Chief executive, Imperial College Healthcare Trust ▼31

The second most influential trust chief executive after sir Robert Naylor (31), Professor Smith is also the most atypical.

A distinguished gynaecology academic, the leader of England’s largest trust is best known for piloting the country’s first academic health science centre. The fact he has slid down the rankings is a result of Imperial losing its unique status following the establishment of four other AHSCs.

It may be his next contribution to policy will come through his advocacy of “physician executives”. Imperial’s clinician-led system could yet prove influential on national policy. But achieving foundation status, delayed by the merger which gave birth to the trust, will consume much of his time.