Second senior NHS England executive heads for the exit

Just days after NHS England chief executive Amanda Pritchard tendered her resignation, national medical director Prof Sir Stephen Powis has also said he will step down.

The double resignations have come just as the government is due to publish its 10-year plan to reform it in the summer, and after the Darzi report on the state of the health service concluded that it is in "critical condition" with systemic problems that could take up to eight years to put right.

NHS England confirmed Powis' departure this morning, indicating that he had notified Pritchard that he intended to step down in January and will continue in the role until early July, after which he reportedly plans to retire. He has been the national medical director since 2018, taking up the post after 12 years as medical director at the Royal Free NHS Trust.

As the most senior doctor within the NHS in England, he played a key role in the pandemic response, has led several national reviews and led teams that implemented the national cardiovascular, respiratory, and stroke programmes, the creation of the first national patient safety strategy, and the successful rollout of medical examiners.

In the months before his departure, Powis will focus on the medical training review for postgraduate doctors and ongoing work to improve stroke care, as well as ongoing inquiry commitments, said NHS England.

"I have always been exceptionally proud to work in the NHS and, while stepping down from this role, I remain passionate and committed to improving the health of patients and improving the experience of staff," said Powis.

"My time in post has been dominated by the pandemic and its ongoing impact," he added. "I will forever 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."

Pritchard's resignation last week – with just a month's notice – came as a shock to many inside and outside the NHS, which employs 1.4 million people across the UK, and followed tough questioning at two parliamentary select committees in January, which resulted in a report by the Public Accounts Committee (PAC) that concluded: "Senior officials do not seem to have ideas, or the drive, to match the level of change required" in the NHS.

According to some sources, including the BBC, her decision was also made in part because of a decision by the government to bring in external advisors to take the lead on NHS reform.

Pritchard is being replaced by Sir Jim Mackey, who is described as a "transition" CEO who will lead the NHS – on secondment from Newcastle Hospitals NHS Foundation Trust – "from the current crisis to getting back on its feet."