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| Sir David Nicholson, chief executive of NHS England, announces he is to quit | Sir David Nicholson, chief executive of NHS England, announces he is to quit |
| (4 months later) | |
| Sir David Nicholson, the chief executive of NHS England, dramatically announced the end of his six-year reign after sustained criticism of his role in the Mid Staffs hospital scandal made it impossible for him to continue as the public face of the health service. | Sir David Nicholson, the chief executive of NHS England, dramatically announced the end of his six-year reign after sustained criticism of his role in the Mid Staffs hospital scandal made it impossible for him to continue as the public face of the health service. |
| The £211,000-a-year official had been subjected to weeks of attack from some newspapers – the Daily Mail being the most virulent, dubbing him "the man with no shame" – following publication of the Francis report, which was highly critical of care at the Stafford hospital for four years from 2005. | The £211,000-a-year official had been subjected to weeks of attack from some newspapers – the Daily Mail being the most virulent, dubbing him "the man with no shame" – following publication of the Francis report, which was highly critical of care at the Stafford hospital for four years from 2005. |
| Nicholson was briefly head of the local strategic health authority when the first serious concerns about Mid Staffs emerged, although he was not directly criticised. Campaigners and hostile newspapers cited that brief tenure, though, to say he should have resigned "long ago". | Nicholson was briefly head of the local strategic health authority when the first serious concerns about Mid Staffs emerged, although he was not directly criticised. Campaigners and hostile newspapers cited that brief tenure, though, to say he should have resigned "long ago". |
| Despite the pressure, some of which came from Conservative cabinet ministers, Nicholson retained the support of Downing Street. His decision to step down from March next year also "surprised" the health secretary, Jeremy Hunt, who had been a supporter. | Despite the pressure, some of which came from Conservative cabinet ministers, Nicholson retained the support of Downing Street. His decision to step down from March next year also "surprised" the health secretary, Jeremy Hunt, who had been a supporter. |
| Nicholson emerged from the shadows in October last year, announcing a series of initiatives to require hospitals and GP surgeries to carry out operations and see patients seven days a week plus a nationwide review of emergency healthcare services. | Nicholson emerged from the shadows in October last year, announcing a series of initiatives to require hospitals and GP surgeries to carry out operations and see patients seven days a week plus a nationwide review of emergency healthcare services. |
| Since the publication of the Francis report in February he has been largely silent, leaving the stage to his deputies and allowing Hunt, who is no longer directly accountable for running the NHS, to grab the headlines. | Since the publication of the Francis report in February he has been largely silent, leaving the stage to his deputies and allowing Hunt, who is no longer directly accountable for running the NHS, to grab the headlines. |
| It was left to the professional body representing senior NHS managers to rebut criticism from Hunt that the poor performance in accident and emergency wards was down to Labour's changes to GP contracts. | It was left to the professional body representing senior NHS managers to rebut criticism from Hunt that the poor performance in accident and emergency wards was down to Labour's changes to GP contracts. |
| He was meant to give his first press conference at a key NHS conference in two weeks' time, and his media team had concerns about his reception from certain quarters of the press. | He was meant to give his first press conference at a key NHS conference in two weeks' time, and his media team had concerns about his reception from certain quarters of the press. |
| Nicholson's announcement comes at a critical point for the NHS. The coalition's health reforms have just come into force – with GPs for the first time buying care directly for their patients and a flock of private providers emerging to rival the NHS – just as the service is struggling to make £20bn in "efficiency savings". | Nicholson's announcement comes at a critical point for the NHS. The coalition's health reforms have just come into force – with GPs for the first time buying care directly for their patients and a flock of private providers emerging to rival the NHS – just as the service is struggling to make £20bn in "efficiency savings". |
| Initiatives meant to reduce costs – such as the new NHS non-emergency advice line – have already caused harm to patients. | Initiatives meant to reduce costs – such as the new NHS non-emergency advice line – have already caused harm to patients. |
| Those who worked with Nicholson in the Department of Health said he "could never have articulated his vision for the NHS because every time he pops up there's a media furore". | Those who worked with Nicholson in the Department of Health said he "could never have articulated his vision for the NHS because every time he pops up there's a media furore". |
| However, there was anger from campaigners that Nicholson, who has worked in the health service for 35 years, will walk away with a pension pot of at least £1,875,000 when he retires, according to NHS figures published in March last year. | However, there was anger from campaigners that Nicholson, who has worked in the health service for 35 years, will walk away with a pension pot of at least £1,875,000 when he retires, according to NHS figures published in March last year. |
| Julie Bailey, from the campaign group Cure the NHS, said: "It is an obscene amount of money for failure. He will be able to enjoy the rest of his life, unlike us – we are left with memories of our loved ones suffering under his watch." | Julie Bailey, from the campaign group Cure the NHS, said: "It is an obscene amount of money for failure. He will be able to enjoy the rest of his life, unlike us – we are left with memories of our loved ones suffering under his watch." |
| Nicholson was appointed NHS chief executive in 2007. In the coalition's new NHS, he controlled more than £95bn of health spending. Sources say his announcement gives the chair of the NHS, Professor Malcolm Grant, time to plan an orderly succession. | Nicholson was appointed NHS chief executive in 2007. In the coalition's new NHS, he controlled more than £95bn of health spending. Sources say his announcement gives the chair of the NHS, Professor Malcolm Grant, time to plan an orderly succession. |
| As a quango, NHS England is outside direct ministerial control and the health secretary has no say in the new appointment. | As a quango, NHS England is outside direct ministerial control and the health secretary has no say in the new appointment. |
| Sean Worth, former special adviser to David Cameron, worked with Nicholson on the coalition's controversial health bill. | Sean Worth, former special adviser to David Cameron, worked with Nicholson on the coalition's controversial health bill. |
| He said: "The big problem is who replaces him. Like him or not, he's hugely competent and the names being speculated on to replace him are minnows in comparison." | He said: "The big problem is who replaces him. Like him or not, he's hugely competent and the names being speculated on to replace him are minnows in comparison." |
| Inside the department, the odds-on favourite to take over is Ian Dalton, current president of global health at BT. He was Nicholson's deputy until he left for the private sector this year. | Inside the department, the odds-on favourite to take over is Ian Dalton, current president of global health at BT. He was Nicholson's deputy until he left for the private sector this year. |
| In a letter to Grant, Nicholson said: "I have only ever had one ambition and that is to improve the quality of care for patients. I still passionately believe in what NHS England intends to do. | In a letter to Grant, Nicholson said: "I have only ever had one ambition and that is to improve the quality of care for patients. I still passionately believe in what NHS England intends to do. |
| "My hope is that by being clear about my intentions now this will give you and the board the opportunity to attract candidates of the very highest calibre so they can appoint someone who will be able to see this essential work through to its completion." | "My hope is that by being clear about my intentions now this will give you and the board the opportunity to attract candidates of the very highest calibre so they can appoint someone who will be able to see this essential work through to its completion." |
| But it was events at a small hospital in the heart of England that came back to haunt him at the height of his powers. | But it was events at a small hospital in the heart of England that came back to haunt him at the height of his powers. |
| The 57-year-old had issued a full apology after the Francis report was released, to "patients, relatives and carers [who] found themselves in the position where they not only had terrible things happen to them but the very organisation they looked to for support let them down in the most devastating of ways". But this did little to assuage the anger felt. | The 57-year-old had issued a full apology after the Francis report was released, to "patients, relatives and carers [who] found themselves in the position where they not only had terrible things happen to them but the very organisation they looked to for support let them down in the most devastating of ways". But this did little to assuage the anger felt. |
| Sir David's supporters say his decision to step down is personal – he has just become a father again. "I think we will see a liberated man … which will be interesting," said one source. | Sir David's supporters say his decision to step down is personal – he has just become a father again. "I think we will see a liberated man … which will be interesting," said one source. |
| Hunt said: "Under Sir David Nicholson's leadership, NHS waiting times have fallen, infection rates reduced, and mixed-sex accommodation is at an all-time low. | Hunt said: "Under Sir David Nicholson's leadership, NHS waiting times have fallen, infection rates reduced, and mixed-sex accommodation is at an all-time low. |
| "His job has often been incredibly complex and very difficult, and yet he has always had a reputation for staying calm and maintaining a relentless focus on what makes a difference on the NHS frontline. | "His job has often been incredibly complex and very difficult, and yet he has always had a reputation for staying calm and maintaining a relentless focus on what makes a difference on the NHS frontline. |
| "I am also grateful to him for overseeing the successful setting up of NHS England and giving us an orderly period in which to select his successor." | "I am also grateful to him for overseeing the successful setting up of NHS England and giving us an orderly period in which to select his successor." |
| • This article was amended on 24 May 2013 because the original said Sir David Nicholson would get a "pension of at least £1,875,000". To clarify: that figure refers to the size of his pension pot, not his annual pension. | • This article was amended on 24 May 2013 because the original said Sir David Nicholson would get a "pension of at least £1,875,000". To clarify: that figure refers to the size of his pension pot, not his annual pension. |
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