With the NHS at a crossroads and a looming election causing paralysis across the system, the ninth edition of the HSJ100 and its rankings has been particularly tricky to predict.

Who will wield the most power and influence on the NHS over the next 12 months? Is 12 months the correct timescale? If we were to have a “five year forward view” of the HSJ100, would we see society in the number one spot?

If this is indeed the intention, the system itself requires a radical shift as does the paradigm of NHS “leadership”. A shift towards empowering society, a shift towards creating an inspiring, creative, progressive NHS that is built around people.

HSJ100 2014

The individuals within this list have the power and influence to collaborate, to empower and to start us on this journey of change. National leadership will need to be aligned, to be challenging but supportive and nurturing.

In five years should we be placing so much power and influence on regulation as seen in this year’s HSJ100? While important, should we not be focusing on collaboration and integrating services to be fit for purpose and fit for an ageing society? Should we not be empowering society to take control of their own health and wellbeing?

National leaders will need to create freedom for local leaders

For this to happen, national leaders will need to create freedom for local leaders. Freedom to innovate, to listen and respond to their communities. Freedom to fail in the pursuit of innovation and progress. Freedom to inspire society to take control, collectively.

Power often comes with aggression, dominance and fear, which does motivate but is not sustainable. Real power is inspiring and empowering. It’s not the power of one, or the power of 100 but the power of all of us to really influence the change required. To those listed in the HSJ100, this is your challenge for 2015.

Gavin Johnstone is founder and managing director of Hunter Healthcare

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HSJ100: Our top names are best positioned to shape a year of volatility and voters