More than a third of England’s hospital chief executives have been in post for less than a year, HSJ/Capsticks research reveals.

Graphic showing information about: Lack of experienced trust chief execs

Lack of experienced trust chief execs

The survey, to which all 140 non-specialist acute NHS providers responded, also found that as of this week 11 per cent of trusts had no substantive chief executive in post. Nearly half of trusts had a chief executive who had been in post for two years or less.

In contrast, a significant proportion of the sector has enjoyed stable top leadership, with 26 per cent having had a chief executive in place for five years or more.

The data also indicates a relationship between the turnover of senior leadership and trusts placed in special measures by regulators Monitor or the NHS Trust Development Authority.

Seven of the 24 trusts in special measures were being led by an interim or acting chief executive. Only one, Buckinghamshire Healthcare, had a chief executive who had been in post for five years or more.

Health secretary Jeremy Hunt said last week he expected trusts in special measures to take between three and five years to turn themselves around.

Jon Restell, chief executive of healthcare management trade union Managers in Partnership, said the figures highlighted the need for greater longevity in the top hospital roles.

He said: “The survey sheds light on the problem of poor tenure among hospital chief executives. These figures do not square with the emerging policy consensus that stable leadership over three to five years is essential for struggling trusts to turn the corner.

“We need a new approach to supporting top managers, with a focus on rebuilding trust in the system among leaders at all levels.”

TDA chief executive David Flory last week warned against a “knee-jerk” removal of the leadership at struggling organisations in order “to be seen to be doing something”.

Earlier this year he told HSJ the health service needed to “redefine what success in [chief executive] jobs looks like”, making it as rewarding to get an organisation “which has been in trouble for five years” out of trouble as it was to run “an internationally recognised world-class centre of excellence”.

One senior management consultant working in the hospital trust sector told HSJ the turnover of hospital leaders could slow down and the number of interims decrease as merger plans fell foul of competition rules. She said: “While these plans were being considered there was no point recruiting a substantive chief executive. I can think of a few cases [of] chief execs who were looking to leave when merger or acquisition were on the cards, who are now sticking around.”

Another senior figure in the hospital sector said: “There’s a lot of uncertainty around and some trusts will have interims through doubts over organisational future… it’s easier to have a stand-in while you’re thinking. But high turnover could also reflect poor and worsening quality and financial risks in the smaller trusts.”

NHS Confederation chief executive Mike Farrar said: “It is right that trusts need stability to be able to plan patient care effectively. Having stable leadership is part of that but this doesn’t mean interim leaders aren’t doing an excellent job during the unprecedented challenges facing the NHS.”



More than a third of hospital chief executives in post less than a year