• Leaked document reveals hospital directors raised serious concerns about chief executive David Allison
  • The Wirral University Teaching Hospital had said Mr Allison had left for “personal reasons” on Wednesday
  • NHS Improvement to launch urgent investigation after document reveals scale of governance failings

A leaked document obtained by HSJ has revealed senior executives at Wirral University Teaching Hospital Foundation Trust blew the whistle to NHS Improvement over serious concerns relating to trust chief executive David Allison and chair Michael Carr.

The trust said yesterday Mr Allison had stepped down with “immediate effect” for “personal reasons”.

David allison cropped

David Allison left the trust on Wednesday

However, HSJ can reveal the trust director of finance, David Jago; chief operating officer Janelle Holmes; interim director of nursing Denise Price; and medical director Susan Gilby had raised serious concerns about the trust’s governance and management for several months. They went to NHSI after being concerned no action was being taken.

As a result of enquiries by HSJ today, NHSI has said it will be launching an urgent investigation into the allegations and will be reviewing the offer of a secondment which it has made to Mr Allison.

Multiple sources confirmed Mr Allison was investigated by the chair after he was appointed to the board of digital informatics company Draper and Dash on 20 November without the knowledge of the trust’s executive team. Mr Allison arranged a meeting for trust executives with Draper and Dash managing director Orlando Agrippa. The meeting was arranged via an email from Mr Allison’s trust account but the meetings never took place due to concerns of staff.

HSJ has obtained a document recording the minutes of a meeting held between the trust’s chief operating officer, director of nursing and medical director and NHSI North medical director Vince Connelly in November, where the executives set out their concerns.

The document, written by NHSI, lays out allegations about the trust’s culture, poor governance and operation of the board, and Mr Allison’s and Mr Carr’s behaviour towards executives.

Concerns recorded in the document include:

  • NHSI was told the board “was not functioning as a unitary board. Pre-meets are carefully managed and concerns suppressed. It is felt that the CEO has a lack of grip on the issues facing the organisation and was not paying attention to quality indicators. The CEO responds to quality concerns with dismay and aggression. There is a concern that some key data and supportive narrative may be being carefully managed.”
  • NHSI was told executives have been instructed not to involve non-executive directors in any initiatives or issues in their portfolios without going through the chair.
  • The executives “felt the organisation had a culture that prohibits raising concerns as there was a lack of transparency and honesty when difficult issues are raised. This translated into a lack of visibility of quality and safety and a reluctance to escalate concerns.”
  • NHSI was told “senior colleagues were moved out of the organisation very quickly with no obvious explanation… They felt that this was related to a reluctance to escalate concerns and inability to accept appropriate challenge”.
  • Consultants at the trust were said to be “reluctant to take on senior leadership roles as history showed that they may [be] subject to investigations [and/or] intimidation if things did not work out”.
  • Mr Allison intentionally misrepresented the executive team’s views at committees where they were not present and in public meetings, it is alleged according to the minutes. This involved a recommendation to the trust remuneration committee on the appointment of a HR director, which was opposed by the executives, they state. The committee was told in September the executives supported the individual and had requested the appointment “despite the medical director previously indicating the opposite”.
  • In September, the council of governors agreed to extend the tenure of Mr Carr, who has been chair since 2010. Governors were said to be reluctant but were told by Mr Allison the extension had the executives’ full support. The minutes said: “This was not the case as the executive’s views had not been sought.”
  • The executives, including Mr Jago, met with Mr Carr to “discuss their concerns”. The chair was told NHSI should be involved but “he said he didn’t want to involve any external agencies as this would have unintended consequences and would then be out of control”. He asked them not to raise the issues externally. The minutes said: “Nine weeks on there is no indication that any actions have been taken in relation to this and the chair has provided no feedback to any of the execs.”
  • ”The executives are concerned about the impact this is having on securing sustained improvements to quality and patient care and the experiences of staff. The impacts described above are examples of incidents impacting perversely on the organisation to move forward. There are other examples and the behaviours continue,” the document said.

In response to questions from HSJ today, an NHSI spokeswoman said: “We will be investigating the issues raised as a matter of urgency and alongside this are in the process of reviewing proposed secondment arrangements.”

The trust and Mr Allison were approached for comment but did not respond before publication.