Attracting clinicians into chief executive positions is a challenge as old as the NHS. Throughout the 70 years of the NHS, there’s a danger that too great a cultural distance has separated the doctors, nurses and other professionals that deliver care, from those who decide how that care should be arranged and resourced. Though the challenge is not unique to the NHS it is notable that, compared to other national healthcare systems, relatively few talented individuals seek to progress from the clinical frontline to the NHS boardroom. That seems odd given how many executive opportunities exist across 227 NHS provider trusts.

Why do we need more clinicians at board level? Clinical expertise is no prerequisite for success – many of the NHS’ most-lauded chief executives honed their leadership skills in other industries, or through diverse NHS careers. But the chief executive, and other executive director roles are more complex and challenging than they have ever been. There is also a well-recognised need for NHS leadership that reflects the diversity of its workforce.

This report shows that among the advantages clinicians bring to these roles, is their deep understanding of what matters most to patients, their loved ones and staff. Holding that line under pressure relies on recognising this. Clinicians know first-hand that decisions driven by short-term financial or operational efficiency imperatives can undermine quality, damage staff morale and cost more in the longer term.

The survey that informed this report shows that, despite the difficulties, clinically trained chief executives get much satisfaction from their responsibility to improve the experience and outcomes of NHS care. The short profiles of the chief executives included in this report give further insight into the value a clinical background offers to executive director roles.

We are grateful to the trust chief executives who shared their experiences in the survey and case studies. Our hope is that this report will inspire more clinicians to see the chief executive and other executive board roles as a worthwhile and rewarding career that offers the prospect of making the lives of thousands of patients and staff better.



Chris Hopson                                                                                               Peter Homa CBE
Chief Executive, NHS Providers                                                               Chair, The Leadership Academy