We’re on course for the two most directly powerful people in UK healthcare — health secretary and NHS England chief executive — to undergo a change in the space of five weeks. They could learn quickly and stay focused by getting out and speaking to our 20 ’wildcards’, chosen as part of this year’s HSJ100 judging process, writes Dave West.

“Listen hard” was Sir Simon Stevens’ advice to his successor as NHS England chief when asked at the NHS Confederation conference earlier this month. 

It applies at least as well to the new health and social care secretary, who has been rushed, with little health experiece or preparation, in to a very busy department on Victoria Street.

So, who should Mr Javid and the next NHS England chief executive listen to? HSJ would — normally — right now be in the process of producing the 2021 HSJ100, our annual listing of the most powerful and influential people in health. We have decided to postpone that until the search for the new NHSE chief concludes, for reasons that, hopefully, are obvious.

But in a bid to be helpful to the incoming NHSE chief we have, for the second year, produced a list of 20 ‘wildcard’ figures who would not normally feature in the HSJ100. This year we posted the question of who, beyond the normal healthcare hierachies and leadership networks, the next NHSE chief be listening to as they take up post.

Some will have been sceptical about Sir Simon’s plea for his sucessor to listen. He has not always been famed for listening to harmed patients, say, nor all local NHS bosses or his own staff.

But on the other side of the tally there are individuals, groups and causes which have felt heard and embraced at the top of the NHS tree more than they would ever have dreamed of; agendas much accelerated, making more progress than they could otherwise. Examples include racial equality in NHS leadership and workforcepersonal budgets and personalisation; and action on obesity and diabetes. “Listening hard” will have helped with Sir Simon’s famous ability to avoid controversies and crises, too.

He did not arrive as NHS England chief with the ties or allegiances of a traditional NHS boss - for better or worse, he was never chief executive of an NHS trust, commissioner, health authority, or region. Maybe this has made him more open minded to some points of view.

As a political animal, he is an enthusiast for challenging the health service as well as championing it — for putting grit in the sometimes reluctant NHS oyster. In his immediate prior experience overseas at UnitedHealth he was a reshaper and reformer of services, not a provider.

Nearly all the known leading candidates this time have been, or remain, trust chiefs, and held national NHS director roles. All are currently based in the UK. Their views on how to run the NHS are likely to be more familiar to current NHS leaders and may be rather more set in stone. All the more reason to keep an open mind and look out beyond the health service hierarchy.

Also read:

HSJ100: The wildcards

The next NHS CEO will have much to learn from the diverse voices of the HSJ100 wildcards

The 20 ‘wildcards’ the NHS’s new bosses should listen to