2013 A year into the job and Dr Geddes has been asking uncomfortable questions - like are we recruiting the right people to become GPs? He also argues that seven-day services can allow professionals to better spread their workloads. The Yorkshire GP is deeply critical of the barriers to effective care of patients with long term conditions and suggests that the shrinking of QOF payments could give CCGs more cash for local priorities. However, he has been dogged by practical problems over late and incorrect GP payments.

2014 His position above some NHS England colleagues may be a surprise, but he will have a critical hands-on role in primary care contracting.

50 Tamara Finkelstein

Director of public services, Treasury

2013 One way or another, Tamara Finkelstein has spent much of her working life at HM Treasury. Currently she is responsible for oversight of major public services expenditure. Previous roles have included stints as director of government treasury management, and director of operations. Work in the field has included being deputy head of Sure Start - and her previous experience as a speechwriter and private secretary to then chancellor Gordon Brown will doubtless help her deal with ministers begging for a bigger share of the pot for their departments.

2014 Will play a key role in big decisions about Department of Health spending (and underspending).

51 Ian Cumming

Chief executive, Health Education England

2013 The former national director of quality and chief executive of West Midlands SHA, he said this year that HEE exists to help improve the quality of care.

2014 Changes to workforce planning will impact all NHS organisations in 2014.

52 Una O’Brien

Permanent secretary, DH

2013 In 2013, she saw significant amounts of her power move to NHS England and Monitor - hence her drop in the rankings.

2014 The influence of most DH civil servants is now much diminished.

53 Dr Paul Flynn

Consultants’ chair, BMA

2013 This summer, he savaged the Commons Public Accounts Committee for failing to understand consultants’ work and was then embroiled in contract negotiations.

2014 As chair of the BMA consultants’ committee, Mr Flynn will be key in contract negotiations and publicly representing consultants over the next 12 months.

54 Catherine Davies

Director, co-operation and competition, Monitor

2013 In post since late 2012, she is a staunch advocate of competition - recently telling a King’s Fund event it is about practicality, not ideology.

2014 A new entry, illustrating the rising profile and influence of the competition watchdogs.

55 Dr Mike Bewick

Deputy medical director, NHS England

2013 Formerly NHS North of England medical director, he this year became one England’s most senior GPs with responsibility for primary care reform.

2014 A key operator under Sir Bruce Keogh (6), leading primary care reform.

56 Dr Kathy McLean

Medical director, NHS Trust Development Authority

2013 Central to the NHS Trust Development Agency’s medical leadership agenda, Dr McLean condemned poor practice at five trusts which were then placed in special measures.

2014 The NHS Trust Development Authority has a big year in prospect and Dr McLean has a key role.

57 Adrian Masters

Director of strategy, Monitor

2013 Central to shaping the payments regime. In October, he said changes will let providers develop new service models.
2014 At the heart of work on major reform of NHS payment systems.

58 Paul Bate

Director of strategy, Care Quality Commission

2013 Moved from his role as David Cameron’s (non-political) adviser to join the new CQC leadership “dream team”.
2014 Mr Bate’s focus in 2014 is likely to be on developing inspection regimes for non-acute settings, particularly social care.

59 Dr Geraldine Strathdee

National clinical director for mental health, NHS England

2013 Used World Mental Health Day to attack the “scandal” of poor access to good, cost-effective treatment.
2014 Developing parity of esteem and funding of mental health will be crucial.

60 Margaret Hodge

Chair, Public Accounts Committee

2013 Loved, loathed and fearless - in 2013 she was the scourge of the DH and providers for everything from IT calamities to poor out-of-hours services.
2014 Civil servants continue to be united in their desire to avoid a Ms Hodge monstering.

61 Ros Roughton

National director, commissioning development, NHS England

2013 In the tough inaugural year of the new commissioning landscape, commissioning development chief Ros Roughton has been keen to save money by more efficient use of outsourcing.
2014 Will quietly steer the development of the new commissioning sector.

62 Dr Steve Kell

Chair, NHS Bassetlaw CCG, co-chair of NHS Clinical Commissioners Leadership Group

2013 Dr Kell took on the new role at lobby organisation Clinical Commissioners in March. It is hoped he (and co-chair Amanda Doyle can become the national voice of NHS clinical commissioners and communicate issues from the frontline.
2014 Will continue to grow in confidence as the independent voice of CCGs.

63 Ben Dyson

Director of commissioning policy and primary care, NHS England

2013 An important link between NHS England and GPs, Mr Dyson has had his work cut out for him in 2013.
2014 He will use his civil service background and brain to navigate the commissioning agenda.

64 Dr Mike Durkin

Director of patient safety, NHS England

2013 In 2013, patient safety had perhaps its highest profile to date - and a few knocks, due to issues such as the NHS 111 debacle.
2014 Post-Francis plans give emphasis to NHS England’s patient safety role.

65 Niall Dickson

Chief executive, GMC

2013 A hugely busy year for the General Medical Council with challenges ranging from the Francis report to doctors’ training - but at least revalidation is underway at last.
2014 Post Mid Staffs, the GMC has increased expectations of trusts offering doctor training.

66 Andrea Sutcliffe

Chief inspector of social care, Care Quality Commission

2013 This year Andrea Sutcliffe became England’s first chief inspector of social care, joining the CQC from the Social Care Institute for Excellence, where she was chief executive.
2014 Has to show how a single chief inspector can improve a vast sector.

67 Harry Cayton

Chief executive officer, Professional Standards Authority

2013 Professional regulation has had a high public profile in the light of the Francis report, meaning a busy year for Harry Cayton and colleagues.
2014 He will be influential on the expected reforms to professional regulation in 2014.

68 Professor David Fish

Chief executive, UCLPartners

2013 David Fish remains an influential voice at UCL Partners, which aims to translate cutting edge research and innovation into measurable health outcomes.
2014 The most influential of the academic health science centre leaders, this clinical neurologist is driving significant population-focused service changes across a large swathe of the south-east.

69 Professor John Appleby

Chief economist, The King’s Fund

2013 Another busy year for John Appleby who has published on topics as varied as spending in NHS England and pressures on A&E services.
2014 The current challenges in health will exercise his talents in 2014.

70 Lord Victor Adebowale

Chief executive, Turning Point

2013 In 2013, Lord Adebowale continued to have a wide portfolio of activities, including his role as a non-executive director at NHS England.
2014 Expect him to continue to be an advocate for the third sector in 2014.

71 Jon Rouse

Head of social care, local government and care partnerships, DH

2013 In March, Mr Rouse was appointed from the London Borough of Croydon, where he had been chief executive. In his own blog he describes it as “an interesting transition”.
2014 Integrated care will seem a utopian dream when social care cuts are the reality.

72 Dame Moira Gibb

Non-executive director, NHS England

2013 As a former local authority chief executive (Camden), Dame Moira brings formidable experience to her new role.
2014 Must show her NHS England colleagues that councils offer solutions.

73 Carolyn Downs

Chief executive, Local Government Association

2013 With the transfer of public health to local authorities, the LGA has gained more influence over the nation’s wellbeing.
2014 Councils’ relative success in coping with budget cuts could strengthen her negotiating hand.

74 Jeremy Taylor

Chief executive, National Voices (82)

2013 In 2013, Jeremy Taylor continued to work hard to make sure the patient point of view was considered at the top table.
2014 His voice will remain crucial to the patient experience agenda in 2014.

75 Viv Bennett

Director of nursing Public Health England and chief nurse, DH

2013 Viv Bennett has been promoting the public health role of all nurses, not just those in obviously public health roles.
2014 She will need to focus on strengthening the voice of nursing across public health next year.

76 Professor Alistair Burns

National clinical director for dementia in England, Department of Health (67)

2013 Professor Burns’ role is central to achieving the prime minister’s dementia challenge - no mean task in the face of an ageing population and tightening budgets.
2014 He will be working to make sure dementia retains its current high profile.

77 Dame Julie Mellor

Parliamentary and health service ombudsman, NHS Ombudsman

2013 Continuing to hold the NHS to account, this year Dame Julie turned her attention to sepsis, revealing shocking instances of poor care.
2014 The ombudsman has promised to start investigating more NHS complaints.

78 Dr Peter Melton

Accountable officer, NHS North East Lincolnshire CCG and co-chair, NHS Commissioning Assembly

2013 Dr Melton is hugely respected for his thought leadership on, among other things, the role of clinical commissioning groups in mitigating risk.

2014 His will be a trusted private voice for clinical commissioners at senior levels.

79 Dr Clifford Mann

President, College of Emergency Medicine NEW ENTRY

2013 Has had a high profile in 2013 as the voice of the emergency doctor in the continuing crisis over A&E care - is not afraid to speak out.
2014 Expect to hear more from this well respected clinician as A&E continues to hit the headlines.

80 Sir Robert Lechler

Executive director, King’s Health Partners Academic Health Sciences Centre

2013 Sir Robert continued to lead one of the most ambitious accredited academic science centres and remained a strong advocate of innovation.
2014 Even if the merger of Guy’s and St Thomas’, King’s College Hospital and South London and Maudsley foundations trusts does not come to pass, Professor Lechler still has considerable influence on services and the research agenda.

81 Dr Martin McShane

Director domain 2 (long term conditions), NHS England

2013 Former GP commissioner Dr McShane has taken on what must be one of the toughest briefs in the new NHS England - transforming the approach to long term conditions.
2014 This thoughtful clinician is responsible for the most politically important clinical domain.

82 Dr Daniel Poulter

Junior minister, DH

2013 He has had a high profile for a junior minister, making announcements on areas including vulnerable children and NHS care for war veterans.
2014 If “Dr Dan” remains in health, his experience will only grow.

83 Dr Mike Dixon

Chair, NHS Alliance

2013 A long time advocate and pioneer of medical leadership, Dr Dixon remains influential in persuading others that clinicians should be at the heart of commissioning.
2014 He will remain an energetic voice as the focus falls on primary care.

84 Jeremy Hughes

Chief executive, Alzheimer’s Society

2013 Jeremy Hughes continued to press for dementia to take centre policy stage - and, with the prime minister’s Dementia Challenge, his voice was certainly heard.
2014 He will be hoping the dementia challenge will bring meaningful change.

85 Kingsley Manning

Chair, Information Centre

2013 As the first chair of the new organisation, Mr Manning was clear in 2013 that he had a number of issues in his sights, not least cyber security and the problem of data being misused or misrepresented.
2014 He is overseeing the body at a time when quality data is a rising NHS priority.

86 Dr Mark Newbold

Chief executive, Heart of Birmingham Foundation Trust

2013 Dr Newbold maintained his reputation for penetrating thought leadership, particularly on the future shape of hospital care.
2014 As chief of one of the largest trusts and chair of NHS Confederation’s hospital forum, expect continuing influence.

87 Dr Jennifer Dixon

Chief executive, The Health Foundation

2013 After a successful stint at the Nuffield Trust, Dr Dixon took over from Stephen Thornton at the Health Foundation.
2014 After her impact at the Nuffield Trust, there is much anticipation over what she will do with a far larger budget.

88 Roger Witcomb

Panel chair, Competition and Markets Authority

2013 A busy year for Mr Witcomb and the Competition Commission as controversy arose over foundation trust mergers.
2014 Will influence this powerful new watchdog’s approach to NHS mergers.

89 Dr Richard Vautrey

Member, GP negotiating committee, BMA

2013 Was beaten to the top job by Dr Chaand Nagpaul this summer, but Dr Vautrey remains an influential and respected figure in medical politics.
2014 Policy makers and GPs will listen to him as they wrangle with difficult issues.

90 Robert Francis QC

President, Patients Association

2013 Robert Francis QC delivered his landmark judgement on the health service in February 2013, spelling out in detail the widespread systemic failures. His was a constant presence throughout the year.
2014 His authoritative voice will be maintained at the Patients Association.

91 Dr Johnny Marshall

Policy director, NHS Confederation

2013 Dr Marshall joined as policy chief in February and is extending the Confed’s partnership work in health and social care.
2014 An alliance builder with his finger on the clinical commissioning pulse.

92 Jan Sobieraj

Director, NHS Leadership Academy

2013 The former PCT and hospital chief has pushed ahead with the new academy’s task of training 10,000 new NHS leaders.
2014 The Leadership Academy will need to start delivering results from its government investment.

93 James Titcombe

Adviser, CQC

2013 After fighting for answers after his son’s death at Morecambe Bay Foundation Trust, James Titcombe was appointed in September to advise on quality and safety.
2014 The uncompromising Mr Titcombe’s effect on the CQC will be something to watch.

94 Dr Geraint Lewis

Chief data officer, NHS England

2013 The man charged by Tim Kelsey (17) with ensuring the NHS makes maximum possible use of one of its greatest assets: a nationally collected data set.
2014 The former Nuffield Trust senior fellow will run the landmark care.data programme, which seeks to link patient data across all care settings.

95 Dame Gill Morgan

Chair, Foundation Trust Network

2013 Chair of the Alzheimer’s Society since July and the FTN since November, the ex-NHS Confederation CEO has influence across a spectrum of issues.
2014 Expect this “activist” chair to be higher placed in 2014.

96 Professor Paul Corrigan

Freelance consultant

2013 A leading opinion shaper, Professor Corrigan has used his voice as a columnist and role as a consultant to press for genuinely integrated care.
2014 Incoming NHS chief Simon Stevens (2) will have him on speed dial.

97 Dame Ruth Carnall

Adviser, Greater London Authority

2013 Previously the chief executive of NHS London, Dame Ruth was appointed in June to advise Boris Johnson on challenges such as population growth.
2014 She will work closely with Lord Darzi (40) to develop a sustainable answer to the capital’s health issues.

98 Camilla Cavendish

Journalist/associate editor, The Times

2013 Asked by government to review healthcare assistant training post Francis - she wants a compulsory certificate before they can care for patients unsupervised.
2014 A CQC board member, columnist and member of the Tory inner circle who will be influential.

99 Tony Gallagher

Editor, The Daily Telegraph

2013 Among the most influential figures in the UK media - his newspaper is a leading voice on health issues.
2014 Gets more private briefings from government than any other editor.

100 Ed Jones

Special adviser to the secretary of state, DH

2013 A former Deloitte consultant and financial PR with little health background, he became Jeremy Hunt’s adviser in May when Sam Talbot-Rice left after six months.
2014 His political feedback will be vital as the election draws closer.