The NHS’s ability to make significant savings over the next two years through service change could be limited by its problems recruiting “top drawer” hospital leaders, the health service’s chief executive has suggested.

Approximately 20 per cent of the £18.9bn efficiency savings the NHS aims to deliver by 2015 are intended to come from concentration and centralisation of hospital services, and the provision of better community services to reduce demand for secondary care.

NHS chief executive Sir David Nicholson, giving evidence to the public accounts committee on Monday, was asked to what extent “poor local leadership” was an “inhibitor” to the NHS delivering these changes.

“There’s no doubt a limiting factor in our ability to make the changes and deliver all of this is our ability to recruit really top drawer people to be chief executives of - particularly - provider hospital trusts,” he replied. “We have a whole load of vacancies around the system at the moment. We’re working really hard to place them, but they’re not attractive jobs for people at the moment.”

NHS deputy chief executive David Flory told the same committee he expected the NHS would deliver £12.4bn of its planned savings by the end of 2012-13, but only £875m of those would have come from “transformational service changes”.