Sir Simon Stevens is standing down as the head of the NHS in England after seven years marked by tussles with ministers over money and the successful rollout of the Covid vaccination programme. NHS England said Stevens, 54, would leave his post as chief executive in July. Downing Street said the former NHS manager and Labour government special adviser under Tony Blair would become a life peer. NHS sources say that his successor is likely to be someone who is less outspoken and less willing to challenge the government, especially over the health service’s budget, which led to rows with No 10 and the Treasury in recent years. Insiders identified Amanda Pritchard, Stevens’ deputy, Sir James Mackey, chief executive of the Northumbria NHS trust, and Dr Tim Ferris, an American doctor who is the NHS’s director of transformation, as likely contenders to replace him. While NHS England’s board chooses its preferred successor, the government – through Matt Hancock, the health secretary – has a right of veto. The NHS hopes to appoint Stevens’ replacement by the time he steps down on 31 July. Pritchard, who is on secondment from her role as chief executive of the Guy’s and St Thomas’ trust in London, is a strong contender. She is admired by fellow NHS bosses and has inside knowledge of how the government works from a spell in Tony Blair’s Downing Street delivery unit in 2005-06. NHS insiders say that she has been prepared for the top job in recent months, for example through making an appearance answering MPs’ questions alongside Stevens at a recent evidence session with the health and social care select committee. She would be the service’s first female chief executive. Mackey has won admirers in the NHS for his stewardship of the Northumbria acute care trust. He took a two-year sabbatical from that to lead NHS Improvement, the service’s financial regulator, which will merge with NHS England next year as a result Boris Johnson’s planned shake-up of the service. Like Pritchard, he has plenty of experience running an NHS trust which, insiders say, is essential, given the service’s spiralling waiting-list of people awaiting hospital treatment, especially surgery, which currently stands at a record 4.7m. He has a long track record of innovation and managed to keep the number of operations cancelled because of the pandemic lower in Northumbria than in many comparable trusts. The NHS reform bill due to be unveiled in the Queen’s speech on 11 May will hand the health secretary back much of the power over NHS England that the department of health ceded under reforms in 2012. One senior NHS official said: “The government want someone who’s much less political and much more operational than Simon. With him going there’ll be a change of style as well as a change of person in the top job. If the secretary of state is increasing his powers of direction over the NHS, and he’s going to be more assertive, they’re not going to have a Simon Stevens-type chief executive, who acts like a health secretary. They’ll want someone who can concentrate on operational delivery and a different power balance.” Stevens has used the independence that the NHS England chief executive enjoys to press the government – publicly and sometimes to its discomfort – to give the service more cash. In 2017 he told a committee of MPs that a claim by the then prime minister Theresa May that the NHS was getting more than the £8bn extra funding it had sought, was “stretching it”, leading to fury in No 10. Lord Prior, NHS England’s chair, said: “Simon has successfully led the NHS through its greatest ever challenges – the worst pandemic in a century, the greatest funding squeeze since the second world war, and unprecedented political volatility, working alongside three prime ministers and four chancellors.” Although ministers have routinely praised Stevens’ ambitious plans to reform and improve the NHS, his tenure has been marked by a series of behind-the-scenes rows with different governments over issues such waiting times and the NHS’s budget. Relations with the Treasury have been intermittently tense as it demanded more visible improvements for its belated injection of significant extra funding in recent years. Some senior officials are also tipping Ferris as a potential successor. The Americanused to be chief executive of the Massachusetts General Physicians Organization, a not-for-profit healthcare provider. Announcing the move, Stevens said: “Joining the health service in my early 20s was one of the best decisions I’ve ever made, followed three decades later by the privilege of leading the NHS through some of the toughest challenges in its history.” Boris Johnson paid tribute to Stevens, whom he became friends with at the University of Oxford in the 1980s despite their respective involvement in the Conservative association and the Labour club. He said: “Sir Simon has led the NHS with great distinction for the past seven years. I want to thank him for his dedicated service throughout, but especially when facing the extraordinary pressures of the past year, and for his huge contribution to our vaccine rollout.”