Chief executive, NHS South (2010 ranking: 71)

In his last role before retirement, the leading health service manager of his generation is still wielding huge influence. In fact, Sir Ian has shot back up the list after being given stewardship of NHS South - with its myriad of reconfiguration and performance challenges.

He also continues to exercise influence nationally. His review of how the NHS can exhibit and promote innovation will be out soon. As the performance manager par excellence he is also Sir David Nicholson’s most powerful tool in running the rule over failing health economies.

Sir Ian, especially in his South West heartland, continues to ensure innovative models are developed. Weston Area Health Trust is learning the integration lessons of Torbay’s health economy. The relatively large number of community social enterprises emerging in the area is widely believed to be a result of Sir Ian’s decree.