The next chief executive of NHS England will have a different role and need a different style to previous leaders. Here are 10 suggestions for things they should do when they take over.

There will soon be a new NHS “big beast” in town when the next NHS England chief executive takes over. We are all keen for her or him to be a success. Here are 10 ideas and suggestions from me about factors that could contribute to that success, offered from the heart (and at no charge).

Equality and diversity

Strive for a top team that reflects the NHS workforce − which is diverse. It is 70 per cent female. One fifth of the workforce is black and minority ethnic; one tenth is lesbian/gay/bisexual/transgender. Develop people at all levels; recruit for attitude and aptitude − and eventually you will get there.

Suggested reading

Intelligent Kindness by John Ballatt and Penelope Campling, on reforming the culture of healthcare, and Who Cares Wins by David Jones, which examines ethical businesses.

Recommended viewing

Student nurse Molly Case reading her poem Nursing the Nation at this year’s Royal College of Nursing congress; and lawyer and author Susan Cain’s TED talk on “the power of introverts”.


Ignore legal advice that tells you not to share everything. Take a leaf out of the book of David Dalton at Salford Royal Foundation Trust. Open your mind (and the windows at Quarry House) and let the sunlight in.

Demographics and money

Perhaps patients, the public, media and politicians don’t yet fully appreciate that an NHS designed for the 1960s isn’t fit for the 21st century, and that we face many more years of escalating demands to meet the needs of a growing number of old and frail people with multiple morbidities, with reduced money?

‘Remember that integrated care doesn’t mean giving all the money to acute trusts or another top-down reorganisation’

So it is your job to explain this to them. You need to be a great communicator. Marshal your skills and those of the whole NHS. Make great care for old and vulnerable people the service’s number one priority and people will be very, very pleased.


It is also your job to help politicians of all parties understand that the NHS is far too precious to be the subject of the kind of scenes we recently saw in the House of Commons in the debates over the Keogh review.

Social media

Find a clever, tech savvy person to teach you about Twitter, YouTube, websites and blogging. Now start learning by doing. Don’t let the trolls diminish your efforts, but do get help so that you don’t confuse genuinely upset patients or families with trolls.


Banish it. Practice “mindfulness meditation” instead.


In tough times, the tendency is to cut budgets for education, research and innovation. Confound people and do the reverse.

Fill your team with innovators to help you find new answers to emerging problems.

Remember that integrated care doesn’t mean giving all the money to acute trusts or another top-down reorganisation.

Know this:

None of the above is a criticism of past NHS leaders. However, we are at a tipping point. The public has woken up to what healthcare professionals have always known, which is that NHS care is often excellent but also variable. They have discovered that there are good services and some that are not, and that those with more expertise get better outcomes.

‘If you have honest and open dialogue, most people will understand there is a case for major change’

And that there is no such thing as excellent care without kindness and compassion.

Grasp the opportunity to discuss everything with the public, including what they expect you to commission with the resources available. If you have honest and open dialogue, you will find that most people will understand there is a case for major change.

If you take the road less travelled, as suggested above, good NHS leaders will follow you. Good luck, and may you find courage and experience kindness on your way.

Lisa Rodrigues is chief executive at Sussex Partnership Foundation Trust