Daily Insight: Why NHSE is not appointing a chief operating officer (yet)

Some head scratching greeted the news that national elective recovery director and former NHS Improvement chief executive Jim Mackey would be taking over as the lead of NHSE’s operations directorate when Sir David Sloman finally enters a well-earned retirement this September.

Five months seems like plenty of time to appoint a substantive replacement, and – in any case – why not simply promote Sir David’s deputy, Sarah-Jane Marsh? Why also is Sir Jim making it very clear that he is not, repeat not, going to be the interim COO – and how long will this strange arrangement last for?

The answers to all these questions – and some related ones – can be found on HSJ’s latest podcast, which can be accessed and listened to free here.

For those who do not have the 15 necessary minutes to spare, suffice to say the main issues behind the proposed set-up are: the government’s foot dragging on senior appointments, Ms Marsh’s relatively recent promotion to a national role, and next year’s general election.

The exception that proves the rule

The odd management arrangements at NHSE (the departing Tim Ferris will also be replaced by an interim) recognise the reality of the reluctance of health and social care secretary Steve Barclay to say “yes” (or, indeed, “no”) to senior appointments. However, there is some sign the log-jam may be beginning to let a little water through.

After an eight-month wait, the South West London Integrated Care Board has got itself a new chair in Mike Bell. But nothing, of course, is simple in today’s NHS, and Mr Bell will continue to chair Lewisham and Greenwich Trust – which of course operates in the neighbouring South East London ICB.

Sir David, that great rationaliser of chairs, will be happy. He may also be hopeful that any appointments thaw might finally see his protégé Caroline Clarke named director of NHSE’s London region.