Prior to this he served as NHS Medical Director and Director General in the Department of Health from November 2007 to March 2013. Following the 2012 health service reforms he was appointed National Medical Director of NHS England from April 2013 to January 2018. During a decade as the most senior doctor in the NHS he had responsibility for national clinical policy and strategy, with a focus on clinical leadership, quality and innovation at a time of constrained public sector growth. In the Department of Health he was the sponsor for NICE, the Healthcare Commission and the National Patient Safety Agency and had responsibility for the Medicines Pharmacy and Industry Group. As a board member of NHS England he has overseen the implementation of wide-reaching reforms to the health service following the Health and Social Care Act 2012, and had a leading role in the development and the delivery of the NHS Five Year Forward View.
Prior to joining the Department of Health, he had a distinguished international career as a cardiac surgeon, having first been a consultant at the Hammersmith Hospital in London, then University Hospital Birmingham before becoming Professor of Cardiac Surgery at UCL and Director of Surgery at the Heart Hospital.
He has served on the boards of the Picker Institute, the Commission for Health Improvement and the Healthcare Commission. He was knighted for services to medicine in 2003.