NHS Forth Valley: Embattled leadership of Scottish health board criticised by governance review

A review of NHS Forth Valley’s governance “raises red flags across virtually every aspect of the health board”, according to union officials.

A corporate governance review, presented to the board of NHS Forth Valley on Wednesday, identified “a failure to agree an appropriate business model” and criticised the NHS board's executive leadership team.

The report read: “The other underlying issues that were identified by interviews as contributing to the difficult relationships within the executive leadership team included the review of poor performance in the accident and emergency department at Forth Valley Royal Hospital, and the handling of grievances and disciplinary action at senior management level.”

The document has been published a year after NHS Forth Valley was escalated to stage four of the NHS Scotland Performance Escalation Framework for concerns relating to governance, leadership and culture. It is the only health board in the country escalated to this level. If things deteriorate, the board could be escalated further, and be placed under the direct supervision of Scottish ministers.

GMB Scotland said the corporate governance review exposed “alarming levels of dysfunction at the very top of the health board”.

Karen Leonard, the union’s organiser in NHS Scotland, said the findings confirmed the need for the special measures imposed in November last year and must signal a more extensive overhaul to ensure the health board is being properly led and managed.

“Health service staff and patients will be dismayed and alarmed by this report, which raises red flags across virtually every aspect of the NHS Forth Valley board and executive team,” she said.

“It exposes a lack of communication, a lack of understanding, a lack of scrutiny and strategy and an apparent lack of experience and competence in many of those in leadership roles. In short, it exposes a lack of all the things that staff and the patients they care for have every right to expect.

“There is clearly friction between board members and some executives as well as a mutual lack of faith in their ability to drive forward the change required. This board and its senior leaders must now act with urgency to ensure patients in Forth Valley and the NHS staff caring for them are given the quality of leadership they deserve.”

NHS Forth Valley said a “wide range of changes and improvements” had been made since it commissioned the review in January. The health board claimed a number of the recommendations highlighted in the report had already been addressed.

Janie McCusker, chair of NHS Forth Valley, said: “There is no doubt that the last 12 months have been challenging. However, I’m confident that the action already taken and the wide range of work carried out in the last year means we are now in a much better position as we continue our improvement journey.

“There are also lots of skills and expertise in all areas of the organisation which we will continue to harness to take forward further changes and improvements, working closely with partners across Forth Valley and beyond.”