Almost half of primary care trusts have executive directors working in an “interim” or “acting” capacity, an HSJ investigation has revealed.

The situation appears to be driven by the planned abolition of PCTs, the need to make 45 per cent management cost savings and the decision to group PCTs into clusters.

Concerns are also growing that PCTs, which are not being fully replaced with commissioning consortia until at least April 2013, could lack the necessary leadership during the crucial handover period.

HSJ contacted all 151 PCTs and received information on executive board members from 116 organisations.

There were 85 directors at 56 organisations who were not employed on a permanent basis. A further 46 directors were working out their notice or had agreed dates to leave their post.

HSJ found only 13 vacancies for which active recruitment was underway.

Managers in Partnership chief executive Jon Restell said that while “no PCT would be wise to be recruiting substantially to posts”, PCTs will still exist for two years, which is “long enough” to require leadership.

He said that while the number of directors was shrinking, “the workload is not being reduced” and departures were turning the relationships between commissioners and providers “upside-down”.

“A hell of a lot of leadership has been missing,” he added.

One in seven PCTs had seen a reduction in the number of executives since September 2010 and 27 of the 116 organisations’ chief executives were working in an interim capacity or were due to depart soon.

HSJ found 116 directors who were working in more than one role for multiple organisations, including other PCTs and local authorities.

At NHS Swindon the acting chief executive is also group director of adult social care at Swindon Borough Council, while all three of the voting executives are “acting” in at least some of their roles.

A spokeswoman for the PCT said that the chief executive position had been filled on a temporary basis after the previous chief executive died in February 2010.

She said: “The PCT, local authority and strategic health authority have no concerns regarding governance issues.”

At NHS Sefton, the chief executive, director of finance and director of public health are all “acting” in their positions.

Assistant chief executive Barbara Strong said having directors in interim posts went “hand in hand” with the plan to cluster PCTs.

“These are perfectly able people; we’re getting on with it,” she said.