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The power of governors in the NHS has never really been tested and they are often more the passive recipients of information than driving forces within their organisation.

But in principle, governors have the power to block mergers and acquisitions. At the tiny Queen Victoria Hospitals Foundation Trust in Sussex, a majority of the current 22 governors would like to see at least a pause to the planned acquisition by University Hospitals Sussex FT. A request to this effect was turned down by the board, which said the governors could not restrict its business.

This clash with the board – which is likely to take further moves towards a merger on Thursday – is linked to arguments over the role of governors within the trust and the need for confidentiality of some material they might have access to, leading to a council of governors meeting being described by the trust chair Beryl Hobson as “the most unedifying meeting” she had ever attended. The “very challenging” meeting had “comments expressed around bullying behaviour,” according to the board minutes.

Whether the governors’ objections to the trust’s direction of travel will be assuaged or overruled is anyone’s guess but NHS England is understood to be pushing for the merger, making it likely there will be some moves to ensure the governors aren’t able to stop it – despite their apparent supremacy in the 2012 Health and Social Care Act.

Toxic cultures

What is the difference between pockets of poor behaviour and a trust-wide cultural problem? This is a question University Hospitals North Midlands Trust may be asking itself at the moment.

HSJ has revealed the findings of an external review into the imaging department at the large Midlands trust. According to a letter sent to consultants, staff reported concerns over a “toxic” and “unhealthy” culture within the department.

This appears to have affected all consultant staff within the unit, the letter claimed. “Poor behaviours” allegedly included consultant and managing staff and the latter was accused by some staff of having an “excessively authoritarian” approach.

At first glance these would appear to be issues specific to the imaging department but the story follows an internal trust-wide survey of consultants in which hundreds of doctors claimed to have experienced bullying and racial discrimination.

The British Association of Physicians of Indian Origin union has told HSJ it is concerned there is a wider problem the trust isn’t recognising.

Whether this is true or not will perhaps be uncovered by an independent review the trust has now commissioned to be carried out by Roger Kline, covering all staff within the organisation.