The Healthcare Commission today said it would investigate serious concerns about care and management at Birmingham Children's Hospital foundation trust.

Clinicians at the hospital and at University Hospitals Birmingham foundation trust reported problems including a perception of 'poor and disorganised management processes and lack of confidence in managers at all levels'.

They also reported a failure to report incidents, a feeling that their concerns about care had not been taken seriously and problems with staffing.

The trust's commissioning primary care trusts, led by Heart of Birmingham teaching PCT, ordered it to carry out a review in response to the complaints.

"Serious untoward incidents are reported through their main commissioner; however, internal reporting of incidents relating to delay in service delivery or clinical incidents are not reported by the service leads and therefore not reported through the governance framework for consideration at board level," said a report for Heart of Birmingham, South Birmingham and Birmingham East and North PCTs.

"The lack of clinical incident reporting is an area of serious concern with regard to good governance."

The concerns relate to services including renal transplant, liver transplant, neurosciences and vascular.

The PCTs said there needed to be better reporting and more service support and development of clinical and managerial leadership.

Heart of Birmingham chief executive Sandy Bradbrook said: "This is a good example of how commissioning organisations can exert appropriate pressure and direction on organisations providing services to ensure patient safety and improvement of quality services.

"We have responded quickly and collaboratively to ensure service improvements for children at the Birmingham Children's Hospital. With the actions that are currently being taken, we are assured that there is no immediate risk to patient safety."

A spokesman for the hospital said in a statement: "Birmingham Children's Hospital would like to emphasise that there is absolutely no clinical risk to patients.

"The issues that have been raised are all standard operational ones and we have agreed a plan with the PCTs and the clinicians concerned about addressing the issues raised.

"We believe that we have nothing to hide and we have approached Great Ormond Street Hospital and they've agreed to review the situation and produce a public report on their findings."

The Healthcare Commission today announced it would investigate the concerns at the request of health secretary Alan Johnson.

Head of investigations Nigel Ellis said: "We cannot comment in detail at this stage; however, we are taking the concerns raised very seriously. We will publish an independent report detailing our findings in due course."

The commission said it was liaising with foundation trust regulator Monitor.