Intended for healthcare professionals

Views & Reviews If I Ruled the NHS

Create a clinical chief executive role in hospitals

BMJ 2015; 350 doi: (Published 23 April 2015) Cite this as: BMJ 2015;350:h2041
  1. John Fabre, professor emeritus, King’s College London
  1. john.fabre{at}

The NHS remains an admirable institution but is in decline. A root cause of the malaise is the absence of a national clinical leadership structure, interestingly from its inception.

If I ruled the NHS I would begin by establishing a clinically strong NHS England board. Currently, only four of 17 board members have a medical or nursing background. I would ask nine of the medical royal colleges to put forward one nominee each and the Royal College of Nursing two nominees (excluding current members of their councils) to join as executive directors. In addition, two clinical chief executives and two …

View Full Text

Log in

Log in through your institution


* For online subscription