The must-read stories and debate in health policy and leadership.

Rob Webster made a bit of HSJ history on Wednesday when our judges placed him in the number one spot of our Top 50 chief executives list. Mr Webster is the first chief executive of a mental health trust to take the honour.

The first wave of the pandemic put paid to the 2020 judging process and it was the performance of trust chief executives during the pandemic as well as their fitness to lead their organisations within an NHS reformed along the lines set out in February’s white paper that drove the 2021 ranking.

Bigger doesn’t necessarily mean better in our top CEOs list, and running a large or prestigious trust is no guarantee of inclusion.

The chiefs missing from the Top 50 include those leading University Hospitals Birmingham Foundation Trust (the largest by bed numbers); Mid and South Essex FT (third largest), Nottingham University Hospitals Trust (sixth), and University Hospitals of Leicester Trust (seventh).

Number three in our previous Top CEOs list in 2019 was Stephen Dunn, who has suffered a fall as dramatic as his rise. The jury may be literally out on his role in handling West Suffolk’s whistleblowers, but the judges detected fire among the smoke and he didn’t make the cut.

Perhaps even more surprising is the departure of Northumberland, Tyne and Wear FT chief John Lawlor and the queen of Essex, Clare Panniker. Read all our analysis and the full list here.

Another tricky balancing act

Trusts must balance the recovery of elective wating lists with the recovery of a large proportion of their workforce, who have borne the brunt of the NHS’ first covid winter.

Indeed, some trust chiefs are warning that the NHS should start off the next financial year focusing on staff recovery and postpone ratcheting up elective recovery efforts and other long-term priorities until the second quarter.

One trust chief executive said if there is an expectation from the centre that “April is the start point [for elective recovery], that will cause a massive problem”.

A national framework setting out priorities for the system’s elective recovery plan is expected before the end of the month. Watch this space to see if NHS England and Improvement bosses head this warning…