Essential insight into England’s biggest health economy, by Ben Clover


London Eye was told that when Sir David Sloman was made the new regional director for London, the tenure of various chairs in the capital was one of his keen interests.

A few weeks into the role and that already seems to have been borne out.

Guy’s and St Thomas’ chair Sir Hugh Taylor has been made interim chair of King’s College Hospital Foundation Trust and there has been another appointment at North Middlesex University Hospitals Trust.

Sir Peter Carter’s appointment at North Mid (also as an interim) looks consequential.

His predecessor Dusty Amroliwala had been appointed for 12 months without competition two years ago, and there does not appear to have been a formal competitive process for the extension last year.

During his time chairing the board, the trust retreated significantly from any further link-up with the Royal Free chain.

This work was quite far advanced for a while with Sir David as accountable officer for the trust and a former Royal Free director installed as chief executive at North Mid. All of that was rolled back while Mr Amroliwala (a former non executive director at Barking, Havering and Redbridge University Hospitals Trust) was in charge.

Indeed, the trust published quite a long report on why there appeared to be no real upside to further integration with the Royal Free.

If the idea were to remove chairs who might veto important reconfigurations, then it’s interesting to consider what needs doing in London, and how.

NHS Improvement can control the appointment of chairs to non-foundation trusts, or foundation trusts in special measures (thus King’s). The other London trusts in special measures are Barts Health Trust, Barking plus St George’s University Hospitals Foundation Trust. The former two are only in special measures for finance. St George’s remains in special measures for finance and quality.

The Whittington is a non-foundation trust situated between the Royal Free and NMUH. It also runs community services across Islington and Haringey. There could potentially be an argument for all three organisations to have one chair.

The appointment of a new chair for Imperial College Healthcare Trust will also be a big deal.

An interim is in place while a replacement for Sir Richard Sykes is found. Sir Richard was a famously forthright figure and reportedly vocally anti any kind of merger with, say, Chelsea & Westminster Hospital Foundation Trust.

Would a new chair be so opposed? Would a new chair be prepared to drop Imperial’s opposition for the Royal Brompton relocating south of the river? Some parts of the London system think Imperial should reconcile themselves to this.

The most consequential joint appointment of a chair before Sir Hugh’s expansion south was in outer north east London.

Joe Fielder chairs the board of relatively well-thought of North East London Foundation Trust and local acute provider Barking, Havering and Redbridge University Hospitals Trust. A joint appointment across sectors like this is unusual. Some sources on the patch believe that something closer to a full merger is the natural endpoint for the two trusts.