The sixth consecutive year of the HSJ100 has again revealed a significant reordering of the individuals deemed to be at the leading edge of driving innovation and influence across the NHS and broader healthcare sector, says Frank McKenna from Harvey Nash plc.
While the HSJ100 is not meant to be empirically definitive, it does reveal a range of ingredients that many use when looking through the prism of influence.
The challenge for the judging panel this year has been attempting a long range forecast of influence while the Health Bill continues its turbulent passage through Parliament after the mauling it has received by the professions. Not surprisingly, the nature of leadership rather than management has come to the fore in such discussions.
What is clear is the emerging dominance of the shadow NHS Commissioning Board (Sir David Nicholson and the increasing influence of Bill McCarthy) and the remaining power of the centre, both in terms of Richmond House and the SHA cluster chief executives.
Those attached to policy formulation and regulation also feature highly as do those representing staff and the unions at a time of immense upheaval and change (Peter Carter and Brendan Barber).
Perhaps for less positive reasons, Robert Francis QC is likely to wield a very different form of influence on the service in 2012 once he completes the report into the public inquiry at Mid Staffs. His inclusion at number three is an understandable sign of the need for clinical quality and safety to be indelible features of how the service responds to the Nicholson challenge.
Frank McKenna, group director of healthcare at Harvey Nash plc and a former NHS human resources director