NHS breeds leaders who are ‘too insular’, says ex-ICB chief

The NHS has some of the best leaders in the public service, but they often have a mindset that is too insular, according to a former ICB chief and senior civil servant.

Mark Fisher, who retired from Greater Manchester Integrated Care Board in March, also said the health service makes a “fundamental error” by undervaluing partnerships with local government and others.

Before joining the ICB in 2022, Mr Fisher held several senior posts in Whitehall, including director general of the Grenfell Tower inquiry and a director role in the Cabinet Office.

Asked about NHS leadership, he told HSJ he found the service had “some of the best leaders you’d find anywhere in the public service”. 

But he added: “I do think, if the NHS has a fault, it does breed leaders whose focus is largely within the NHS, and it sees itself as being able to solve its own problems. That’s a category error, a fundamental error. Many of the solutions to the NHS’s problems lie outside the NHS.”

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Source: HSJ, 20 August 2026