Case Studies

Aspirational Operations at the North Middlesex University Hospital NHS Trust


The Trust had experienced a difficult period in the preceding 12-18 months to the start of this recruitment due to:

  • Significant and high-profile changes of the leadership team
  • Uncertainty around the possibility of acquisition by The Royal Free
  • Having one of the worst A&E performance rates in the country
  • A poor organisational culture.


Understanding the Trust’s requirement and situation was particularly critical. The CEO, Maria Kane was looking for someone with NHS operational experience but, most importantly, someone with strong leadership credentials. We consulted and leveraged our relationship with NHSE/I, who worked closely with us and the Trust to identify high-quality and experienced individuals.


We went to our executive and interim networks to engage the most suitable established COOs, Divisional Directors and Managers in similar-sized or larger organisations.

We bolstered this with a wide array of Executives, Directors and Associate Directors across the NHS family who were highly regarded as leaders in their disciplines and could demonstrate some exposure to a demanding operational portfolio. The challenge in recruiting to this COO post was how to position it in the market.

The role had been occupied by a credible secondee from a neighbouring Trust for a period of 12 months. This was a deterrent to our connections in the market looking for a COO role because they deemed the internal a certainty. Candidate management and transparency was key here and we made it a priority from the start to discuss the Trust’s relationship with the Royal Free and assuage any concerns that the candidates may have. Maria was very keen to have early conversations with those strong candidates we believed would form our shortlist.


We developed a shortlist of four candidates, including two established COOs and two aspirant COOs, one of whom had most recently been a joint Medical Director.

The successful candidate, Dr Andy Heeps, had the least operational experience of the four. However, his career trajectory had been very steep and while he would have traditionally pursued the Medical Director post, he opted to follow his operational aspirations.

To provide additional support to the Board, we also conducted informal market soundings on Andy prior to shortlist, with his permission, so that we could further inform the panel of his track record of operational delivery. Our sources were very positive and earmarked him as a future NHS Chief Executive.

Since his appointment, Maria and the Board have been overwhelmingly positive. His style, intellect and cultural fit with the rest of the team have seen him build credibility quickly across the organisation and with system partners. His clinical background has been a huge asset to the Trust as he has had the ability to make significant contributions beyond his operational portfolio.

“I would definitely recommend using Hunter Healthcare for the search and selection of executive and non-executive board positions. As a CEO, I have used Hunter to source North Middlesex a new COO, CNO, MD and Chair, whilst they also found my replacement CEO at BEH, along with a COO, MD & Chair. I have always been impressed with Hunter’s ability to deliver under any circumstance, no matter how challenging the recruitment is.

Hunter have a diligent and process-orientated approach, which is underpinned by deep-rooted market networks and candidate relationships, across local, regional and national level. Hunter go above and beyond to really get under the skin of an organisation, ensuring they invest significant time up front on stakeholder engagement and cultural diagnosis. As a consequence, Hunter can really push the boundaries on candidate identification, and are not afraid to be creative and present left-field options, whilst always driving the importance in diversity of shortlist. (My COO, being a medic as case in point.)

Hunter are responsive, stick to deadlines, have excellent market knowledge and write detailed but user-friendly reports and briefing documents. I also found Hunter’s networks with NHSI particularly useful when it came to navigating the closing stages of the recruitment process, whether it was panel management, offer negotiation, reference taking or managing stakeholder politics.”

Maria Kane
Chief Executive
North Middlesex University Hospital NHS Trust