Across four NHS trusts in the North East, a domino effect of leadership changes has unfolded, a real-life game of “musical chairs” at chief executive level. Gateshead Health Foundation Trust has appointed Sean Fenwick, previously Chief Operating Officer at South Tyneside and Sunderland FT, as its interim CEO. He replaces Trudie Davies, who has moved to North Cumbria Integrated Care FT as acting CEO, following the temporary departure of Lyn Simpson to head the Humber Health Partnership.
On paper, the arrangement reads as an efficient exercise in redeployment. Experienced leaders are stepping into roles where they are needed most, maintaining operational oversight without leaving critical vacancies. But underneath the surface lies a more pressing issue: what does this carousel of interim appointments mean for organisational stability, patient services, and the NHS’s long-term resilience?
Interim leadership is nothing new. It can provide flexibility during times of restructuring, allow for rapid deployment of skills, and act as a bridge while permanent recruitment is underway. But when multiple trusts are simultaneously relying on secondments, the effect can be destabilising. Strategies risk being paused or diluted, as leaders inherit priorities mid-stream. Staff can be left uncertain about direction, while the relationship-building essential to effective NHS leadership becomes a game of catch-up.
The timing is especially challenging. These trusts are grappling with record-high waiting lists, tightening budgets, and the operational demands of new care models and digital transformation. Leadership in this context is not just about “keeping the lights on” — it’s about steering through unprecedented system pressures with a clear, sustained vision.
Critics will point out that such rapid reshuffling suggests gaps in succession planning. While the NHS rightly values collaboration across trusts, the current chain of secondments raises the question of whether enough is being done to cultivate a pipeline of leaders ready to step in permanently. Without that, we risk a cycle where organisations lean repeatedly on interim solutions rather than building leadership capacity from within.
There is also the risk of short-termism. Interim CEOs, however committed, may be less able to drive transformative change when their tenure is measured in months. Initiatives requiring deep cultural shifts — from integrated care models to community-based service redesign — benefit from leaders who will be there to see them through, weathering political headwinds and operational setbacks alike.
Of course, these secondments reflect the NHS’s collaborative ethos: trusts helping one another, pooling leadership talent to ensure no organisation is left without experienced oversight. This is admirable in spirit. But collaboration works best when underpinned by stability, not as a workaround for the absence of it.
The North East’s chain of interim appointments is more than an HR shuffle; it’s a signal. The NHS must invest as much in leadership continuity as it does in service delivery innovation. Patients feel the impact of unstable leadership just as much as delayed appointments or budget cuts. Stability at the top creates confidence at every level, among clinicians, managers, and the communities the NHS serves.
Without that stability, even the most well-intentioned leaders will find themselves spinning on the carousel, moving to the next trust before they can finish what they started.
