Three women lead the HSJ top 50 trust chief executives

Marianne Griffiths is the first woman to take the number one spot in HSJ’s annual assessment of trust chief executives. But the Western Sussex boss was run close by East London’s Dr Navina Evans, while Sarah-Jane Marsh from Birmingham Women and Children’s secured third place.

HSJ’s fifth ranking of all 249 provider trust chief executives is notable not only for women taking the top three places, but also for the rise of mental health chief executives and the relative demise of their teaching trust counterparts.

• The full top 50 can be viewed here

There are the same number of female chief executives in this year’s Top 50 compared to 2017 (22), but only six among the top 15, the same as in 2016 but two down on last year. However, this will surely be overshadowed by the fact that the top three are all women.

The results are a sharp contrast with the first HSJ Top 50 in 2014. That year, the top 10 were ranked and only one – Dame Julie Moore – was a woman.

Marianne Griffiths has had a meteoric rise. She went straight into the Top 50 at number three last year after recovering from a serious illness to take Western Sussex to an outstanding Care Quality Commission rating. Following Sir Andrew Morris’ retirement and Sir David Sloman’s slip down the rankings, Ms Griffiths moves up to number one on the back of the continuing excellence of Western Sussex and her work attempting to turn round Brighton and Sussex University Hospitals Trust, where she is also chief executive.

The judges were asked to assess three criteria: leadership style and personal example; the performance of the organisation; and the contribution of the wider health system

Chalices do not come much more poisoned than Brighton with its horrendous mix of performance, finance and governance (race) issues. It would be very surprising if Ms Griffiths was not the kind of chief executive Jeremy Hunt had in mind when he suggested that those taking on the toughest jobs in the NHS should be better rewarded by the annual honours system.

Navina Evans was equally unknown a few years ago outside mental health. The fact she now finds herself the sector’s most admired chief executive and in the overall runner’s up spot is a tribute to East London’s steady improvement on the back of its outstanding CQC rating. The last year has seen the trust gaining devolved commissioning responsibility, buddying up with the struggling Norfolk and Suffolk Foundation Trust, and winning a £195m community services contract in Bedfordshire.

But judges were most impressed by Dr Evans’ commitment to staff wellbeing, championing diversity, service development and personal example as one of the NHS’s very senior leaders from an ethnic minority background.

Number three Sarah-Jane Marsh also runs an organisation rated outstanding by the CQC. A little of the shine has been taken from that accolade by the inadequate rating given to the organisation’s community CAMHS last month, but Ms Marsh’s rapid acknowledgement that the public should be “disgusted” by its performance was welcomed as an unusually plain spoken admission from a senior NHS leader.

The Birmingham chief is also chair of the NHS England maternity transformation programme and is not afraid of making her views known publicly – often via Twitter. For example, she has been outspoken about how the NHS’s lack of funding is undermining the huge advances it made during the first decade of this century. The securing of former NHS England medical director Sir Bruce Keogh as the trust’s chair was hardly a surprise, but highlights Ms Marsh’s ambition for her recently merged organisation.

Perhaps the least known name to win a place in the top 15 is Angela Hillery from Northamptonshire Healthcare. She was praised for her system work – Ms Hillery is the Northamptonshire sustainability and transformation partnership lead and the trust has signed a pioneering contract with a local GP federation.

The judges (see box below) were asked to assess the chief executives on three criteria: leadership style and personal example; the performance of their organisation when judged against its peers; and the contribution of the wider health system.

With performance under pressure across the board, the judges spent much of the time deliberating leadership style and the role chief executives played across their health economies.

Better team players

A theme that emerged from these discussions was that mental health and community trust chief executives tended to be better team players than their acute counterparts.

The Shelford Group trusts have only five of its 10 chief executives represented in the top 50

A case in point was University Hospital Birmingham’s Dame Julie Moore, who was placed eighth in 2017 (and second in 2016). The judges were in no doubt that Dame Julie remains a master of her art – running a big teaching hospital – but felt her style and approach were struggling to get traction in the Heart of England hospitals she took over two years ago, and did not fit as well in the era of STPs and integrated care systems.

Dame Julie remains firmly in the top 50, but overall 17 acute trust chief executives have left the list this year, along with one community and one specialist trust leader. They have been replaced with the chief executives of eight acute, seven mental health, three community and one ambulance trust. A third of the top 50 lead mental health trusts.

Another very significant sign of the times is that the Shelford Group of NHS teaching trusts has only five of its 10 chief executives represented in the top 50.

All of that said, the two highest new entries both lead acute trusts. Little surprise that Northumbria’s Jim Mackey finds himself in the top five on his return from NHS Improvement, but the jump of Western Suffolk’s Stephen Dunn’s straight into the top 50 at number eight is a real turn up for the books.

When Mr Dunn was appointed a trust CEO, he was probably best known for his involvement with controversial policy “wheezes”, particularly the Circle Hinchingbrooke deal and the friends and Family test. But since then he has proved himself – perhaps surprisingly – as a floor walking CEO in the style of Sir Andrew Morris or Sir David Dalton (albeit with an additional fondness for Twitter). West Suffolk is now arguably the best small hospital trust in the country, scoring the highest marks in last week’s staff survey for employees recommending their organisation for work or care. As one judge said of Mr Dunn: “The job has been the making of him.”

Another acute chief worthy of highlighting is Robert “double bounce” Woolley from University Hospitals Bristol. Mr Woolley is the first chief executive to take his organisation from requires improvement to outstanding over the course of just two CQC inspections. The judges acknowledged he is not everyone’s cup of tea, but he was celebrated for making considerable progress in a notoriously difficult health economy with a long record of underperformance.

A third chief executive leaping into the top 15 is Rob Webster from South West Yorkshire Partnership.

The SWYP boss was praised for his unbending commitment to system working (he is the lead for the West Yorkshire and Harrogate STP) and the personal example he sets in his leadership style. The ferocity with which he tore into trolls who attacked a transgender member of his staff on social media was just the most overt example of a man whose walk matches his talk.

Those dropping down or out of the top 50 included some notable names. These included Sir David Sloman, who has slipped out of the top 15 amid suggestions his trust is heading for financial stormy weather.

Other notable serving chief executives disappearing completely from the top 50 include Oxford’s Bruno Holthof, Wigan’s Andrew Foster and the Royal Marsden’s Cally Palmer. If their absence causes some head scratching, it is less likely to be the case with Leicester’s John Adler and Barking’s Matthew Hopkins.

The influence of the WRES scores, which measure the experience of BME staff, was noticeable among the judges – with one teaching trust chief executive losing their place in top 15 as a result and another award winning chief being excised from the top 50 completely.

Given this is the fifth time we have published a list of top chief executives, it is worth concluding by looking back at the first in 2014. As indicated above, only the top 10 were ranked that year. Of those, five have retired and therefore were not considered for this year’s ranking: Sir Andrew Morris and Sir Andrew Cash now lead STPs, Peter Homa chairs the Leadership Academy and Sir Robert Naylor acts as the NHS’s de facto estates tsar. Five still hold chief executives posts but none remain in the top 10 (although Sir David Dalton hovers at number 11).