Samantha started her career as a general and paediatric nurse. Having completed the NHS Management Training Scheme, she worked in a variety of operational management roles across the NHS including as a chief executive for 2 trusts. She has worked nationally at NHS England leading the New Models of Care programme before moving to run primary care services as chief executive of the largest primary care provider in England. Throughout her career Samantha has worked in both the public and private sector focused on delivering health services.

Samantha was appointed as expert adviser to the Prime Minister for NHS transformation and social care in 2021 where she led on all elements of health and social care policy before taking up post as the interim Permanent Secretary and Chief Operating Officer for 10 Downing Street. Samantha was most recently the expert adviser to the Secretary of State for Health and Social Care.