Sir David Nicholson has admitted that his “becoming the story” after the Francis report publication contributed to his decision to announce his retirement.
The NHS England chief executive last month announced he would retire by March next year. It followed a firestorm of criticism of his role and leadership, with prominent calls for his resignation, in the wake of the public inquiry report into Mid Staffordshire Foundation Trust.
Sir David, in an interview with HSJ ahead of this week’s NHS Confederation conference, said he wanted to be honest with NHS leaders in his speech at the event. That meant he could not “come to the confederation and pretend I was carrying on when I wasn’t. To get the announcement out before confed was really important to me.”
Sir David said there were three reasons he decided to retire. The first was the sheer length of time in a demanding job. He said: “Eight years is the longest anyone has ever been NHS chief executive for, it’s a tough job to do.
“The second was I’m genuinely excited about the kind of things were starting to do in NHS England and the work on the strategy. What’s clear to me is you need someone who’s going to commit at least five years to making that happen. Even in my worst excesses I’m not going to go on [that far].
“The third thing is I had sort of become part of the story. This is a really tough job and you don’t need that stuff around you when you’re trying to make the changes we need to make.”
However, Sir David told HSJ he was “not going to be sitting with my pipe and slippers” until his retirement.
Sir David’s speech today is expected to cover the strategy, culture change, a focus on patients, and his own reason for retiring now. Sir David will talk about his own diagnosis with diabetes last year.
Asked about whether NHS England would be weakened because of unstable leadership, Sir David said many large organisations underwent leadership transitions without a hiatus.
He said: “You have to understand the way NHS England is setting itself up. It is a very strong board − particularly I think the non-executive directors are very strong.
“They want to create something which is long-lasting and significant and not something which will shift every time you have either a new executive director or even a new government.
“What’s really important to the chair in appointing my successor is to get someone who buys into the values and principles of NHS England as we’ve set them out.”
In relation to his successor, he said he was and should not be involved in the appointment. He said: “The cornerstone to any cultural set of issues is the NHS constitution.
“Creating an environment where the kind of behaviours that are in the NHS Constitution can flourish is the most important thing for a leader in our circumstances to do.
“One of the things NHS England has constantly advocated is a set of values and principles and I think buying into those is going to be a critical part of it [appointing a successor].”
HSJ also pressed Sir David on whether health secretary Jeremy Hunt − who has earned a reputation as an interventionist over issues such as A&E and the GP contract − had overstepped his role in the new system.
Sir David said: “No I don’t think he has overstepped his role at all. He’s carrying out his role as secretary of state.
“He’s representing the government and representing the public. The issues he has raised are the right issues.” He said the future of care for the elderly, on which Mr Hunt has initiated a review, was the right area to focus on.
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Nicholson says 'becoming the story' after Francis part of retirement decision