The NHS risks “a drift into…risk aversion and blame”, Sir Bruce Keogh has said, criticising the “terrible statistic that the life expectancy of a chief executive in our NHS is only two and a half years”.

The NHS England medical director, who is stepping down later this year, was speaking at the NHS Confederation conference yesterday.

He said: “In the face of relentless pressure that everyone in the service is feeling at the moment, there is a risk that we drift into a focus on risk aversion and blame.

“And I would invite people to ask politicians, arm’s length bodies of which I’m a part, and regulators what it is that results in the terrible statistic that the life expectancy of a chief executive in our NHS is only two-and-a-half years?

“I would ask people to reflect on whether that is a fair reflection of the capability of those individuals or whether it’s really a reflection of the inadequate support that they receive? I know where I cast my vote.”

He said: “Good leadership is supportive, empowering and values driven. It is not frightening and suppressive and I think we all need to pledge that we will focus on ensuring we will provide support for leadership. Because if we don’t, we’ve seen on occasion in our health service where that leads.”

Sir Bruce also spoke about changes which had delivered major quality improvements in the NHS in recent years – including networking trauma and stroke services, reducing hospital infections, and standardising hip fracture treatment – and said it needed to be able to change quickly again.

He said many people were happy with the NHS, tending to mean they are worried when services face significant change.

Sir Bruce said: “It’s our responsibility to replace the fear of the future – which is attached to the kinds of changes we need to make – with convincing arguments for the benefits of that change, which mean people do not fear the loss that ensues.”

In particular he said there was a need to re-shape services for older people, which were “fractured by administrative, financial, philosophical and practical differences”, pointing to the split between health and social care services, and criticising ”an impractical and unsustainable construct that makes it difficult for people working in the NHS to deliver the services they want”.