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When a trust “discovers”/announces a financial black hole, it’s not normally the chair that resigns.

But at King’s College Hospital Foundation Trust, which this week announced it was looking at a deficit of up to £90m (original plan: £5m) this is what has happened.

Charles Alexander, also chair of Guy’s and St Thomas’ FT, stepped down from KCH, with the trust issuing a statement that it needed “increased capacity” in its non-executive leadership “so it can focus on financial recovery”.

“Given the size and complexity of both King’s and Guy’s and St Thomas’, independent board leadership for both trusts is the best way to create the focus and capacity required.”

Mr Alexander has been in post for just 12 months and this wasn’t the tone when his joint appointment was announced in summer 2022 – then the talk was of the work the trusts could do together with a joint chair.

KCH had then chair of GSTT Sir Hugh Taylor installed in a joint arrangement when it was still in special measures – it exited the equivalent, SOF level four, in December 2022. Had it not been subject to performance management by NHS England this move would have had to be approved by KCH’s governors, who would have been unlikely to grant what was an unprecedented step for a Shelford Group trust.

But what is more surprising than moves at the top of the office is that NHSE’s assessment of KCH’s financial health in December 2022 could have been so wrong.

‘Favouritism, nepotism, bullying and harassment’

A major hospital trust has seen its “well-led” rating drop from “outstanding” to “inadequate” after the Care Quality Commission found a “significant deterioration” in its leadership.

CQC inspectors found a culture of “disconnection” between the senior leaders of Newcastle upon Tyne Hospitals Trust and its staff, who described workplace bullying as “commonplace” and said they suffered detriment for raising concerns.

The overall rating for the trust was downgraded from “outstanding” to “requires improvement” following the inspections between June and September last year – when the trust was under the leadership of Dame Jackie Daniel.

Staff described bullying from management and senior clinical staff towards junior colleagues, and of a culture of “favouritism and nepotism” at the trust which meant some people were “protected” when bullying and harassment allegations were raised against them.

Sir Jim Mackey, who became CEO of Newcastle Hospitals FT earlier this month, said a new executive team is “resetting the relationship” with staff and taking a “zero tolerance’ approach on bad behaviour.

Dame Jackie declined to comment when approached by HSJ.

Also on today

The NHS’s over reliance on the Bradford Factor is potentially discriminatory and highlights the urgent need for a shift in how the service manages sickness absence, writes Roger Klein. And we report that Department of Health and Social Care officials described the announcement of a visa clampdown for health and care workers as “confused at best”.