Responding to the publication of the terms of reference for the review of health and social care leadership in England, the chief executive of NHS Providers, Chris Hopson, said:

"Trust leaders will welcome these terms of reference as they set out how the review can increase support for leaders who have some of the most difficult roles in the country, given the size and complexity of the trusts they lead.

"Trust leaders on the front line are doing everything they can to ensure additional investment in the NHS is well spent, improving care, reducing variation, cutting waste and leading the transformational change the NHS needs.

"They are also dealing with the impact of an unprecedented global pandemic and four structural fault-lines that have emerged over the last decade – the longest and deepest financial squeeze in NHS history; a consequent inability to grow NHS capacity to meet growing demand; a broken workforce model including 93,000 vacancies and a social care system under impossible pressure. These issues are not solved by changing senior leaders.

"So it is important that the review reflects these multiple challenges, while also exploring how to improve performance and bring about change. We also welcome the focus on increasing incentives to encourage the best leaders and leadership teams to take on the most difficult leadership challenges.

"Ultimately, we want to avoid a blame game where fingers are pointed at NHS leaders for not being able to meet any unrealistic expectations imposed upon them at a time when the whole system is under huge pressure."