This year’s HSJ100 unveils a more diverse group of leaders but for the first time without any ranking

Welcome to the new HSJ100.

HSJ’s annual ranking of the most powerful and influential people in the English NHS and health policy was launched in 2005 (albeit as the HSJ50).

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In that pre-social media age, who exercised power within health and care was much less well understood outside the corridors of power. As a result, the HSJ100 quickly became the bellwether for which individuals and agendas were on the up or down. For all the criticism it attracted, it was inevitably the best-read piece HSJ published each year.

But even the most successful projects have a shelf-life and in 2018 the old-style HSJ100 was definitely showing its age.

A series of events (Theresa May’s exit from office and the general election) meant there was no 2019 HSJ100, and we took the opportunity to have a rethink.

We concluded that while there was now a good understanding of the very top of the tree, say the top 40 most influential people, knowledge of the power players below that was still patchy.

So, we drew up an exclusion list of figures based on the results of the last 15 years which sought to remove the ‘shoo-ins’ from our list. It is, of course, an objective judgement, but it does clear the decks to look a little deeper.

We also decided to limit our list to 80 names and fill the last 20 spaces with “wild cards” – people who were not exercising power at the very highest level but should be.

The HSJ80 – more diverse

The ‘HSJ80’ names those figures who will exercise the most power and/or influence in the English NHS and health policy over the next 12 months. Our judges were, as ever, under instructions not to draw a distinction between benign or malign effect or to make any attempt to ‘balance’ the list between gender, discipline, ethnicity etc.

So, what did we find once our judges had stripped away the tallest poppies?

The answer is a more diverse group of leaders.

In the ‘old’ HSJ100, women consistently made up about 30 per cent of the total. In the new HSJ80, this proportion rises to 40 per cent.

Even more striking is the proportion of people with a black, Asian and minority ethnic background. The number of BAME figures in the HSJ100 could be counted on one hand (usually with a few fingers to spare). But 12 (15 per cent) of the HSJ80 are BAME, suggesting that the snowy peaks of NHS leadership may be beginning to melt.

Many of the HSJ80 are figures who have bobbed in and out of the HSJ100, sometimes for years – but others were much less well known until recent events transformed their profiles.

Professors Sarah Gilbert, Peter Horby, Trish Greenhalgh, and – to some degree – BBC medical editor Fergus Walsh have been blasted into the limelight by their work on coronavirus.

The Black Lives Matter movement and the resulting focus on inequality (accentuated by covid of course) have pushed Marie Gabriel, Habib Naqvi and Owen Williams up the pecking order.

Unlike the HSJ100, we have not attempted to rank our top 80 as we were not able to find the digital equivalent of a wall and a hundred plus post-it notes that are usually deployed. If any reader would like to have a go – perhaps during any second wave lockdown – we would be very interested in seeing the results.

Also read:

The revamped HSJ100 mirrors the current times

HSJ80 full list: The most influential people in health

HSJ100: The wild cards

HSJ100: Exclusions

HSJ100: Judges

The ‘new’ HSJ100 reveals a more diverse leadership cohort