'The DoH will not comment on whether posts such as director-general of commissioning will disappear rather than be filled, but is it likely that much of the spate of high-profile leavers, so far and to come, is part of a coming restructuring.'

It will be a fascinating spring for Whitehall watchers. On Tuesday, the DoH confirmed that Duncan Selbie was leaving his job as director-general of commissioning to take on a 'troubled' acute trust (see news story). He was the third incumbent in a post that has existed for little more than a year.

And he is not alone. Last week, Professor Antony Sheehan joined Leicestershire Partnership trust after stepping down as DoH director-general of health and care partnerships. The
week before that communications director Matt Tee was confirmed as the new chief executive of NHS Direct.

Announcements about some other top posts are expected in the coming weeks. The DoH will not comment on whether posts such as director-general of commissioning will disappear rather than be filled, but is it likely that much of the spate of high-profile leavers, so far and to come, is part of a coming restructuring.

When David Nicholson took on the NHS chief executive's post he must have been frustrated at the extent to which his leverage was stifled by the weight of this giant Whitehall department.

Since then he will have needed to work closely with permanent secretary Hugh Taylor on one of his biggest priorities - the much-anticipated division of labour between the DoH and the NHS.

The details of what the new structure will look like will not emerge officially until after the biggest reshuffle of them all is cemented.

But the next few months will show the shape under the surface of what a post-Blair health service will look like - and what judgements are already being accepted about the major successes and failures of the last 10 years.