Unions have reacted angrily to a 100,000 pay-off for chief executive John Daley, who left Dudley Priority Health trust earlier this year after a controversial tendering exercise collapsed.
Mr Daley, who left the trust in May, will also have use of a Mercedes car part-provided by the trust until the lease period ends.
Unison's West Midlands regional officer, Geoff Poxon, said: 'The staff side is very unhappy with the deal, as is the board. We all understand he was entitled to it, but he was on an 18-month termination agreement. How did he get it? That is the bugbear.'
Dudley health authority's director of nursing, Keith Salmon, said: 'We feel it was an unusual deal, but there is nothing we can do.'
A spokesperson for senior civil servants' union, the First Division Association, said most executives are now on three- or six-month notice arrangements. Even those on fixed-term contracts are unlikely to leave with more than a year's salary. Mr Daley was appointed on a three-year rolling contract.
Gill Cooper, acting chair of the trust, stood by the payment, saying Mr Daley had been paid 'what he is entitled to legally'.
She added: 'Mr Daley was paying the extra cost of a top-range car himself and it would have cost the trust more to terminate the lease.' But she said the trust no longer offered such long termination deals.
Mr Daley left the trust with chair Harry Nottingham and director of nursing services Ian McComiskie.
Dudley HA says it took the controversial step of market-testing community nursing services provided by the trust after local fundholding GPs threatened to move their contracts elsewhere.
The Community Practitioners and Health Visitors' Association mounted a campaign against the move, and ministers were said to be alarmed by the plans.
But Mr Salmon said: 'With the three senior managers gone, the main objection and concern (of the GPs) was removed.'
Instead of appointing new management staff, the trust is planning to bring in a consultancy team.
It is considering tenders from two community NHS trusts.