this week

Managers at University Hospitals Coventry and Warwickshire trust claim they and their staff are under increasing pressure in trying to put together an action plan following a damning report from the Commission for Health Improvement.

The plan has still not been agreed and has been sent back and forth between the trust and CHI for final approval amid speculation about growing friction between the two organisations over its contents and the timetable.

Trust chair Gary Reay told a board meeting last week that people within the trust were forced to work solely on the action plan at the expense of other work.

CHI is due to visit again in January to assess what changes have been made and, following the star-ratings announced last month, chief executive David Loughton has been given three months to demonstrate improvements or face a franchise.

A spokesperson for West Midlands regional office admitted there were pressures, but denied any problems with producing the action plan: 'I am not aware that we are facing any deadlines. But there is no particular delay in putting together the plan. . . Obviously there is a hell of a lot of work to do following any CHI report and this is no different. It is just that there are more elements to sort out than would normally be the case.'

News of the difficulties come in the wake of the departure of trust director of personnel Roger Faulkner, who was also responsible for risk management.

Meanwhile, Epsom and St Helier trust's action plan has been agreed with CHI two months after its highly critical report. A CHI spokesperson said the 36page plan was 'a comprehensive document with good aims and sensible timescales'.

The trust's new chief executive, John de Braux, said: 'Ever since the report was published our staff wanted to take action to implement the findings of the review. . .Over the next 12 months we will implement the actions identified in this plan so we can assure the public that we are delivering high-quality health care.'