The post of chief executive of the NHS in London could be re-advertised following David Nicholson's appointment as NHS chief executive.

The post of chief executive of the NHS in London could be re-advertised following David Nicholson's appointment as NHS chief executive.

Mr Nicholson had been in post for less than a month when it was announced that he would be moving to take over the top job in the NHS, which he is due to start in September.

It is not yet known when a new appointment could be made, and a decision will be taken by the end of the week on whether to re-advertise the post. The other, quicker, option is to choose previous candidates who got through to the pool stage of the recruitment process for the 10 strategic health authorities which launched in July, but were not given a job.

These included Duncan Selbie and Carolyn Regan, both former chief executives of SHAs in the capital, who insiders say are possible contenders for the job.

Ms Regan, former chief executive of North East London SHA, is now managing director of the same area until a new structure is announced in the autumn. When she failed to get the London SHA job she said she was considering opportunities outside the NHS.

Mr Selbie, former South East London SHA boss, is now acting director of commissioning at the Department of Health. Neither Ms Regan or Mr Selbie could be contacted by HSJ.

The chosen candidate will have to take through a controversial restructuring scheme which will see the 780 staff employed by the previous five London SHAs reduced to around 150.

NHS Confederation chief executive Dr Gill Morgan said the vacancy would be 'confusing' and a 'challenge' for London. 'But at least London is largely unreconfigured and is already going through its fitness for purpose process. It does have some real challenges, but at least it's ahead of the game on the timetable.'

However, one London primary care trust chief executive said it was 'disappointing' that Mr Nicholson had left so soon, particularly as the NHS in London was 'in a state of flux'.

And King's Fund chief executive Niall Dickson said Mr Nicholson's departure was a 'blow' to the health service in the capital.

'David Nicholson has a very important role presiding over services in London that cost more than a£7bn a year while the capital is still facing serious financial problems and there is a clear need to rationalise services and drive efficiency', he said.

Mr Nicholson beat two shortlisted candidates from the independent sector to take the top job: Ian Smith, chief executive of UK healthcare provider General Healthcare Group, and John Rowe, executive chair of Aetna, one of the largest health insurers in the US. A fourth shortlisted candidate, former US Veterans Administration chief executive Ken Kizer, is understood to have withdrawn from the race after being shortlisted.

Dr Morgan said the appointment showed that 'NHS managers are among the best in the world'. She added: 'David's appointment will be a real boost for the morale of NHS managers, as many themselves embark upon new positions in reconfigured NHS organisations.'

Mr Nicholson said he was 'absolutely over the moon' about the appointment, which comes after 25 years working for the NHS.

In a note sent to NHS chief executives last week, acting chief executive Sir Ian Carruthers thanked them for their 'continuing hard work at a time of immense pressure and change'.

Sir Ian, who will take up post as chief executive of South West SHA in September, paid tribute to Mr Nicholson.

'We all know David as someone who is passionate about the NHS and tireless in his drive to improve health and patient care. He leads by example, inspiring his colleagues and helping people give their best. I know he will be an excellent and inspiring leader of the NHS through the next period of delivery and reform.'