Mar 272014

Independent review of board governance by Deloitte finds serious problems at Rotherham NHS Foundation Trust

board governanceThe board running a debt-ridden NHS trust was “dysfunctional”, “ineffective” and “severely fractured”, according to the sharply critical findings of a formal review previously withheld from the public.

Some directors at Rotherham Hospital engaged in “inappropriate conduct” that was required to “be addressed as a matter of priority” with the report also stating the chaos was “having a detrimental impact on the health of the Trust and remedial action should be taken immediately.”

The review was told some non-executive directors (NEDs) were “behaving irascibly, indiscreetly, impulsively and surreptitiously” with staff reporting “feeling intimidated” by one, unnamed NED. During one meeting the NED was said to have “kicked a chair and banged their fist on the table.”

Rotherham NHS Foundation Trust previously refused to disclose the contents of the independent review of board governance by Deloitte following a freedom of information request from the Yorkshire Post.

But the Trust relented after a complaint was made to the Information Commissioner and has now released most of the review, although a small number of key passages are still redacted.

The report, completed last July, detailed an array of failings at the top of the Trust where financial mismanagement led to senior executive roles being taken over by private consultants at a cost of £1.5m to the public purse.

Drawing on interviews with directors, staff surveys and observing board meetings, it concluded: “The Trust Board is dysfunctional and ineffective”.

“Relationships at Board-level are severely fractured and strained at present. We do not believe that the situation is recoverable and are of the opinion that on balance the NED (non-executive director) cohort should be urgently refreshed.”

One director told the review: “This is the most dysfunctional board I’ve encountered.”

Another said: “There is mistrust. People are not honest with one another because if it not a safe place to be.”

Monitor, which regulates NHS foundation trusts, intervened in the management of the Rotherham trust in February last year, which led to the controversial involvement of private firm Bolt Partners in running the hospital.

But the review found that “members of the Board do not appear to be aware of the Governance Plan submitted to Monitor in March 2013 as part of the licence conditions.”

It said: “The underlying reasons behind the breakdown in Board relationships are complex and multi-factorial, but appear to centre around a lack of clarity and behaviours that are perceived to be inappropriate.”

At one point the review raises the issue of some, unnamed directors’ outside interests and an apparent failure to formally declare them as required.

It says: “Whilst we accept that the advice given to NEDs (non-executive directors) in relation to declaring and managing conflicts of interest may have either been non-existent or ambiguous, for the avoidance of doubt, we are of the opinion that all instances at the Trust relating to outside interests that have been reported to us are a breach of commonly known and accepted governance standards in public life”.

“It is beyond the scope of this report to determine whether individuals have a case to answer but as a minimum the Trust’s policies relating to disclosure should be urgently clarified and all Directors should be required to sign a Code of Conduct stating that they have read and agree to abide by the Code.”

A section on the behaviour of NEDs included a series of examples of “inappropriate conduct”.

It said: “One senior manager stated that, ‘Directors that aren’t present at the meeting will be openly criticised by X (NED)’.

“Staff reported that, ‘NEDs go behind your back to gather information’ and, ‘The NEDs try to gather information to attack the EDs (executive directors)’.”

On another occasion staff reported being told by a NED: “The Trust is skint.”

The report went on: “A member of staff commented, ‘They pick on a person in the room and grandstand in front of the others’.

“People have reported that the consequence of this style is that people do not want to attend meetings and will only share the information that they need to.”

Other examples of behaviour remain redacted by the Trust.