Delays in appointing chairs and non-executive directors in North West region are delaying key decisions and putting a heavy burden on 'half- strength boards', according to senior managers.
Five trust chairs and 15 non-executive director posts at trusts and health authorities have been empty since the terms of appointment holders expired last year.
Two of the vacancies - at Christie Hospital trust and Mancunian Community Health trust - involve chairs who would like to be re-appointed.
Senior trust managers expressed anger at the treatment of chairs and non-executive directors 'left hanging in limbo'.
One said: 'It is a disgraceful way to treat chairs who have given a lot to the service. I wouldn't want to be reappointed if I'd been left waiting like this.'
At Clatterbridge Centre for Oncology trust, the post of chair has remained open since November, while the appointments of two of five non-executive directors have expired.
Director of patient services Gill Oliver said 'a tendency to put off major decisions' was inevitable.
Last month Burnley Health Care trust held its second board meeting without a chair in place. This week Brian Foster was re-appointed, but the trust remains short of a non-executive director.
Hugh Lamont, head of communications at North West regional office, admitted the situation was 'not ideal' and said it was linked to a backlog that developed when 17 chairs' posts became vacant in November.
He added that 'in some cases' the minister responsible, Tessa Jowell, had rejected NHS Executive recommendations and asked it to 'provide an extended list' of candidates'.
Mr Lamont said several appointments were 'in the pipeline' and existing arrangements were 'perfectly acceptable' as long as there were other non- executives in place to act as chair.