After many months, we once again have a full complement of strategic health authority chief executives, even if one of them has been given the honour of being made temporary flu czar (news, page 7).

The appointments of North Lancashire PCT chief executive Ian Cumming to NHS West Midlands and City of York council chief executive Bill McCarthy to NHS Yorkshire and the Humber - one appointment process painfully drawn out and the other impressively speedy - will calm nerves locally and revitalise the NHS management team.

Their backgrounds in primary care and local government will mean they bring to the top table valuable experience of commissioning and of tailoring services locally.

As SHAs prepare for an assurance framework all of their own, gearing up to demonstrate how they respond to being performance managed as well as performance managers, these new voices will be a welcome addition to the mix.