NHS England has been unable to appoint chairs for the NHS boards of four integrated care systems.
NHS integrated care boards, part of ICS, are due to take on responsibility for planning and funding most NHS services from April.
A national recruitment process for the roles, led by NHSE, has failed to appoint for the Devon, Lincolnshire, Hereford and Worcestershire, and Cheshire and Merseyside ICSs.
Thirty-eight of 42 ICSs have now appointed a chair designate, according to an updated list from NHS England published on Friday.
Recruitment of ICB chief executives is ongoing, with appointments expected in the next month. Appointments are made by NHS England, with government approval.
Devon ICS, which has previously struggled to attract suitable leaders, confirmed it had interviewed people for the chair role. A spokesman said it was “vital” to appoint the right candidate.
Dame Suzi Leather, who has chaired the county’s health and care system since 2018, continues in a caretaker role until next steps are agreed.
Meanwhile, former NHS chief executive Sir David Nicholson will continue as chair of Herefordshire and Worcestershire ICS until a new chair is found.
Sir David is also chair of Sandwell and West Birmingham Trust and Worcestershire Acute Hospitals Trust.
In the Lincolnshire ICS, Elaine Baylis, who holds the same role at United Lincolnshire Hospitals Trust and Lincolnshire Community Health Services Trust, will stay on as interim.
She said: “I look forward to establishing the arrangements for the integrated care board that will bring a different approach to the planning and delivery of health and care in the county.
“This complements the work I am already part of in the county’s NHS which will provide consistency and continuity as we progress towards statutory status in April 2022.”
Neither Lincolnshire or Hereford and Worcestershire ICSs would confirm if they interviewed candidates for the role. NHSE said recruitment for chairs in the four ICSs remains “ongoing”.
HSJ revealed last week that Cheshire and Merseyside ICS had failed to appoint a chair for the second time running.
Current interim chair David Flory, who holds the same role at Lancashire and South Cumbria ICS, has agreed to extend his contract until next spring.