A lack of vision and clinical strategy risks “inhibiting improvement in clinical care” at the University Hospitals of Leicester, according to a Midlands and East strategic health authority cluster investigation.

An appreciative inquiry took place into quality and patient safety at the hospital in April, at the request of the trust.

Whilst it found no immediate patient safety risks, the inquiry team identified a variety of “concerns about the management” from staff.

A report to the trust board said: “While the visibility and approachability of the chief executive and executive directors was reported as good, they were told about several examples of what was described as ‘reactive management’, with staff feeling the focus was on money rather than quality.”

Reviewers also concluded the emergency department at the Leicester Royal Infirmary “frequently became overheated” and had seen the withdrawal of 12 junior doctors in August. The management of patients through the hospital “did give them cause for concern”.

The review also found the trust had not identified its full cost improvement programme for the year and expressed concern regarding “a lack of strategy to deal with a potentially worsening financial situation”.

Meanwhile, the trust received the highest number of complaints of all trusts in the East Midlands.

It had 1,725 formal complaints in 2011-12, 850 more than Nottingham University Hospitals Trust, which had the next highest number of complaints, according to data from the NHS Information Centre.

But Leicester said it was possible its number of complaints was inflated by it accepting complaints going back over many years.

Trust director of safety and risk Moira Durbridge said improvements to tackle complaints included “reducing the number of ward moves a patient experiences, increased staffing levels on medical wards and the introduction of discharge co-ordinators”.