Ashworth special hospital is to be integrated further into mainstream NHS mental health services following the surprise departure last week of chief executive Hilary Hodge.

Peter Clarke, chief executive of Salford Mental Health Services trust, will continue as acting chief executive at Ashworth indefinitely - but without giving up his links with Salford.

Mental health experts believe replacing Dr Hodge through a formal appointment process would be impossible given Ashworth's record of eight chief executives in the past eight years.

Mr Clarke was brought in nearly two months ago while former Royal College of Psychiatrists, president Dame Fiona Caldicott investigated disagreements between Dr Hodge and Ashworth consultants.

Dame Fiona found that relationships had broken down irretrievably. Dr Hodge has now left to work on mental health issues for the World Health Organisation.

In a statement to Ashworth staff, Mr Clarke said his arrival was 'not just a case of another chief executive has gone and another bobs up'.

The move is linked with significant changes in relationships and roles across the mainstream NHS, high security hospitals, regional offices and the High Security Psychiatric Services Commissioning board, he said.

High security services will continue, but will increasingly be integrated with the wider NHS, Mr Clarke said.

His link with the Salford trust will allow a strategic alliance to be explored. But Mr Clarke denied this was a merger. 'The legislation precludes that. Ashworth will need to develop links and partnerships with other forensic and mental health services.

'Salford will be continuing to build its general mental health connections, particularly in the Manchester, Salford and Trafford health action zone.'

Former Special Hospitals Service Authority chief executive Charles Kaye said Mr Clarke's description added up to a merger by another name, which was the logical thing to happen now.

All three special hospitals should be drawn organisationally into the world of trusts, he said.

And he claimed that the isolation of high security services from other psychiatric services had been worsened by the 1996 changes that made them special health authorities operating on their own.

Mr Kaye described morale at Ashworth as 'on the floor'. Dr Hodge was the third chief executive in a row to leave in 'unfortunate circumstances' and he could not see anyone rushing forward for the job. 'It is like a manager's graveyard, ' he said.

Putting Mr Clarke, an experienced manager, in charge might work because his link with Salford would mean that he would not be as exposed, said Mr Kaye.

Edward Peck, director of the centre for mental health services development at King's College, expressed 'immense personal empathy for Hilary Hodge'.

He was surprised at her departure because she had clearly been appointed to the post on the basis of her known management style to do a particular task. 'It will be very difficult to fill that post now, ' he said.

'Hilary has a great track record and commands great respect in the health service.

'If Hilary Hodge cannot do that task, and is not supported in doing it, it will be very hard to find anyone else who will.'

Patricia Abbott, acting chair of Ashworth's medical advisory committee, told HSJ that she had been asked 'because of the sensitivity of the situation' not to comment beyond a statement claiming that the consultants' position had been vindicated.

She added: 'We are very happy with the news that Peter Clarke is continuing as acting chief executive and we are hoping for closer links with the wider NHS.'

Broadmoor Hospital board calls for more resources Broadmoor Hospital's governing body is calling for more money from the High Security Psychiatric Services Commissioning board, claiming that it 'is not as well resourced' as other special hospitals.

Chief executive Julie Hollyman said the hospital was suffering from staff shortages and that, in common with much of the NHS, it faced recruitment problems with psychiatric nurses.

As a result, the hospital board was 'exploring options to ensure that we maintain safety and security within the hospital within our existing pool of staff ', she said.