Marianne Griffiths leads the HSJ Top 50 chief executives list in which mental health leaders continue to be over-represented while those heading acute trusts are under-represented, writes Alastair McLellan
The sixth HSJ listing of the NHS’s top 50 chief executives confirms trends which began to be established a few years ago.
There are now 24 women in the top 50, up two from last year and 10 from the first ranking in 2014. There are six women in the top 15, the same as last year and the top two places are taken by the same female leaders.
Mental health trust chief executives continue to be over-represented in the list, while acute leaders are under-represented. The Shelford Group of England’s 10 largest teaching trusts have just four representatives in the top 50, down from five (following Dame Julie Moore’s retirement) last year, and just one in the top 15.
This year’s judges included: Care Quality Commission chief inspector of hospitals Ted Baker, NHS England/Improvement director of emergency and elective care Pauline Philip, Unison head of health Sara Gorton, NHS Providers chief executive Chris Hopson, Mind chief executive Paul Farmer, NHS Employers chief executive Danny Mortimer and NHS Confederation chief executive Niall Dickson (for full list see below).
Judges were asked to assess chief executives on three criteria: leadership style and personal example; the performance of their trust against peers; and their contribution to the wider health system.
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Marianne Griffiths is again the top-rated chief executive. Made a dame in the New Year Honours list she has turned around Brighton And Sussex University Hospitals Trust – securing it a “good” CQC rating after four years of “inadequate” or “requires improvement” scores. Her other charge – Western Sussex – remains “outstanding”.
The challenges at Brighton are well known and have defeated some big names among Dame Marianne’s predecessors. One of the HSJ judges – who was previously sceptical of her achievements on staff engagement – admitted that spending time with the CEO had “turned those views around”.
The analysis of staff survey scores produced by Listening into Action shows B&SUH recorded the third highest improvement.
In second place once again is Dr Navina Evans – chief executive of East London Foundation Trust. The mental health chief was again praised by judges for her personal example and commitment to patient and staff engagement. Dr Evans is leading the “making the NHS the best place to work” group within Julian Hartley’s national workforce implementation team.
Last year’s number three Sarah-Jane Marsh drops eight places. Her trust has a tricky mix of specialist and general services for children and women, as well as responsibility for a troubled mental health service. Ms Marsh remains well-respected and liked – last December’s HSJ 100 saw her named the 37th most influential person in the NHS - and her trust remains rated ’outstanding’. But she will have to work hard to turn-around problems at home if she is to avoid accusations that her role as chair of the NHS England Maternity Transformation Programme has resulted in her taking her eye off the ball.
The breakfast table conversations with husband, Sir David Nicholson – chair of the troubled Worcestershire Acute Hospitals Trust – will at least provide a ready-made mutual support group.
If Ms Marsh’s star is waning a little, then that of West Suffolk’s Stephen Dunn is shooting into the firmament.
If you had suggested a few years ago that Mr Dunn – best known at that time for his involvement in the Circle Hinchingbrooke deal and other controversial projects undertaken as a regional system manager – would become the NHS’s third most highly rated CEO, the response would have been laughter.
But Mr Dunn now runs the best small hospital in the country and is establishing a reputation as one of the NHS’s very few tech-savvy trust CEOs.
Julian Hartley’s five-year slog at Leeds is finally paying off with a “good” CQC rating and, again according to LiA, the best staff survey performance of any trust.
The growing influence of Northumberland, Tyne and Wear’s operational model is reflected in John Lawlor taking the last place in the top five. Surrey and Sussex’s Michael Wilson jumps back into the top 50 at number six, his success in achieving an outstanding rating more than trumping judges’ previous concerns about his sometime “challenging” personal approach.
Another important arrival in the top 15 is North East London’s John Brouder – whose staff survey performance according to LiA is even better than his neighbour Dr Evans. That two mental health trusts in one of the most challenging parts of the country have recorded such significant advances is one of the most cheering episodes to emerge from this trying time for the NHS.
Perhaps the most interesting aspect of this year’s HSJ Top 50 chief executives ranking is the absence of leaders who have regularly appeared in the ranking – and the identity of those who have replaced them.
The most notable absentee from the top 50 is Nottingham University’s Tracy Taylor, who has appeared in every ranking since 2014. Her trust had a difficult time on many fronts in 2018 and faces especially stubborn problems in turning around emergency care performance.
Other significant absentees include: Susan Acott, Will Hancock, Bev Humphrey, Jane Tomkinson, and perhaps most surprisingly of all, Roger Spencer – all of whom had appeared in three out of the five previous top 50s.
There was no suggestion these chiefs had done anything “wrong”, rather that others deserved recognition more.
Seven CEOs return to the top 50 – most significantly given Mr Spencer’s demotion - national cancer director and Marsden chief executive Cally Palmer.
However, there are also an equal number making their first appearance.
London Ambulance chief executive – and would be country and western star – Garrett Emmerson gets credit for turning the trust around. Mr Emmerson previously worked at Transport for London, making him a rare example of a chief executive from outside the NHS making an immediate impact.
Lesley Watts – who was named “chief executive of the year” at the 2018 HSJ Awards – makes a belated entrance to the top 50 – which is now increasingly filled with quiet achievers like herself.
The other first-timers are Cara Charles-Barks, Siobhan Harrington, Siobhan Melia, Patricia Miller and Paul Roberts.
Of course – one year does not make a career. Given the top 50 has now reached its sixth year, it is worth recording who has stayed the course since its inception in 2014.
The six “perennials” are: Stuart Bell, Sir Michael Deegan, Julian Hartley, Anthony Marsh, Sarah-Jane Marsh and Claire Murdoch.
Those still in the top 50 who have recorded five appearances consist of: Tom Cahill, Sheena Cumiskey, Cally Palmer, Claire Panniker and Joe Rafferty.
Of these 11 stalwarts, five are the chief executives of mental health trusts and just three run acutes.
Care Quality Commission chief inspector Professor Ted Baker
NHS England director of workforce race equality standard implementation Yvonne Coghill
Former Royal College of Physicians president Professor Dame Jane Dacre
Outgoing chief executive of Salford Royal Foundation Trust and Pennine Acute Hospital Trust Sir David Dalton
NHS Confederation chief executive Niall Dickson
MIND chief executive Paul Farmer
Unison head of health Sara Gorton
NHS Leadership Academy chair Peter Homa
NHS Providers chief executive Chris Hopson
HSJ correspondent James Illman
NHS Clinical Commissioners co-chair Dr Graham Jackson
HSJ editor Alastair McLellan - chair
NHS Employers chief executive Danny Mortimer
NHS national urgent and emergency care director Dame Pauline Philip
Director of health and wellbeing system improvement programme Local Government Association Caroline Tapster
Speciality registrar and author of MBA dissertation on NHS leaders Dr Alex Till
Korn Ferry associate client partner Kate Wilson
Our judges took account of three main criteria in making decisions on the HSJ top 50 chief executives.
- The personal example set by the chief executive. This covers their leadership style and behaviours including approach to mentoring and developing more junior staff; encouraging inclusive leadership; how they work with their board, both executives and non-executives; and their standing among their peers and personal qualities.
- The performance of the organisation they lead, given the circumstances it is in. This will include performance against the key targets; financial performance; staff survey results; and quality of care.
- The contribution the chief executive has made to the wider health and social care system. This might be through leading on important projects, either nationally or locally. Examples include success in leading a Sustainability and Transformation Partnership; taking on a national role such as lead for an area of care; or spearheading local improvements.
- Acute care
- BRIGHTON AND SUSSEX UNIVERSITY HOSPITALS NHS TRUST
- Care Quality Commission (CQC)
- Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust
- David Nicholson
- Emergency care
- Julie Moore
- Mental health
- NHS England (Commissioning Board)
- NHS Improvement
- North East London NHS Foundation Trust
- Top Chief Executives
- WORCESTERSHIRE ACUTE HOSPITALS NHS TRUST
Griffiths heads Top 50 chief executives ranking for second year
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Griffiths heads Top 50 chief executives ranking for second year