Doctors at a psychiatric hospital in Cumbria have claimed that services are being seriously damaged by mismanagement.

Mistrust between senior doctors and managers at Garlands Hospital in Carlisle was revealed by a leaked report from the medical staff committee last week, signed by 16 doctors. It says the structure linking management and clinicians at North Lakeland Healthcare trust is 'ineffective', with clinical resources 'stretched to the limit'.

It claims managers have failed to provide locum cover for sick colleagues, and ignore the 'damage done to clinical services and to the remaining staff by insufficient cover.' And it says managers failed to deal with poorly performing staff - 'morale and the reputation of North Lakeland Healthcare have declined as a result'.

The doctors, who include committee chair Dr Chris Hallewell and Dr Alasdair Mcdonald, a former medical director, have now withdrawn their support from the trust's clinical leadership group and urged it to 'involve medical staff in decision-making'.

Trust chief executive Alan Place and Dr Hallewell issued a joint response to the leak, saying it would be 'inappropriate' to debate internal management in the media, and discussions between managers and clinicians were underway to resolve the issues of concern.