Medway’s hospital chiefs have been able to turn around years of instability at the top without resorting to paying large six-figure salaries to temporary directors.

The financial regulator NHS Improvement have ordered hospitals to end “eye-wateringly high” payments to stand-in bosses after finding that salaries of more than £400,000 had become routine.

Last year the Medway Messenger revealed how Medway NHS Foundation Trust paid its then interim finance director, Tim Bolot, and his company £749,350. During this period the trust’s deficit tripled to more than £30 million.

Darren Cattell, a qualified accountant with 20 years of experience in the NHS, took over the post in January this year.

On the trust’s website, he is described as having a “wealth of experience in financially challenged NHS organisations” including developing financial recovery plans when a trust faces severe financial difficulties.

The trust’s annual report showed that in 2015/2016, he earned £40,000-£45,000 for the months he worked that financial year. They also paid Mill Street Consultancy Ltd, of which Mr Cattell is a director, £38,000 for those months of the financial year.

According to The Times, Jim Mackey, of NHS Improvement, wrote a letter to hospital leaders in which he said his analysis found interim finance directors are being paid about £1,800 a day, which he said was equivalent to £432,000 a year — twice as much as permanent staff.

Interim medical directors are routinely paid £2,000 a day, equivalent to £480,000 a year, well over twice a permanent salary. Stand-in chief executives are on the equivalent of £408,000 a year and temporary nursing directors can get £264,000.

James Devine, executive director of human resources and organisational development, said: “Over the past 18 months, we’ve made significant progress in providing the trust with the leadership and stability that it requires. This progress was recognised by the Care Quality Commission during its recent inspection.

“In previous years, there have been occasions where we’ve had little option but to recruit interims to help provide that level of leadership, expertise and stability at an executive level – an issue that many other NHS Trusts continue to face.

“We are pleased to say that we are almost at the end of our executive recruitment campaign, where we will have permanent people in place."

He added: “We are also now in the position in which we have candidates of the highest calibre applying to come and work here in executive, and a range of clinical and non-clinical roles across our hospital.

“This is testament to the improvements our staff have worked so hard on over the past 18 months to provide the best of care to our patients.”

Other interim directors in 2015/2016 include Karen Rule, interim director of nursing, who took home £40,000-£45,000 and Dr Diana Hamilton-Farley, interim medical director, who earned £70,000- £75,000. The pair joined the trust in October 2015 through the buddying scheme with Guy's and St Thomas', and their salaries are for the months they worked that financial year. They have since taken up the roles permanently.

Chief executive Lesley Dwyer was paid a total of £220,000-£225,000 last year.

Previous reports from the hospital watchdog, the Care Quality Commission, highlighted poor staff morale including “change fatigue” among frontline staff and “inconsistent leadership”, and last year, inspectors raised questions about the ability of the board to drive improvement.

But since then all of the positions at board level have been filled with only a few interim staff remaining.