Sir David Nicholson resigns … but hangs on

Mid-afternoon, as all attention is on the health secretary and what is happening in the nation’s accident and emergency departments, a resignation is slipped out.  Sir David Nicholson, the CEO of NHS England, is to step down from next March.

It was not entirely unexpected, the only surprise is that he is hanging on for so long.  He says it is to allow the NHS Commissioning Board to find his successor but it would be easy to believe that he can’t quite let go just yet.

He must have know that after Mid-Staffordshire and the excoriating Francis report that it was inevitable.  Although he was not blamed at all in the report for what happened at the beleaguered trust, families whose loved ones had died held him directly responsible.

He was first of all at the local health authority at the time the order went out to make savings at the hospital which led to dramatic staff cutbacks. He then went on to rise up and up in the NHS and yet did not know about the problems unfolding at Mid Staffs.

Yet, as we reported in February, there was data – some of it real time – to show that Mid Staffs had a higher than average mortality rate.   Some believe he knew that.  There was never any proof but the secondary question remained:  should he have known?

In March he gave rather tetchy evidence to the health select committee, again failing to answer questions put to him by equally exasperated committee members.

All the time, though, he retained the support of the health secretary and the prime minister.  The suspicion, of course, was that he was the only person – following the departure of Andrew Lansley as heath secretary – who knew how the massive NHS reforms were meant to work.

Much is made of the fact he was once a Communist party member but the fact is Sir David was an NHS man through and through.   He genuinely did appear to love it, although love it as a bureaucrat rather than someone on the ground doing the hard graft as it were.

In his resignation letter he expresses pride in what he has achieved as well as profound regret at what happened  at Mid Staffs.

And, of course, questions are already being raised about the size of his pension pot.  It will be substantial, whatever it is.

Follow @vsmacdonald on Twitter.