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Boris Johnson has handed a powerful new role to one of his advisers, as he continues to overhaul his Downing Street team.
Samantha Jones, currently the PM's adviser on NHS reform, will become interim permanent secretary and chief operating officer at No 10.
She will be in post for six months, ahead of a contest to fill the position permanently.
It is the latest change to No 10 staff after a recent wave of resignations.
The departures come as the prime minister seeks to head off a leadership challenge from Tory MPs unhappy with his premiership.
Mr Johnson has been under increasing pressure in recent weeks over reports of parties in Downing Street during Covid lockdowns.
Ms Jones is being described as the "most senior civil service leader in No 10" but she will report to Cabinet Secretary Simon Case, who will remain head of the civil service.
Her role will be to examine the way Number 10 is run and help to set up a new Office of the Prime Minister, as promised by Mr Johnson after Sue Gray identified "failures of leadership" in her report on lockdown parties.
Tory MP Steve Barclay was recently appointed the PM's new chief of staff, alongside his role as a minister at the Cabinet Office.
And former BBC journalist Guto Harri has become director of communications following the resignation of ex-Daily Mail reporter Jack Doyle.
Prior to joining the Downing Street team, Ms Jones was the chief executive of NHS trusts in West Hertfordshire and Epsom and St Helier.
The news of her new role comes after Mr Johnson also carried out a mini-reshuffle of his cabinet on Tuesday.
Jacob Rees-Mogg has been given a new role in government as the minister for boosting the economy in the wake of Brexit.
He has been replaced as Commons leader by Mark Spencer, who was government chief whip.