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HSJ’s annual list of the most powerful and influential people in and around the NHS always draws comment. Many on either the main list or the “wildcards” were delighted but others complained that many worthy contenders were left out.

The reality is that the list is doing what it is intended to do – identifying those with power and influence rather than those who perhaps ought to have it. There has also been a very significant turnover in the top 20, as HSJ deputy editor Dave West points out.

So there is a raft of NHS England people towards the top of the list because – like it or not – NHSE is where a lot of power resides. As ever, the omissions of senior NHSE people are as interesting as the inclusions.

There is also evidence of the intensely political environment the NHS operates in – not just the inclusion of health ministers (and health and social care secretary Sajid Javid tops the list) but of figures at Number 10 and the Treasury.

It’s possible next year’s list will look different – more evidence of power seeping down to integrated care systems and more patient representatives – but for now, the list is how our judges see the world.

Fair process or conflict of interest?

NHSE’s in the early stages of a drive to rationalise procurement frameworks, to shape how trusts and health systems buy things. This came to the fore in late March when NHSE produced an endorsed list of 36 digital and IT frameworks that it said are the best routes to market for trusts.

Thirty-three of those 36 “most optimal routes to market” are managed by four organisations: North of England NHS Commercial Procurement Collaborative, London Procurement Partnerships, Crown Commercial Service, and NHSE.

The list was the first output from the digital category council set up by NHS’s procurement target operating model programme, or PTOM.

It subsequently emerged that those four organisations with frameworks on the endorsed list were also part of PTOM’s digital category council.

They have all denied there were conflicts of interest, saying the list of endorsed frameworks was decided by a different workstream that they were excluded from.

Considering there are other framework suppliers that have been excluded from this list, perhaps it would have been prudent to be more transparent on how the list was chosen from the get-go?

NHSE is currently looking for a consultant to come in and shape the next steps for PTOM’s framework rationalisation work. Hopefully they will see the need for less opacity going forward.

Also on today

In North by North West, Lawrence Dunhill says that delays and uncertainty around the New Hospitals Programme are reaching the point where leaders are starting to go public with their frustrations. And in news, we report who the government has lined up to be the country’s first patient safety commissioner.