David took up the post of NHS Chief Executive in September 2006. He was appointed Chief Executive of the new Strategic Health Authority for London in early 2006 having previously been the Chief Executive of Birmingham and The Black Country SHA (from 2003) and of West Midlands South and Shropshire & Staffordshire Strategic Health Authorities (from 2005).

In April 2002 David became Director of Health and Social Care for the Midlands and East of England. Before taking this role he held a number of positions in NHS organisations including Regional Director for Trent and nine years as Chief Executive of Doncaster Royal Infirmary NHS Trust. He was awarded the CBE in January 2004 for his services to the NHS.