Can a doctor lead the National Health Service?

Simon Stevens, former health adviser to the Labour party and current global health president at United Healthcare, has been announced as the next NHS England chief executive. The National Health Service (NHS) has been described as being the UK's social conscience and the nearest thing that we have to a national religion; Stevens has landed what is arguably the most important job in the country. Morale in the camp is low. It feels like there is a constant media onslaught and we are being asked to do more for less. Our leader in waiting will need to lift spirits and quickly get to grips with the problems faced by frontline staff every day.

Stevens joined the NHS in 1988 as a management trainee after graduating from Balliol College, Oxford. He then worked as a manager in different parts of the health service for 9 years before moving into government. His knowledge of the intricacies of the NHS, its history and its politics stand him in good stead.

Looking towards the distant future, with almost 150,000 -doctors currently employed by the NHS why does it still seem inconceivable that a doctor might one day run the NHS? Dr Amanda Goodall, an expert on management at Cass Business School, wrote of the association between leaders, who are experienced with the core business, and improved organisational performance. She explored this relationship within several disciplines; for example, universities improved their performance over time when led by stronger academics, excellent basketball players improved winning percentage and playoff success as coaches, and the most successful team leaders in Formula 1 motor racing are more likely to have started their careers as drivers or mechanics.¹

Leaders who have walked the floor, or in our case walked the wards, can also improve performance of healthcare organisations. The higher-ranked hospitals in the US News and World Report's ‘Best Hospitals’ are led disproportionately by clinicians. Hospital quality scores were approximately 25% higher in hospitals run by clinicians than average hospitals.¹

The idea of clinicians as leaders is not a new one. There are immediate benefits of putting someone who has been at the sharp end of delivering care in the driving seat. Awareness of common frustrations and sticking points in the system, clinical credibility, experience of working environments and a sense of what matters most to patients will be invaluable in creating strategy, tackling negative cultures and defining priorities for resource allocation.

Senior clinicians may be wary of the top job, citing their more focused repertoire. Steve Jobs, possibly the greatest leader within the consumer industry in recent times, didn't possess the most knowledge on every aspect of his company. His appreciation of Apple's core business led to his success – cutting-edge technology and brilliant product design. Confidence in Jobs’ technical expertise permeated throughout his organisation. It filtered down to the customers too; we trusted his judgement and bought his products.

The focus of recruitment for executive jobs within the NHS thus far tends to be on finding someone with strong financial credentials. However, the Francis, Berwick and Keogh reviews all highlight that now, more than ever, we must put patients at the centre of everything that we do. We can't say that clinicians will always be the best managers, but a hybrid of an excellent manager with experience of caring for patients as our leader remains an exciting prospect.

• © 2014 Royal College of Physicians