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The local heroes of the NHS will have to wait if they are to ever make a big dent in the HSJ100.

This year’s latest power list, published yesterday, saw big names from government and its arm’s length bodies dominate, not the managers and clinicians who will be delivering on the ground. This despite Boris Johnson’s declaration that his government is now all about delivery.

Sajid Javid tops the 80, not NHS England chief Amanda Pritchard, who is second, even though she is closer to the sharp end of operations and was appointed by the government as an experienced and trusted ‘deliverer’.

Seventeen of the top 20 work for central agencies and eight of those for NHS England — both counts are the same as in 2018, the last comparable list. But in 2018, three of the top five were from NHSE, now it is just one, although a further three NHSE directors, including Ms Pritchard’s effective number two Julian Kelly (7), make the top 10.

The consolidation of NHS Improvement into NHSE has cleared space in the top 20, as has the expectation of another quiet period for the Care Quality Commission, with its most prominent influencer, the chief inspector of hospitals, announcing his retirement.

But the vacuum has not been filled by top NHS trust leaders, for example, nor by regional directors, and no ICS executive jobs have yet been confirmed, which hindered their cause, while two of our judges who are influential ICS leaders excluded themselves. Read Dave West’s full analysis here.

One less job

NHS England has excluded overworked GPs from delivering coronavirus vaccines to 12 to 15 year olds unless there isn’t any capacity elsewhere (an unlikely event).

This decision makes sure no further pressure is placed on practices which are currently buckling under the workload of increased appointments, coronavirus backlog and the vaccination programmes.

Instead, youngsters from this cohort will be jabbed at hospital hubs, vaccination centres and community pharmacy sites – as well as schools – under new plans to increase rollout over half term.

Like anyone else signing up for a vaccine they can make their appointments through the national booking service or by calling 119.

So far uptake among teenagers has been low, particularly among the 12 to 15 year olds – with 16 per cent vaccinated since they first became eligible in September.

The rollout has been such a struggle that the chief executive of East Suffolk and North Essex FT has been recruited to lead the rollout across the group. An essential role given that infection rates in schools are increasing rapidly.