Managers at first PFI hospital criticised for lack of leadership

Manager at Britain's first PFI hospital, opened by Tony Blair two years ago, were heavily criticised yesterday by a government watchdog, which said the NHS trust lacked leadership, direction and planning.

The chief executive of the North Cumbria Acute Hospitals NHS Trust resigned last week in advance of publication of the report by the Commission for Health Improvement (CHI). Nick Wood had been in the post for only 16 months but had faced problems from the start after the trust was formed from the merger of two former trusts, Cumberland Infirmary in Carlisle and the West Cumberland Hospital in Whitehaven.

Cumberland Infirmary was the first hospital to be built under the private finance initiative, which is now fuelling a national expansion of the NHS. But the hospital suffered a series of problems, including leaking sewage, and unions claimed that it had 89 fewer beds than the one it replaced.

The CHI report says managers of the merged trust have failed to develop a strategy for running it from the two sites and that "tensions appear to have worsened'' since the merger. It also criticises the "low profile" of the trust's board of directors and the high number of senior jobs filled by temporary staff. Waiting times for cancer patients were too long, it said.

Cumberland Infirmary was investigated shortly after it opened in April 2000 when a rise in emergency admissions led the hospital to cancel emergency admissions. That report blamed the management of patients rather than the shortage of beds and made a total of 19 recommendations.

The latest investigation, a routine inspection by CHI made in October last year, follows the establishment of the merged trust in April 2001.

Mr Wood joined in September 2001 and the trust has had three finance directors since. There has also been a high number of cancelled operations and outbreaks of infection.

Peter Homa, the chief executive of CHI, said yesterday that the trust faced a "significant management agenda''. He added: "It needs to engage and listen to staff and stakeholders and provide a clear vision and achievable action plan if it is to move forward and implement change in line with clinical governance priorities."