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The NHS takes a step into the unknown today as PCGs start work. But people well used to the ways of the health service will be steering the new organisations. Mark Gould reports

If anyone expected the creation of 481 chief executive posts to bring a rush of new blood into the health service they will have been disappointed by the start of primary care groups today.

Those who value health service experience, on the other hand, will be relieved if not delighted to discover that the men and women who will steer commissioning in the new NHS have that attribute in bundles.

An HSJ survey of health authorities carried out in mid-March found that, of the 239 PCG chief executives who could be identified at that stage, no fewer than 138 came from health authorities.

In many cases, today's PCG chief executive will be yesterday's HA locality commissioning manager - same patch, same people, different post.

Of the rest, 37 move over from fundholder or practice manager posts, while 32 come from trusts. A further 10 come from total purchasing pilots or other NHS commissioning posts.

They include three former chief executives - Alan Carpenter, of East Wiltshire Healthcare trust, Gina Brocklehurst, of Trecare Learning Disabilities trust and Mike Harrison, of Southend Community trust.

From outside the NHS, there are a handful of management consultants, a brace of business development advisers and an academic - Manchester University's health services management unit senior fellow Angela Schofield.

HSJ tracked down a cross-section of the new chief executives and asked them about the challenges ahead.

A full list of all 239 PCG chief executives included in the survey can be found on the HSJ web site at