Ian Dalton – who in title has been NHS North East chief executive since 2007 – has for some time spent much of his effort on national roles, having first been made national director for the response to swine flu more than two years ago.

Next month he will return in substance to the North to become chief executive of NHS North of England, the strategic health authority cluster of the North East, North West and Yorkshire and the Humber.

Mr Dalton is almost certain to continue as a regional boss in the NHS Commissioning Board when it is established next year. He retains his current national role as lead for provider development, including the significant task of getting trusts authorised as foundations, so he will have a lot on his plate.

His own home region is way ahead of the pack on this issue with the vast majority of trusts becoming foundations years ago. Mr Dalton was no doubt aided by local circumstances in the North East, but could he make provider reform a priority across the whole of his new realm?

For example, the picture in Yorkshire and the Humber is a bit different. This month the SHA reminds us that two trusts have not even agreed dates with the Department of Health for submitting a foundation application.

These include Leeds Teaching Hospitals Trust, the £930m turnover giant, and Mid Yorkshire Hospitals Trust. As of August, Mid Yorkshire was recording a £3.5m year-to-date deficit and failing to meet the accident and emergency waiting target.

There is also a rough ride ahead for Scarborough and North East Yorkshire Healthcare Trust, which is attempting a merger with York Teaching Hospital Foundation Trust.