Pressure is growing for the chief executive of the University Hospitals Coventry and Warwickshire trust to resign following its highly critical Commission for Health Improvement clinical governance review, and no-star performance rating.

Six Labour MPs are calling for David Loughton to consider his position, while the chair of the local community health council believes the whole trust board should be replaced, and individual consultants have insisted the management cannot remain in post.

CHI attacked the trust for its aggressive style of leadership, unsafe clinical practice, and broken relations between senior doctors and managers. But both the board and staff organisations continue to emphasise their support for Mr Loughton.

In a statement issued by the trust on Thursday, the board said its backing for him was 'unanimous'.

Pat Sheehan, speaking on behalf of the joint staff consultative committee, said the staff side 'fully supported'Mr Loughton.

The six local MPs calling for Mr Loughton's resignation are Mike O'Brien, Geoffrey Robinson, Jim Cunningham, Andy King, Bill Olner and James Plaskitt. They represent areas which are, they say, 'critically dependent' on the Walsgrave hospital, one of three within the trust.

The MPs issued a joint statement saying: 'We view with alarm and regret the contents of the report of the Commission for Health Improvement. . . given the crucial importance of confidence in the leadership in the trust, we believe it is right that the chief executive, David Loughton, should consider his position.'

Mr O'Brien added: 'Mr Loughton has sought to divert attention and blamed everyone except the person with whom the buck stops. He has been in charge of Walsgrave Hospital for a long time and there have been growing concerns about him.

The sentiments were echoed by Coventry CHC chair Rosemarie Tonkinson: 'There needs to be a change at the highest level. The autocratic culture is too entrenched. It has been run as a business, not for the patients. They need to look at the trust board as well.'

She pointed out that the CHC had been pushing some of the issues highlighted by CHI for years, but had got nowhere with them.

'The message we have been getting is that everything will improve when the new hospital is built. But if we have got the same staff running it, nothing is going to change.'

Mr Loughton said he was confident of improving the situation before the three-month deadline set as a result of the trust's 'nostar' ranking.

He said: 'The events with CHI were the thing that tipped us into the red. Prior to that we were going to be amber - the same as 80 per cent of the other trusts.'

He added: 'We have already sent in our action plan to CHI. . .I am confident that it is acceptable.We have had more compliments than criticisms. . . I think we provide a very good service, but there is obviously room for improvement.'

As HSJ went to press, sources said that Mr Loughton had no plans to step down.