Mike Richards, national clinical director for cancer, Department of Health

It has been hard to find a crucial policy decision in which Mike Richards has not had a hand this year. Described as “the most influential of all the czars”, he will be well aware that his legacy will be the review of co-payments health secretary Alan Johnson asked him to lead earlier this year.

This review was an unenviable job with a terrifyingly short timescale - and it will not have gone unnoticed that it was handed to Professor Richards rather than the chief medical officer.

It could have easily blown up in his face but Professor Richards has handled the task with candour and something approaching gusto, freely admitting that his opinion on the issue changed during the process. Having put on record that he would not be pushed into reaching a particular conclusion, he has now formed policy after the review’s recommendations were accepted in full by health secretary Alan Johnson (3).

In snatched minutes between review work he also oversees the cancer plan and end of life care strategy and recently intervened in a controversial reconfiguration plan.