In a combative speech to NHS leaders, Streeting said the Government needed to ‘reward success and set people free and support systems that aren't'.

Streeting outlined a range of measures, including publishing results and a new pay framework for senior managers, including scrapping annual uplifts for those underperforming and removing failing leaders.

Additional support is to be provided to those ‘in the middle of the pack' with those at the bottom allocated turnaround teams.

Streeting said: ‘We need to be open and honest around poor leaders. It's about weeding out the rotten apples.'

He added: ‘There are parts of the country where there are systematic challenges. We need to get the best leaders into these areas.'

Cool reception

The ideas of league tables and sacking underforming managers drew a cool response from NHS leaders.

Nuffield Trust chief executive Thea Stein said: ‘We know from the special measures for quality regime that "naming and shaming" NHS trusts can make it harder to recruit staff, which doesn't help patient care at all.'

Stein said trust performance was often determined by ‘luck and history as much as leadership' and a system was required that encouraged leaders to go to the most challenged trusts not one that rewarded them from choosing the easiest places to work.

Deputy chief executive of NHS Providers, Saffron Cordery, said league tables brought ‘significant risk of unintended consequences', adding taking steps to resolve the root causes of pressures on the health services was ‘critical' before any plans to introduce league tables and threats to ‘sack failing managers' are put on the table.

NHS providers Matthew Taylor, chief executive of the NHS Confederation, said the prospect of more league tables would ‘concern health leaders, ‘as these can strip out important underlying information'.

‘League tables in themselves do not lead to improvement, trusts struggling with consistent performance issues – some of which reflect contextual issues such as underlying population heath and staff shortages – need to be identified and supported in order to recover,'  Taylor added.