Vacancies at the top force merger delays

But there is dispute over whether regional offices, trusts or the Department of Health are to blame for the delays.

Epsom and St Helier trust was launched on 1 April after a merger of Epsom Health Care trust with St Helier trust, but there is no chief executive in post.

Proposals to merge were approved on 10 March and a chair was appointed two weeks later, but interviews for a chief executive are not due to take place until next week.

Director of communications Helena Reeves said recruitment delays were not the fault of the trust: 'Talk to London region. The appointment process hasn't been handled by the trust itself.'

But a London regional office spokesperson said: 'It's not entirely down to us. I would dispute that.' He said delays were caused by the fact that the trust's consultation on mergers ended three weeks after consultations on a number of other mergers in the region.

Many sources contacted by HSJ suggested that delays in the process were higher up the chain.

The DoH said: 'We recognise there have been a few unavoidable delays.' These were caused by several factors, including 'ministers' need to take account of the volume of correspondence and petitions submitted and to ensure that the right decision is made'.

A DoH spokesperson added: 'To further improve the speed of merger decisions, each minister will now take responsibility for particular regions.'

But HSJ sources said long waits between the end of merger consultation and ministerial approval had left regional offices and trusts with 'impossible timescales' in the recruitment of chief executives.

Wiltshire Healthcare and East Wiltshire Healthcare trusts 'had hoped to merge in April' and were given the ministerial go-ahead on 17 March. But failure to appoint a chair means they will continue independently until October.