A report into the financial crisis at Brent primary care trust has highlighted 'grave failings' in leadership.
The report was commissioned by NHS London to look at why the PCT went from predicting a£2.8m surplus in May 2006 to a£25m debt in the space of six months.
Independent reviewer Michael Taylor found senior management had failed to act on early warnings of financial difficulties. He said "weak financial management", "a divided senior executive team" and "weak scrutiny by the PCT board" were among key reasons for the rapid deterioration of the trust's finances.
The PCT, which has since changed its leadership, is implementing a raft of recommendations.
"It makes a depressing read, as it reflects a lot of past failings," PCT chief executive Mark Easton told HSJ.
He said one of the biggest management challenges for the future was rebuilding trust among PCT partners, and staff. He added that a turnaround plan had helped the organisation get back on track financially and it was predicting to break even or have a small surplus in 2007-08.
He said the trust should be in a position to invest money in services the following year.
But Brent council chief executive Gareth Daniel said it would take time to repair damage caused by cuts.
"There were failings at local level but also failings in governance and oversight at both regional and national level," he told HSJ.
Union Managers in Partnership, which is representing four managers named in the document, claimed the report was unfair. Ray Rowden, the officer dealing with their case, said it raised issues about how people were being judged nationwide against the code of conduct for NHS managers. "If anyone pursues further action against any of our members on the basis of this report we will defend them robustly," he said.
"There's no doubt something went amiss in Brent and I don't think any of our members would deny a degree of accountability for what went wrong. But impugning people's reputation on evidence that has never been tested - that's a step too far."