A troubled NHS trust branded one of the most challenged in the country has been forced by health regulator Monitor to appoint a new interim chief executive and chairman.
It comes after Medway NHS Foundation Trust in Kent announced last week that its chairman Denise Harker and chief executive Mark Devlin were stepping down.
Monitor said it was using its powers to make the trust appoint Christopher Langley as interim chairman and Nigel Beverley as interim chief executive "to address the wide range of significant problems" it faces.
The trust was one of 11 placed in special measures last July following what Health Secretary Jeremy Hunt described as "fundamental breaches of care" uncovered in the Keogh Review.
Last December a major report by health statistics firm Dr Foster named the trust as having higher than expected death rates among patients in hospital.
Monitor said it was taking action to make sure the new executive team strengthens its leadership and reviews the trust's strategic plans over the next five years.
Stephen Hay, Monitor's managing director of provider regulation, said: "Medway is one of the most challenged trusts in the country and we believe that a change in leadership is essential for the trust to tackle the difficult issues that it faces.
"I am disappointed with the way this trust has been managed by its previous leaders, so we have acted quickly to ensure the right people are brought in to deliver immediate improvements at this troubled trust."
The trust, which runs the Medway Maritime Hospital in Gillingham, is said to have made progress since the damning Keogh Review.
But Monitor said it has taken further action because of concerns, including over the trust's A&E performance and ailing financial position.
Colin Wilby, senior independent director at the trust, said: "The board welcomes Nigel Beverley and Christopher Langley to Medway NHS Foundation Trust and looks forward to working constructively with them to bring about the improvements in performance that we all want to see for our patients and staff."