An independent review into the management and leadership of a hospital trust could be the reason the trust’s chief executive stood down last month – and it hints that more heads could roll.

The report, completed by Deloitte LLP and commissioned by NHS Improvements, stated that while Barking, Havering and Redbridge University Hospitals Trust was no longer in financial special measures, a leadership change was necessary to ensure its recovery.

BHRUT was placed in financial special  measures in 2015. The trust ran out of cash in October 2017 and received two emergency government bail outs; one in October 2017 of £15.7 million and a further £5 million in November 2017.

Former trust chief executive Matthew Hopkins was widely credited with pulling the trust out of special measures, but stood down from his role on July 27 “to seek new opportunities.”

The report identified “an absence of proactive chief executive (CEO) leadership” and “a lack of urgency in the management of the financial recovery plan by the board, and the CEO in particular.”

The report said: “[Deloitte] are therefore of the view that the trust would  benefit from a different style of CEO leadership to guide the organisation out of financial special measures.”

Dr Nadeem Moghal, the medical director of the trust, has also come under fire in the report after an informal vote of no confidence was lodged against him by a group of consultants earlier this year.

Dr Moghal has been at the trust since January 2015, and is described by colleagues as having taken a “proactive approach to tackling inappropriate behaviour amongst medical consultants” and has promoted more structured job planning and greater transparency in the trust.

But the MD has been criticised by some consultants for his “at times overly robust” approach.

The Deloitte report said: “We have concerns that sentiment amongst the consultant body has reached a level where the MD’s position may be unsustainable over the longer term.

“There is a need for a more detailed review of medical leadership and culture before taking definitive action as a board.”

The report also slams non-executive directors on the trust’s board.

The report acknowledged that there had been a number of “extenuating circumstances” during August and September 2017 which stopped non-executive directors  from providing effective oversight and scrutiny over the deteriorating cash situation.

But, while they claimed they were not made aware of the extent of the crisis, the report strongly denies this.

It says they were “unequivocally made aware of the extent of the looming cash crisis in an e-mail from the former interim CEO Chris Brown on August 17, 2017” and that board did not respond to this situation “in an appropriate manner.”

The report added: “We also have concerns regarding the level of impetus
NEDs have provided in relation to delivering a financial recovery plan post October 2017.

“Accordingly, we are of the view that the trust would benefit from refreshing the NED group through adding fresh perspectives and developing existing NEDs.”

Barking, Havering and Redbridge University Hospitals Trust has been approached for a comment.

Joe Fielder, trust chairman and Chris Bown, interim chief executive issued a joint statement.

It said: “We have already made significant improvements in our financial processes, controls and governance. Many of these changes were recommended in an independent report by Grant Thornton that was published in April. We commissioned them to investigate why we had experienced a severe cash shortfall.

“We have brought in external expertise to help us put in place a financial improvement plan which has been signed off by our board and by NHS Improvement. Our staff understand the problems we face and are responding well to the challenge.

“We remain focused on providing the best possible care to our patients while also tackling our financial deficit to ensure our trust becomes sustainable.

“Chris, as our new interim chief executive, will now work with our board and ensure that we complete all the work required by the Deloitte report after we have considered its recommendations fully.”