Chief executives 'frustrated' by lack of guidance for management boards

The delays in publishing guidance on the roles and responsibilities of management boards running strategic health authorities have 'frustrated' some of the 27 chief executives so far appointed to lead them.

While expressing delight and excitement at their appointments, several of the chief executives designate admitted the lack of guidance on the limits to SHA freedoms - due in November 2001 - meant they could only guess at how some aspects of their organisations would work.

Speaking just ahead of publication of the guidance, Candy Morris, who will lead Kent and Medway SHA, said the lengthy and thorough recruitment process had given people time to prepare for change.

But she told HSJ: 'Equally, it has caused a great deal of frustration because we have been waiting for some guidance which still hasn't come out.What it means is we can use our imagination, but it has been a bit difficult and uncertain.'

She said she hoped her background running a partnership across two health authorities - West Sussex and East Surrey - would give her a 'head start' in taking forward the strategic agenda.

Mike Marchment, who will run Coventry, Warwickshire, Herefordshire and Worcester SHA, said a lot was hingeing on the publication of central guidance on how the SHA franchises will work: 'I think there will be a certain degree of scepticism about how much freedom there can be. The guidance is more likely to constrain flexibilities than extend them.'

Mr Marchment, director of performance management for Trent regional office, suggested that the Department of Health would have been more radical by doing away with the guidance entirely.

'You could argue they could say:

'We have had this thorough recruitment process, We have appointed talented people, let's just let them get on with it'.'

Both Mr Marchment and Ms Morris said they hoped they would be allowed to find imaginative and radical ways to manage SHAs. But they said the greatest challenge would be 'keeping the train on the rails' with NHS performance, as the structural changes took effect.

Jane Herbert, chief executive of South Manchester University Hospitals trust, is moving down to Bedfordshire and Hertfordshire SHA. She told HSJ: 'I just hope I get some relocation expenses - and you can quote me on that.'

She said her career - which has seen her working in the private sector and in the NHS in Scotland - was marked by change, and that she thought she would adapt quickly from her trust background.

Duncan Selbie, who will run South East London SHA, agreed that a trust background - he is chief executive of South West London and St George's Mental Health trust - gave him 'very transferable' skills. He said: 'I think it will prove very useful to have contemporary experience of the front line.'

David Johnson, chief executive designate for North and East Yorkshire and North Lincolnshire SHA, leaves Leeds Teaching Hospitals trust, Britain's largest.

He said he had used the interview process to demand that the new organisations entered 'a more effective dialogue with ministers and policy-makers' than currently existed, a view which he felt had been accepted.

Of 96 existing HA chief executives, 50 were shortlisted and 27 appointments to SHAs made.

The appointment to Avon, Gloucestershire and Wiltshire is expected to be filled in the coming weeks.

Three further candidates will be given work with the DoH and be ready to succeed the current crop of SHA leaders. Mr Crisp said that a number of the shortlisted candidates would take up posts running PCTs, while a few were near retirement.

Mr Crisp has also appointed Tony Shaw, former chief executive of Southampton and South West Hampshire HA, to oversee a programme of project work, looking at issues like primary care development and links between clinical areas and universities.