Chief executive, NHS Confederation (2010 ranking: 26)

Only four people have appeared in the top half of the HSJ100 for its entire, six-year history: Sir David Nicholson, Andrew Lansley, cancer tsar Sir Mike Richards and Mike Farrar.

There were sighs of relief this year when the capable former SHA chief arrived to lead the troubled NHS Confederation, which had been rocked by accusations of financial mismanagement and the Foundation Trust Network’s decision to go it alone.

Mr Farrar quickly established himself as a powerful commentator on the NHS reforms, skilfully representing the frustrations of members while retaining the DH’s trust. But perhaps his biggest challenge in 2012 will be dealing with the impact of those reforms on the confederation’s membership and income.