The report, Leadership vacancies in the NHS: what can be done about them?, reveals that there are vacancies in a wide variety of director's positions across NHS boards.
Almost one in 10 (9%) vacancies are finance director positions, putting further monetary pressure on NHS trusts already facing tough budgetary decisions.
Nursing director positions are the hardest to fill, according to the report. Vacant positions remain unfilled for an average of nine months, with one remaining vacant for 28 months.
Unsurprisingly, vacant CEO positions have the highest negative impact on trusts. Overall around 7% of trusts are without an acting CEO, but this rises to 28% among trusts placed in special measures.
King's Fund programme manager for leadership development Ayesha Janjua told HR magazine unfilled director positions can make it "difficult for trusts to be strategic".
"It's difficult to think long-term in those circumstances," she said. "And a lack of strategy can be linked to poor performance and low morale, which can have a knock-on effect on patient care."
Janjua added that the vacancies can create a "leadership vacuum" that presents serious challenges for HR directors within the NHS.