A balance of power in the NHS

Gill Morgan, outgoing chief executive of the NHS Confederation, will be a hard act to follow. What qualities will be needed to succeed her?

    • Guardian Professional,
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Wanted: supreme diplomat, with substantial experience in healthcare, able to balance the different factions of the NHS and lobby on behalf of all of them to achieve more for the NHS.

One thing is clear: whoever follows Gill Morgan as the chief executive of the NHS Confederation will have a hard act to follow. The NHS Confederation is a curious organisation.

It's an independent charity with a turnover of £31m a year. It's a membership body, representing all types of NHS organisations in England: foundation trusts, primary care trusts, ambulance trusts, independent providers and mental health trusts.

It covers the whole of the UK, but in different ways, with separate NHS Confederations in Wales and Northern Ireland, and a subscription-based information service in Scotland, where it does not represent NHS organisations.

The stated aim is to influence policy, support leaders and promote good employment practices, by encouraging dialogue between different interests. The real aim is to prevent too much internecine squabbling and to try and exert influences behind the scenes at the Department of Health, to make the orders coming out of the department more in line with what the trusts want.

Morgan has handled this tricky process admirably, according to most accounts.

She now leaves the organisation to become permanent secretary to the Welsh assembly, and has gathered considerable plaudits for the way she has run the NHS Confederation over the past six years. Now, though, the NHS Confederation must find a new head, at a time when both the NHS and the confederation have been changing.

For now, Steve Barnett, formerly the director of NHS Employers is the acting chief executive of the NHS Confederation. It is the task of the 12 trustees of the confederation, under the chair, Peter Mount, to pick Morgan's replacement, via an interview panel of four.

"It's clearly a very interesting job," says Janice Miles, chief operating officer at the NHS Confederation. The pay for the job is £191,000 and Miles expects the job will attract candidates already at chief executive level in other organisations.

"The key is that it must be someone who is a strategic thinker about where the NHS is going," she adds. Perhaps curiously, that doesn't necessarily mean someone who has actually worked in the health service, as long as they have what Miles describes as a "sophisticated understanding" of health across the whole country. That is important - because the NHS Confederation deals, albeit in different ways, with health across the whole of the UK, its head needs to be someone with strong political skills.

The new appointee will also need to understand how member organisations work; again, that is complex. In its most recent annual report, the confederation highlighted the challenges of its role: it said its representation of NHS leaders is "strongest where we work together", but at the same time "our representation is most effective where the different parts of the NHS also have distinct voices to speak out on their particular issues."

Not, then, an easy job. "The new appointee will need a track record demonstrating they can deal with a complex environment," says Miles. They will to work not just with the whole range of NHS organisations, but also with other bodies, such as the medical royal colleges.


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