An influential Conservative member of the Commons health committee has told HSJ that Sir David Nicholson should oversee the end of the NHS reorganisation, and then resign as NHS Commissioning Board chief executive.

Sir David gave evidence today at a session of the committee on the Francis inquiry into the Mid Staffordshire scandal.

He made repeated references to structural change, saying that the mergers of strategic health authorities and primary care trusts in 2005-06 caused “confusion”, and loss of “corporate memory”.

He said: “There were a whole lot of changes going on… which created an environment in which leaders lost their focus.”

Sir David also said the current reorganisation was a time of “maximum risk” and highlighted the loss of thousands of managers.

Dr Wollaston said this was a deliberate attempt to draw a direct parallel between now and 2006, and that in highlighting the issue, Sir David was drawing attention to all those who had been responsible for organisational change.

“There’s a sense in which it’s in everyone’s interests to watch Nicholson’s back,” she said. “I thought there was a warning there.”

Dr Wollaston told HSJ “there has been a closing of ranks behind David Nicholson”. It was “no coincidence that Sir David declined to blame any ministers for structural reorganisations which had distracted NHS managers from focusing on patients, after four former Labour health secretaries had publicly backed him in the Independent that morning.

“He might have the confidence of the NHS Commissioning Board – the wider issue is whether he has the confidence of the patients and wider NHS staff.”

Dr Wollaston has previously said Sir David’s position was no longer tenable, writing in The Daily Telegraph that “he needs to reflect on the consequences of losing the trust of the public and NHS staff”.

However, following the committee session on Tuesday, she told HSJ he should lead the NHS through the transition to the new NHS structure, and then resign some time after 1 April.

She said: “The last thing we need is a new chief executive tomorrow.”

Dr Wollaston also said it was “astonishing” that Sir David’s response to questions over why the NHS failed to spot that Mid Staffordshire was a mortality rate outlier was to deliver a “lecture” on why mortality rates were complicated to interpret.