TO misquote Oscar WIlde: “To lose one top NHS management structure may be regarded as a misfortune; to lose two looks like carelessness.”

The public will wonder what is going on at Oxfordshire Clinical Commissioning Group as it announces a management restructure. Seven months after it was created, chief executive Dr Stephen Richards stepped down and was replaced by interim chief executive Ian Wilson.

He has now departed and been replaced by David Smith, who will oversee the new restructure.

The clinical commissioning groups were brought in to replace primary care trusts and run our health systems.

Was it too much to expect, when dealing with a multi-million health operation, that Oxfordshire was set up properly at the first time of asking? Or second?