An external review of North Lakeland Healthcare trust has led to the sacking of its chair and the suspension of a number of senior managers.

The review was requested by trust chair Mary Styth, following two earlier investigations into claims of abuse of mentally ill patients.

Its report highlighted a 'dysfunctional relationship' between the chair and chief executive, and a flawed internal investigation of claims dating back to 1996.

Health secretary Alan Milburn dismissed Ms Styth on publication of the report.

The trust has accepted the findings and has suspended its director of personnel, its training manager and one of its locality managers. Chief executive Alan Place was suspended last August .

Ms Styth became chair in November 1997, but told HSJ that she had no criticism of her sacking since the interests of the patients and staff were paramount.

North Lakeland Healthcare trust external review (March 2000). Vulnerable adults to be protected The government this week announced a national framework to prevent the physical, sexual, psychological and financial abuse of vulnerable adults.

Multi-agency policies, co-ordinated by directors of social services, must be in place by next October .

No Secrets: guidance on developing multi-agency policies and procedures to protect vulnerable adults from abuse.