Group chief executive announced for acute NHS trusts in north west London
Professor Tim Orchard has been appointed Group Chief Executive of the North West London Acute Provider Group due to launch formally on 1 April 2026. The move to a group model is the next step in the development of the North West London Acute Provider Collaborative, established in July 2022 and made up of:
- Chelsea and Westminster NHS Foundation Trust
- Imperial College Healthcare NHS Trust
- London North West University Healthcare NHS Trust
- The Hillingdon Hospitals NHS Foundation Trust.
Professor Orchard has been Chief Executive of Imperial College Healthcare since 2018. He was previously Divisional Director for Medicine and Integrated Care and continues as a consultant gastroenterologist and professor of gastroenterology at Imperial College London.
The trusts will remain four separate organisations with a board and chair in common. The group chief executive will become the ‘accountable officer’ for all four trusts. Each trust, including Imperial College Healthcare, will also continue to have its own chief executive, who will report to the group chief executive and remain a key partner to local stakeholders.
Matthew Swindells, Chair of all four trusts, said:
“Tim’s appointment is an important milestone in our journey towards greater collaboration for the benefit of all our patients, staff and local communities. The group model will allow simpler and faster decision-making, reflecting local needs and views while also supporting more joined-up working.
“Tim brings a deep commitment to, and understanding of, health and care, research and innovation and, most importantly, our patients, partners, local communities and staff. The leadership he will be able to provide in his new role will bring an additional boost to the whole group and I’m looking forward to continuing to work closely with him and all our trust chief executives to enable all four trusts to reach their full potential.”
Professor Tim Orchard, Group Chief Executive designate, said:
“Our trusts and hospitals have different but equally important roles in achieving better health and healthcare for our diverse population. As I prepare for my new role, I want to spend as much time as possible engaging with colleagues and wider stakeholders to determine how we best work together. The group model has to add value to all the great things that are already happening and provide more opportunities for our staff to flourish.
“I also want to be clear that moving to a group model won’t create any immediate or sudden changes in how we work. I know staff across our hospitals are feeling the pressure of our operational and financial challenges and it’s vital we maintain our focus on ensuring safe, high quality care, especially as we head in to winter and continue to reduce waiting times. Instead, I want to make it easier for us to draw on our collective skills, resources and ideas to drive change and improvement together and towards our common goals.”
Dame Caroline Clarke, Regional Director for the NHS in London, said:
"Tim is an experienced leader with a deep commitment to quality. His appointment will bring strong leadership to the emerging provider collaborative, not only on the immediate performance challenges facing the NHS but crucially helping us to maximise opportunities to innovate and improve care for the years ahead. I look forward to working with Tim in this new capacity, with provider collaboratives playing a key role in London's delivery of the 10 Year Health Plan."
Professor Orchard will take up his new role formally on 1 April 2026.
Group chief executive - Q&A
How was the group chief executive appointment made? Was it a formal process?
The appointment followed a formal interview process, with the interview panel made up of trust vice chairs, the chair in common of all four trusts, representatives of the council of governors of the two foundation trusts (Chelsea and Westminster and Hillingdon), an independent chair from another NHS trust, and the London regional director of NHS England. The outcome of two stakeholder panels, involving key stakeholders for all four trusts, also fed into the panel’s decision making. The appointment has been approved by the board in common as well as the council of governors of the two foundation trusts.
What happens between now and 1 April 2026?
The chief executives of all four trusts will continue to be the accountable officer for their relevant organisations until 1 April 2026. Alongside this, Professor Orchard will spend as much time as possible engaging with the other trust chief executives, the Board in Common, and with colleagues and staff across all of the trusts, as well as with governors and external stakeholders, on how the organisations can best work together and ensure a smooth transition from collaborative to group. Plans and details of governance and leadership changes will be shared over this time.
Who will be running my hospital – who will make the decisions?
Each trust will continue to have its own chief executive and leadership team who will continue to oversee the day-to-day operations of their trust and work closely with local health and care partners and wider stakeholders. They will report to the group chief executive who will be the ‘accountable officer’ for all four trusts. There will also continue to be a board and chair in common, which has been in place since 2022. Detailed plans for how the leadership teams for the four trusts will work together and with the group chief executive will be developed over the coming months.
When will a new chief executive be appointed for Imperial College Healthcare?
That’s one of the first tasks that needs to be managed now an appointment has been made.
Where will the new group chief executive be based?
He will have a base at each Trust.
Will we be expected to change our organisational values?
Unsurprisingly, all four organisations have developed values that are very similar to each others’. It probably will be sensible at some point in the future to consider whether we want to align around a new common set of values but that would only happen through wide ranging engagement.
Will I be expected to work across different sites – or move site - within the group?
Will services at my local hospital move to other sites?
Moving to a group model won’t create any immediate or sudden changes in how we work or where services are provided. Our hospitals have different but equally important roles in achieving better health and healthcare for our diverse population. The group is a natural evolution of the North West London Acute Provider Collaborative that was established in July 2022. As a collaborative, we have already seen teams across our trusts work more collaboratively, sharing best practice and innovation to make the most of our collective skills and resources. This includes joint developments to improve care pathways, especially those that involve cross site services, as well as some corporate services. This has involved developing more standardised ways of working through to consolidating services where that will have most benefit, the largest example being the development of the North West London Elective Orthopaedic Centre at Central Middlesex Hospital. All of these developments have involved – and will continue to involve – staff and, wherever possible, patients and lay partners from the start, as well as open and transparent decision-making. If proposals for any significant changes emerge - for services, roles or team structures - there would also be formal consultation processes.
Will this lead to hospital closures or mergers?
No, all 12 hospitals in the collaborative will continue to play a crucial role in the north west London healthcare system and beyond. A formal merger of the four trusts was considered but it was determined, certainly at this point, that it would be too time and resource consuming and a distraction from our shared mission to provide outstanding care. We will therefore remain as four separate, statutory organisations.
As a collaborative, we have already seen teams across our trusts work more collaboratively, sharing best practice and innovation to make the most of our collective skills and resources. This includes joint developments to improve care pathways, especially those that involve cross site services, as well as some corporate services. This has involved developing more standardised ways of working through to consolidating services where that will have most benefit, the largest example being the development of the North West London Elective Orthopaedic Centre at Central Middlesex Hospital. All of these developments have involved – and will continue to involve – staff and, wherever possible, patients and lay partners from the start, as well as open and transparent decision-making. If proposals for any significant changes emerge - for services, roles or team structures - there would also be formal consultation processes.
With a national requirement to reduce spend on corporate functions, are these functions now likely to be consolidated?
Collaborative working has already led to the development of some shared corporate services, the biggest of which has been the evolution of a joint IT function, linked to the adoption of a common electronic patient administration system – Cerner - across all of the trusts. We’ll continue to build on this work as a group and, as with services, staff will be involved in any potential change initiatives and, if proposals for any significant changes emerge there would also be formal consultation processes.
Is this a cost-cutting exercise?
Cutting costs is not the primary driver but it will help us to make better use of our collective resources, and we have made a commitment to reduce overall senior leadership/governance costs through this process.
Won’t this just create more management and governance costs, with an additional executive team/board sitting across the four existing teams/boards?
One of the drivers of the change is to reduce the bureaucracy of decision-making and so we will make sure that the group leadership structure has the right balance of local and overarching leadership. We have made a commitment to reduce overall senior leadership/governance costs through this process.
What examples are there of similar group structures across the NHS?
There are a range of partnership models in place for acute NHS trusts across the country, reflecting the move towards greater collaboration across the NHS, especially following the benefits we saw in collaboration through the pandemic. For example, Leicestershire Partnership NHS Trust and Northamptonshire Healthcare NHS Foundation Trust are already in a group structure. Local circumstances and context are key, and our move to a group structure is very much an evolution of the existing collaborative model that has been in place since 2022.
Will the performance, finances and/or resources of my trust be negatively impacted by being grouped in with more challenged trusts?
The primary focus of the collaborative has been to reduce unwarranted variations in quality and experience across all partner trusts. And the collaborative has already helped us make improvements across a range of measures, with the north west London system, as a whole, achieving better than the London average for operational targets in urgent and emergency care and cancer care. The trusts will still be run as separate statutory organisations, with their own accounts and operational targets.
Why hasn’t there been a formal consultation on this change?
The change is to the governance of the four trusts, with no direct impact on services or care. The boards of all four trusts – and the governors of the two trusts that are foundation trusts (Chelsea and Westminster and Hillingdon) - have approved the move and the appointment of the group chief executive. NHS England has also supported this development and appointment and the London regional director was on the interview panel for the group chief executive.
