The largest NHS trust in England has said it is “very sorry” after it was rated inadequate by the Care Quality Commision (CQC).

Barts Health was given the rating in a report published today that identified 65 areas where it must make improvements including poor leadership, a culture of bullying and low staff levels that posed a risk to patient safety.

The CQC had already placed the trust into special measures after Whipps Cross University Hospital in Leytonstone was rated inadequate in a report published in March.

Following that inspection the CQC decided to inspect both the Royal London Hospital in Whitechapel and Newham University Hospital.

Barts Health NHS Trust is responsible for the care of around 2.5 million people, and is believed to be in around £90million of debt due to liabilities relating to a private finance initiative for redevelopment.

The trust said in a statement that it has a "big challenge" ahead but it is already in the process of recruiting a further 500 permanent staff.

Steve Ryan, the Barts Health NHS Trust Chief Medical Officer said: “We are very sorry for the failings identified by the CQC in some of our services at Newham and The Royal London hospitals. We know we have a big challenge ahead but we are determined to rise to that challenge.

“We are already making rapid and dramatic improvements in key areas. We welcome the targeted help the special measures regime provides to support our improvement journey.

“All our hospitals will be part of the trust’s improvement plan in response to special measures, ensuring a consistent approach to the provision and delivery of high quality care. We will work with each of our hospitals with the same level of urgency and commitment.

“Strengthening leadership at each hospital site and working closely with our key partners will enable us to successfully deliver the Barts Health improvement plan.”

A spokeswoman on behalf of the local commissioners NHS Newham, Tower Hamlets and Waltham Forest Clinical Commissioning Groups (CCGs) said the reports would act as a catalyst for improvement.

She said: “These hospitals are at the heart of our community, providing vital services that we all rely on. The CQC reports clearly shows that some quality standards need to be addressed as a matter of priority these include nursing staff levels, management of complaints and learning from serious incidents.

“Barts Health has already strengthened senior management expertise at each hospital and is now getting targeted specialist support through the NHS Trust Development Authority special measures improvement regime.

"We believe that these CQC reports will act as a catalyst to further speed up necessary improvements.