High turnover and difficulty filling vacancies is not confined to managerial executive posts, according to NHS Trust Development Authority chief executive David Flory.

Mr Flory said at a King’s Fund event on Tuesday the struggle to fill clinical as well as executive vacancies “is getting greater”.

The TDA has recently been looking at senior staffing gaps and found the problem extends to finance, medical and nursing directors, as well as chief executives.

Mr Flory said: “The number of vacancies, or interims or temporary arrangements that we’ve got is higher than we feel desirable or expected.

“It’s not only on the executive side. There are some jobs that come up now…that I remember 15 years ago people would have queued around the block for, now we‘re almost having to twist people’s arms to come forward.”

A disparity in salaries may be putting off some potential candidates, according to the TDA chief executive. He said: “There are some anomalies in the system that we need to sort out. You can earn twice as much as a lay member on a CCG as you can being a non-executive at a high profile trust.

 “We’re struggling to find the sort of people we want for some of the most challenged trusts and for some people there’s a feeling of, ‘I’ve had a very successful career, do I want to put my reputation on the line for being the leader of this challenged organisation?’”

Brighton and Sussex University Hospitals Trust chief executive Matthew Kershaw, who was also speaking at the event, said a blame culture contributed to putting off potential chief executives.

He said: “These jobs are difficult jobs and these jobs are not for the faint-hearted. I think if we increasingly make these jobs impossible to do…and the sanctions for not getting it right straight away is for these people to be moved out then ultimately you increasingly lose people’s desire. There needs to be a bit more understanding of the complexity of the role.”

King’s Fund’s interim head of policy Candace Imison, who is also a non-executive director at Kingston Hospital Foundation Trust, also cited a blame culture at the event.

She said “the ramifications of Mid Staffs ripple through board rooms”.

“The reality is as a non-executive director that you’re not in the organisation 24/7 and healthcare is an incredibly complex environment,” she said.

“I’m lucky enough as a non-executive director to understand that environment but I’m very conscious that other non-executive directors don’t and that’s a really big issue.”