NHS medical director, DH (2010 ranking: 24)

The events of 2011 leave Sir Bruce surging up the list. The first NHS outcomes framework is a year old and has emerged as one of the few parts of the reforms not tainted by confusion, anger and backtracking.

As de facto medical director of the NHS Commissioning Board, Sir Bruce’s domain will include translating that work into the outcomes framework for clinical commissioning groups. This will be a lynchpin of the new system and come with performance related cash, certain to ensure it is pinned to GP surgery walls around the nation.

Regularly praised by Andrew Lansley and close to board chair Professor Malcolm Grant, Sir Bruce believes he can make clinicians “the engine room” of the all-powerful commissioning board, with evidence and outcomes trumping all. He will look to reconcile those plans with the NHS’s performance and finance priorities and find a way of getting rogue GP commissioners in line while avoiding accusations of being too “top down”.

Sir Bruce, a widely respected surgeon, will also be instrumental in the prime minister’s priority area of publishing more clinical information and responding to public demands for care standards.