London regional office has sent a troubleshooting team into Barts and the London trust to tackle performance in a month in which the trust has lost its chair and admitted 'red-hot pressures' in intensive care.

The trust invited region to set up a 'partnership and performance review' to develop an action plan to tackle relations between the trust and its NHS partners.

It will be headed by Christine Beasley, director of nursing, human resources and organisational development for London region. A spokesperson for the trust said it hoped to develop the kind of teamwork which had helped it during a recent bed crisis, in which 40 elective operations were cancelled in one week.

Intensive treatment unit director at the Royal London Stuart Withington said he welcomed an outside team coming in 'so they can see at first hand the problems we have been struggling with'.

'ITU has been red hot for the past two or three months, 'he said.' We have three on-call teams between the three sites (Bart's, Whitechapel and the London Chest Hospital) - a total of about 13 or 14 anaesthetists - and we are barely covering the service.'

Dr Withington said the fundamental problem was trying to run the trust on three sites: 'Every department is totally underfunded and under-resourced.' He said there were 'ructions' between senior managers and clinicians as each was pulled in different directions.

'The management team has been trying hard to square the circle, but some of the national targets are in opposition to each other. If you reduce trolley waits in A & E you cancel more elective surgery.'

Ms Beasley said the team would talk to key partners in the local health economy to identify issues affecting performance. It intends to complete its work by September and produce recommendations for a local 'jointly owned' action plan. The other members of the review team are Julian Nettel, chief executive of St Mary's trust, London, John Riordon, medical director, North West London trust, and Martin Vandersteen, chair of Kingston Hospital trust.

City and Hackney community health council chief officer Janet Richardson said recruitment would not improve if the issue of low staff morale in the trust was not addressed. 'Staff need to know they can whistleblow and that they will be supported, ' she said.

The trust spokesperson said staff morale would improve through the development of the new hospital, a private finance initiative scheduled to start in 18 months' time.