Leicestershire health authority has failed to persuade GPs to end their boycott of a primary care group board.
The HA and Trent regional office called a meeting with GPs in the Hinckley and Bosworth area last week , but GPs refused to back down, leaving the HA to fill four places on the board.
Leicestershire local medical committee secretary Dr Keith Evans said GPs' main concerns were the amount of time PCG work would take and the 'fear' that GPs would lose the benefits of fundholding.
Leicestershire HA has appointed a 'dedicated development manager' to work with the PCG, which covers about 15 practices.
An HA board meeting this week is due to consider options for creating a board without GP members. It may use 'a balance of lay representatives and clinical representatives'. This could include two extra nurses, making a total of four nurses, and two extra lay representatives.
HA assistant director of primary care Keiron Murphy admitted that without a full board or chair in place, filling the chief executive post 'will be difficult'.
This week's HA board meeting will consider 'possible options, including a temporary secondment' of an HA employee for a year 'in the expectation that the GPs will come on board and then make a permanent appointment'.
Mr Murphy insisted the temporary chief executive post would attract applicants because staff involved would know 'they would go back to their substantive posts at the end of the period'.