Chief executives feel bruised by constant reorganisation, and 93 per cent described their job as stressful. Twenty-nine per cent deemed it very stressful and 8 per cent rated it extremely stressful.

More than half said they worked 50-60 hours in the average working week, with 23 per cent putting their weekly working hours between 70-90 - an average of 16 hours a day. Constant reorganisation has left 86 per cent of managers feeling 'battered and bruised', with 55 per cent of chiefs losing most sleep over finances and service quality.

Engaging staff and maintaining staff morale are frequently cited as the biggest challenges for the coming year. One participant wrote their biggest challenges would be: 'Keeping services stable in an increasingly chaotic political context. Managing cynicism and the continuing improvements - good performance is rewarded with reorganisation and instability.'

However, finances came top in the list of challenges facing NHS organisations next year, with just under 50 per cent placing it as their top concern.

A total of 71 per cent of those who took part stated that they would still choose NHS management as a career.