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Stephen Powis to step down as NHS England medical director Next boss of NHS England prepares purge of senior leadership team
(about 7 hours later)
Powis, who had a key role in advising ministers and public during pandemic, follows chief executive in resigning Exclusive: Jim Mackey plans ‘big clearout’ as he steers NHS England towards closer relationship with health secretary
The NHS’s top doctor in England, who played a key role in advising ministers and the public during the Covid pandemic, will stand down this summer. The next boss of NHS England is preparing a wide-ranging purge of its senior leadership team as he steers it into a much closer relationship with health secretary Wes Streeting.
Prof Sir Stephen Powis, NHS England’s national medical director, will have spent seven and a half years in post by the time he retires in July. Sir Jim Mackey, NHS England’s chief executive, is finalising plans for “a big clearout” of the top executives who were mainly hired by his immediate predecessor, Amanda Pritchard, who will leave the post in April.
He is thought to have appeared at more of the pandemic-era daily press conferences than any other NHS or medical leader. Mackey’s purge will lead to the departure of many of the organisation’s most senior high-level managers, with only a handful expected to survive, well-placed sources say.
The 64-year-old’s departure follows last week’s resignation of Amanda Pritchard, NHS England’s chief executive, amid a radical reshaping of its relationship with the Department of Health and Social Care (DHSC). Pritchard surprised the service last week when she resigned after holding talks with Streeting over her and the organisation’s future role.
Her successor, Sir Jim Mackey, started work this week working alongside Pritchard before assuming full control of the organisation at the start of April. Mackey is expected to initiate changes to the makeup of NHS England’s senior leadership team shortly and also oversee its shift to working much more closely with the DHSC and shrinking its 13,000-strong workforce. Prof Sir Steve Powis, NHS England’s national medical director and best-known other public face behind Pritchard, followed suit on Thursday by announcing that he too is standing down.
The 64-year-old became well known in the early days of Covid-19 in spring 2020 when he advised ministers on how to handle the virus and appeared regularly at televised media briefings at 10 Downing Street.
“There’s a changing of the guard in the NHS and that’s really just begun”, said a senior source, referring to Pritchard and Powis’s impending exits. Mackey will oversee “a substantive clearout of the exec team”, with more casualties than survivors, a second source added.
Sarah-Jane Marsh, NHS England’s deputy chief operating officer and national director of urgent and emergency care, is likely to remain in her post.
Mackey, an accountant by background, is also weighing up whether to axe Julian Kelly, the deputy chief executive and chief financial officer. Kelly, who is widely respected, does what some see as “probably the toughest job in Whitehall” – trying to make the NHS’s near £200bn annual budget meet its needs while reassuring ministers that it is spending it wisely. His future remains unclear.
A source familiar with Mackey’s thinking said: “It will be a pretty total clearout. And there’s an appetite in some quarters to move Julian Kelly on as part of that. But if you’re going to replace the guy who’s in effect the financial controller of a £200bn budget, you need to know what you are doing before you get rid of him.
“Jim will want his own person in that job, but at the same time it’s a risky time to get someone new in, given the NHS’s finances are in a poor state.”
Kelly is respected at the Treasury, where he used to be its director general of public spending and finance. However, he has risked irritating ministers by warning at recent NHS England board meetings that the £22bn extra Rachel Reeves has given the health service over the next two years will be swallowed up by pay rises and not be enough to pay for the radical transformation of how care is delivered, through “three big shifts” Streeting and Keir Starmer have promised.
Mackey and Pritchard wrote to the chief executives of the NHS’s 220 care provider trusts on Thursday to summon them to a meeting next Thursday to discuss what they warned was a looming £6.6bn hole in its finances in 2025/26. Kelly was not a signatory to the letter.
Mackey plans to bring NHS England into much closer cooperation and alignment with Streeting’s Department of Health and Social Care. A no-nonsense and very experienced local and national NHS leader, he will be tough in demanding that, regardless of its precarious finances, the service speeds up treatment waiting times and somehow balances its books, despite the growing demand for care.
Announcing his departure, Powis said: “My time in post has been dominated by the pandemic and its ongoing impact. I will for ever be humbled by the extraordinary work of staff throughout the NHS to the greatest health emergency in a century and I am very proud of the support and advice I was personally able to give to staff, ministers and the public.”Announcing his departure, Powis said: “My time in post has been dominated by the pandemic and its ongoing impact. I will for ever be humbled by the extraordinary work of staff throughout the NHS to the greatest health emergency in a century and I am very proud of the support and advice I was personally able to give to staff, ministers and the public.”
Wes Streeting, the health secretary, said: “Steve has provided outstanding clinical leadership to the NHS over the last eight years, including during the biggest health emergency our country has faced in modern history. His knowledge, professionalism, and guidance helped the NHS rise to the challenges created by the pandemic.
“I would like to thank Steve, not only for his pivotal role in the Covid vaccine rollout, but for all his work as medical director, including overseeing the team’s work in the creation of the national patient safety strategy.”
Claire Fuller, a GP who undertook a review of primary care services for NHS England published in 2022, is the favourite to succeed Powis, sources say. Dr Vin Diwakar, a paediatrician and the organisation’s national director of transformation, and Stella Vig, a surgeon who is its joint national director for planned care, are also seen as contenders.