Bolton Foundation Trust’s financial governance is “inadequate” in all areas, according to a devastating independent assessment seen by HSJ.

The review by financial adviser Grant Thornton rates the trust “red” for all key areas, including financial management, financial planning and value for money.

However, its new finance director Simon Worthington, who requested the evaluation, told HSJ the document held few surprises for managers striving to turn around the fortunes of the trust, which had a £14.4m deficit at the end of the last financial year.

Concerns include the fact the trust has been unable to set a balanced budget for 2013-14, with a forecast deficit of £7.8m.

Meanwhile, board members and finance staff “consistently described a lack of financial awareness and control across the organisation”, says the report.

The analysis, undertaken in April and May this year, says Bolton has “a large number” of red flags that would normally prevent an NHS trust from achieving foundation status.

It does however note some recent “positive developments” and makes 30 recommendations for the trust’s financial improvement plan.

The auditors said they were “encouraged by the director of finance’s wish for a thorough and open appraisal of financial governance in its widest sense”.

“Getting Grant Thornton to do this report is a very positive thing,” said Mr Worthington, who joined the trust three months ago. “We are going to implement all the recommendations and are being very open and transparent about the issues the organisation has got.”

He said the trust’s improvement plan had three key strands – service and financial recovery, improving financial governance and boosting finance skills.

Mr Worthington said the trust would work with local commissioners to develop a financial framework that would maximise its chances of recovery. It would also “get some cost control processes in place”.

Finally he said the trust was working to meet a 5.4 per cent cost improvement target for this year, involving making £14.6m savings.

The action plan set suggests Bolton gets support from a local trust such as the North West Ambulance Service Trust to “sense check” its accounting processes.

All board members should have risk management training and managers who have not “delivered timely actions against audit recommendations” will have to explain themselves to the Audit Committee and say how issues will be resolved.