STRUCTURE: Local authority chief executives have been drafted in to help fill a leadership vacuum in the North West.

The alarm was sounded by a foundation trust chief executive who warned his board that all its commissioners lacked “substantive” leaders.

Newly published minutes for the 29 November board meeting of 5 Boroughs Partnership Foundation Trust show Simon Barber had warned they were “currently lacking substantive leadership across each of our [primary care trusts]”.

Mr Barber had told directors the chief executives of NHS Knowsley and NHS Ashton, Leigh and Wigan had both taken Department of Health jobs; Warrington had “no substantive chief executive” and was being covered by the chief executive of Western Cheshire; and Halton and St Helens’ Andrew Burgess was on sick leave.

But Mr Barber has now told HSJ that since that board meeting “our local SHA has acted to ensure strong leaders in our patch are in place during this time of transition”.

He added: “Two of our PCTs are getting leadership from the local authorities, because the chief executives of those local authorities have been appointed chief executives of the PCTs. In Warrington the chief executive of the neighbouring PCT has been appointed chief executive of Warrington as well.”

He admitted the situation in November had been “cause for concern, because of the uncertainty”.

“It could be an unintended consequence of the decision in the white paper [to abolish PCTs] that they have experienced difficulty replacing key positions as people move on,” he said.

A spokeswoman for NHS Halton and St Helens said the PCT “does have a substantive CEO in post”.

Asked if any other directors had left the PCT since the white paper, she said its public health director had left in September, and its finance director was due to leave soon.

Helen Bellairs, chief executive of NHS Western Cheshire and NHS Warrington, said: “Where possible we have been sharing skills and expertise across the two PCTs at every level.