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Turnaround CEO leads the 2024 ‘top chief executives’ ranking

Published on: 21 Jun 2024

The chief executive who led his trust out of regulatory special measures has topped the 2024 HSJ ranking of England’s leading CEOs.

Matthew Trainer joined Barking, Havering and Redbridge in 2021 from mental health provider Oxleas when the east London acute was struggling on almost every front. Just under three years later, the trust exited the latest version of special measures, having made “the most improvement on waiting lists for emergency care than any other trust in England,” according to the NHS Confederation. The trust had exited special measures before, in 2017, but had almost immediately been placed back in.

The full list can be viewed here

This is Mr Trainer’s third consecutive appearance in the HSJ Top 50 chief executives. Interestingly, he is not the accountable officer for the trust which is part of the Barts/BHR group led by Shane De Garis, with Mr Trainer as his deputy.

The HSJ Top 50 was launched in 2014. It is judged by leading health service figures, which this year included NHS England chief workforce officer Navina Evans, chair of the House of Commons health select committee Steve Brine, NHS Providers chief executive Sir Julian Hartley, and chair of the British Medical Association consultants committee Vishal Sharma (see full list of judges here).

The judges were asked to choose the top 50 based on three criteria: the performance of the organisation they lead, their contribution to the wider NHS, and the personal example they set. While their track record is taken into account, the judges were asked to focus on the next 12 months.

As is normally the case, the judges ranked a proportion of the top 50 – in this case, the leading 15. The rest are listed alphabetically.

In second place came Sussex Community Foundation Trust’s Siobhan Melia, who has appeared in the last five HSJ Top 50s. Back in her day job after serving as interim CEO at the troubled South East Coast Ambulance Service FT, Ms Melia was commended for her report into the cultural problems so often experienced at ambulance trusts.

This was a theme continued by the judges’ choice of the third placed CEO, Daniel Elkeles. Like Ms Melia, he is an outsider who joined the ambulance sector recently but is busy rethinking how London Ambulance Service Trust should operate in ways many believe will have widespread consequences for the sector. This is the third time in consecutive years he has made the top 50.

Mr Elkeles was the only one of England’s 10 mainland ambulance trust chief executives to make the top 50 in 2024, the North West’s Darren Mochrie having slipped from the rankings since the 2023 list.

The departed

As is usually the case, there was significant churn in the top 50, with 17 CEOs present on the 2023 list disappearing from the ranking (as opposed to 19 from last year’s). Those exiting included some well-known names.

Dame Jackie Daniel, Joe Rafferty, and Carolyn Regan retired, while Caroline Clarke was (finally) confirmed as the NHS England London regional director. Perhaps the greatest surprise absence was that of Eugine Yafele, the number one CEO in 2022, who disappointed some of his many champions by choosing to take a job in Australia less than two years into his tenure at University Hospitals Bristol and Weston FT.

The absence of three still-serving CEOs is easily explained. George Findlay from University Hospitals Sussex, Bradford’s Mel Pickup, and King’s Clive Kay all had difficult years – albeit for very different reasons.

Only one of 2023’s “top 15” chief executives dropped out of the ranking altogether (having jumped straight into the upper echelons last year). However, Hertfordshire Community’s Elliot Howard-Jones is not the first (relatively) young CEO to generate over-enthusiasm early in his career, and he has plenty of time to come again.

The newcomers

The 17 vacant slots in the 2024 top 50 saw no fewer than 10 CEOs appear in the rankings for the first time. Of those, four went straight into the top 15, and two into the top 10.

If the future of the NHS is really an integrated one, then it is very possible that the seventh placed Peter Lewis is leading the organisation that has most to teach the service.

Somerset FT is England’s first mainland acute, community and mental health provider. It also runs a quarter of the county’s 60 GP practices.

Mr Lewis told HSJ in April that he wanted to deliver “acute home treatment” at a scale surpassing existing virtual ward and remote monitoring programmes.

The eighth-placed Olubukola (Buki) Adeyemo was finally confirmed as substantive CEO of the outstanding-rated North Staffordshire Combined Healthcare Trust after two years as interim. She has previously served as the trust’s medical director.

Gender and racial mix — and some notable absences

One very encouraging sign is the presence of seven chief executives from a minority ethnic background in the 2024 top 50, up from four last year and just two in 2022. The standout performance is, as previously mentioned, from Dr Adeyemo. Of these seven ME CEOs, four lead London trusts – three of them mental health providers.

The 2024 list also saw a better gender balance, with 22 women and 28 men. This compared with 20 women and 30 men in 2023, which represented the greatest imbalance for some years.

As ever, some of the leaders of NHS’s largest organisations are missing from the list. Absent in 2024 are the CEOs of Guy’s and St Thomas’ FT, University Hospitals Birmingham FT, Leeds Teaching Hospitals Trust, and Sheffield Teaching Hospitals FT. It is notable that these organisations have not had their CEOs represented in the Top 50 since the departure of high-profile chiefs, respectively, Amanda Pritchard, Dame Julie Moore, Sir Julian Hartley, and Sir Andrew Cash.