Exclusive: Consultants express no confidence in trust chair and board

The senior medics at Moorfields Eye Hospital Foundation Trust sent the letter, obtained by HSJ, to the organisation’s governors on 26 February.

Allegations in the letter include: there was a bullying culture at the organisation, including “coercive behaviour” by the trust’s chair; the trust’s reputation as a research institution was being damaged; and there was “a lack of corporate integrity”.

The letter, from consultants’ committee chair Hari Jayaram, said more than half of the senior doctors — more than 80 consultants — at the trust had contacted him to “voice a lack of confidence in the organisation by the current chair and board”.

It also said morale among these senior doctors was “at a significant nadir, which most colleagues do not ever recall experiencing in their consultant careers” and that senior staff have lost confidence in the trust’s Freedom to Speak Up process.

A ‘frequent inexplicable turnover of senior execs’

Dr Jayaram’s letter also referenced “institutional instability, with frequent inexplicable turnover of senior executives”.

Four executive directors left the trust in various ways during a 15-month period, starting in 2023, with chair Laura Wade-Gery appointed in February of that year. The trust would not confirm whether any of them had raised grievances against the organisation.

The trust confirmed to HSJ that chief executive Martin Kuper had been “absent” since November 2024, an issue raised in the letter, but the trust provided no explanation as to why. It said he had not left the organisation. Two interim chief executives have been in post since he stepped down.

Deputy CEO and finance director Jonathan Wilson left for secondment to North Central London Integrated Care Board in October 2024. Moorfields said the role was as interim director of financial programmes.

Two other executive directors left the trust’s board in 2023. This included research and development director Professor Sir Peng Khaw, whose role was deleted, with his name and title being mentioned in the minutes of the July 2023 meeting, but not those of the November 2023 meeting.

The organisation’s director of workforce and organisational development Sandi Drewett also left the trust in August 2023.

Moorfields’ annual accounts for 2023-24 include a note from auditors Grant Thornton saying the trust had paid “a significant severance package” without receiving NHS England or Treasury approval.

Grant Thornton said: “We were unable to obtain sufficient assurances guidelines had been considered and that all elements of the severance made were contractual in nature.”

The annual accounts for 2023-24 refer to “contractual payments in lieu of notice” of £99,000.

HSJ approached the trust about the rapid turnover of senior executives at the organisation.

A spokesperson said: “Moorfields has a dedicated and experienced leadership team who ensure the trust delivers against our existing strategy and provides excellent patient care. We are committed to our ambitious and exciting plans for the future and continuing our groundbreaking research, treatment, and care for the benefit of our patients.”

The trust said it would not comment on the circumstances around the departures of Dr Kuper, Ms Drewett, and Mr Wilson. It made no response at all when asked about Sir Peng’s role.

Dr Jayaram wrote: “There has been little transparency with the consultant body, and increasingly irregular patterns of behaviour that endanger the trust’s reputation,” adding, “The current circumstances unfortunately appear consistent with a culture of suppression of information and a lack of transparency.”

Chair accused of ‘coercive behaviour’

The letter from Dr Jayaram to the trust’s council of governors set out strong criticism of Ms Wade-Gery.

It said: “Several senior clinicians describe coercive behaviour by the chair over the past two years, with pressure to conform to an unhealthy corporate agenda; consequently these colleagues have not felt at liberty to speak up for what they consider to be morally correct or in the best interests of the trust.

“There have been a number of patronising, demeaning, and disrespectful interactions with clinicians and senior executive colleagues, this being part of an overt and pervasive culture of ‘bullying’ at the upper echelons of Moorfields.”

The letter also said the trust had damaged relationships with academic partner University College London and funding body the National Institute for Health and Care Research in its “drive to commercialise” research projects carried out by consultants who hold dual UCL and Moorfields roles.

Dr Jayaram urged the governors to convene an independent external investigation of the concerns it raised.

The letter was copied to NHSE London regional director Caroline Clarke, UCL president Dr Michael Spence, and Moorfields interim chief executive Peter Ridley.

Trust publishes statement, but makes no commitment to the external enquiry that consultants requested

Moorfields published a statement on its website this afternoon.

It said: “Yesterday Moorfields received a letter from our consultant body which outlines concerns that some of our consultants have. We are in the process of actively listening to these concerns. We recognise that the consultant body is integral to the success and the future of Moorfields, that they provide exceptional care for our patients every day and we welcome their important views. 

“The board is fully committed to building a strong and valuable relationship with our consultant body and we are in the process of actively listening to concerns, beginning an open and transparent dialogue, and agreeing and commencing a plan to move forward. 

“The board is committed to our trust values of equity, excellence, and kindness. We continue to have good relationships with our research partners, in particular UCL and we are focused on ensuring the trust offers outstanding care to our patients and is set up to continue to do this into the future.”