The “startlingly” high turnover of NHS chief executives and finance directors is discouraging trusts from making the bold decisions needed during an economic downturn, recruitment experts have found.

Up to half of senior executives are likely to spend less than two years in the same post, according to a survey by recruitment consultancy Hoggett Bowers.

This compares with the seven years that the average private health sector chief executive officer stays in the job, notes the report, NHS Chief Executives, Bold and Old.

High profile departures are exacerbating the risk averse “heads down” culture, which will “stifle initiative and innovation”, it says.

“The NHS needs to do more to explicitly encourage and demonstrate support for the unconventional, that is, for the bold CEOs who have the capability, drive and tenacity to initiate and inspire innovation.”

A quarter of respondents to the survey, which covered 57 per cent of NHS organisations over four years, were promoted to roles in larger, more complex NHS organisations or the Department of Health.

Almost 30 per cent left their jobs due to mergers or reorganisations, just under 10 per cent left to join other sectors and 10 per cent moved into more junior NHS roles.

Only 5 per cent retired at their full pensionable age and around a quarter had a leaving package such as a compromise agreement, early retirement or ill health retirement.

Hoggett Bowers head of healthcare practice and report author Annette Sergeant called turnover levels “startling”.

Primary care trust mergers had influenced the figures but analysis carried out over the past 12 months showed the results were still relevant, she said.

Interviews with chairs, non-executive directors and chief executives revealed many senior staff who signed compromise agreements left due to difficult relationships with their chair or other senior figures, a failure to judge “local politics” or recognise key influencers or achieving change too slowly.

Long lasting chief executives tended to be politically astute and were able to quickly assess an organisation’s climate and culture.

Frank McKenna, director of NHS and healthcare at HR consultants Harvey Nash, said trusts were increasingly looking for bold, transformational leaders.

He said: “The challenge the NHS has is driving up quality while driving improved costs. The only way that is going to be possible is to radically transform and innovate in a way we have not seen before.”

But some challenged trusts were more interested in chief executives who would ensure targets were met, he said.