The Canterbury District Health Board (CDHB) has lost a fifth senior executive within weeks with the resignation of chief medical officer Sue Nightingale on Friday.

Her resignation was announced by senior doctors’ union the Association of Salaried Medical Staff (ASMS), and has been confirmed by a CDHB spokesperson.

Nightingale was appointed to the role in September 2016 after serving as chief of psychiatry.

As chief medical officer, Nightingale took responsibility for the medical workforce, sat on the CDHB’s board, and took a lead in managing the board’s response to the Covid-19 pandemic.

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News of Nightingale’s departure comes within hours of CDHB chair Sir John Hansen announcing two temporary replacement chief executives following the shock resignation of current chief executive David Meates last week.

Dr Andrew Brant, who is currently the deputy chief executive at Waitematā DHB, will step into the role from early October to the end of the year.

In the immediate term, Nelson-Marlborough DHB chief executive Peter Bramley will start in the role from August 26.

He will work alongside Meates until September 4 and for a few weeks with Brant to ensure a smooth transition.

“Both Andrew and Peter will be based in Christchurch during the week and it’s expected they will also travel to the West Coast as part of the acting chief executive role,” Hansen said.

Meates’ resignation was announced last week following an emergency board meeting.

In a statement, Hansen thanked Meates for his contribution to Canterbury and the West Coast and acknowledged his many achievements, but offered no explanation for the sudden exit.

Meates’ resignation coincides with a tumultuous period for the CDHB, which is under pressure to claw back a mounting deficit that reached roughly $180 million in 2019-20. Three other members of the 11-strong executive management team also resigned recently – planning, funding and decision support executive director Carolyn Gullery, chief people officer Michael Framptom, and chief financial officer Justine White.

Board member Aaron Keown confirmed the current draft annual plan proposed slashing $56m from the deficit.

Hansen has said no decisions have been made about the size of cuts to the deficit but this would be discussed at the next board meeting.

In an email to staff, he said no services would be cut as a result of deficit reduction programme.

ASMS executive director Sarah Dalton said Friday’s resignation would be particularly unsettling for clinical staff.

More than 100 members of the ASMS and the Canterbury Hospitals’ Medical Staff Association held a meeting to discuss what they described as a management leadership crisis on Friday.

Dalton said senior doctors were concerned about the board’s lack of transparency, its “singular focus on the deficit and cost-savings, and its failure to engage with or listen to clinical advice”.

Hansen told staff Bramley and Brant had provided “on the ground leadership” during the first phase of the Covid-19 pandemic, and were well-placed to support the board.

“They know they have big boots to fill.”

A “global” search for a permanent chief executive is under way, but is expected to take a few months.

Bramley’s career path began in academia with lecturing roles at the University of Otago and the University of Canterbury after he gained a PhD in medicine.

Between 1999 and 2007, he held various senior management roles with accounting software company MYOB New Zealand Ltd.

In 2008, he stepped back into health as service manager of Surgical Services at Southland Hospital in Invercargill.

He moved to Nelson in 2010 to take up a senior leadership team role with the Nelson Marlborough DHB, and has been its chief executive since April 2017.

Brant is a respiratory physician and is a Fellow of the Royal Australasian College of Physicians. He has an MBA from Cambridge University and a PhD from the Imperial College, London, UK.

He was the chief medical officer at Waitematā DHB from 2010 until 2019, when he took up the role of deputy chief executive officer.