Sir David Nicholson took the opportunity of his final NHS England board meeting to warn against further “top-down reorganisations” of the NHS.

At yesterday’s board meeting, the NHS England chief executive said: “One thing the politicians need to do now is… not to fiddle around with the organisation of the NHS.

“No top-down reorganisation I think is the thing that is important.”

Sir David will retire at the end of the month, when he will be replaced by Simon Stevens, a former health adviser to Tony Blair as prime minister.

Sir David said the NHS needed “consistency of purpose” and “the commitment to thinking beyond the next month, but over the next four or five years”.

NHS England chair Sir Malcolm Grant thanked Sir David for his stewardship of the organisation and for his “extraordinary” contribution to the NHS in his 36 year career.

He said Sir David was “the architect of the model within the Health and Social Care Act” that established NHS England, and that it was thanks to his leadership that the organisation now had “a real sense of purpose and strategy and future”.

He added: “I’m sure your future will continue to involve Nottingham Forest, running a Twitter account, and of course continuing to keep a close interest in all of our affairs.”

Sir David said that although it had been “a very difficult period for the NHS over the last few years” it had been “an enormous privilege” to have served patients over the full length of his career.

He said he would be watching the live stream of NHS England’s next board meeting, “tweeting my responses to everything you say”.

Sir David added: “Although this is my last board meeting, I haven’t gone yet. So anybody who works for me please realise the work continues until the very last minute that I’m here.”