CROYDON University Hospital board members are plotting a mass walkout if its under-fire temporary chief is given the top job permanently.
Critics of John Goulston, the interim chief executive who is on a six-figure salary, want to see somebody else appointed to lead the hospital full-time, following the departure of Nick Hulme in February last year.
News of the planned exodus comes as Mr Goulston refused to answer our questions about his – and the hospital's – future when we visited him at his townhouse in Forest Hill.
Last month the Advertiser revealed Mr Goulston was hit with a vote of no confidence from board members. It followed a damning report by health watchdog the Care Quality Commission, which said improvements were needed in the hospital's management after its last visit in October.
However, the chief executive has defiantly applied for the top job permanently and denied all knowledge of the vote of no confidence from the non-executive directors, who make up a third of the board and are preparing to resign en masse.
What is known as the executive directors are also understood to have discussed resignation.
We visited Mr Goulston at his home at the weekend after his repeated refusals to answer our questions via the hospital's press office.
When asked why he had been failing to respond over the past few weeks, he said: "I have been on holiday."
Then, when asked about the vote of no confidence in his performance, he added: "It's news to me." He refused to answer any further questions.
Croydon Healthwatch Pathfinder, the local patients' group, is demanding answers from Mr Goulston "for the greater good of the hospital and its patients".
Folake Segun, the group's spokesman, added: "We are concerned to hear that a rift is developing.
"Any lack of unity among the hospital's leadership will have a significant negative impact on patient care."
A source told the Advertiser the vote of no confidence has been overridden by NHS London – the strategic health authority (SHA) which appoints the chairman – and that the non-executive directors have sought legal advice after being overruled.
Mr Goulston, also director of a company called NHS Innovations London, which was earmarked to be struck off in October, had a row with Michael Parker, the former chairman, who was asked to resign by NHS London earlier in December.
The vote of no confidence in the interim chief would have allowed Michael Parker to bring his interim contract to a premature end, the Advertiser understands. A rift between the pair had been rumbling on for several weeks.
Meanwhile Karen Jones, a non-executive director, has also stepped down and Richard Parker, director of operations, has left after being made "redundant", according to an e-mail sent by Mr Goulston.
NHS London has now appointed two members of its own board – Mike Bell and Sara Coles – to fill interim chairman and interim chief operating officer roles respectively at Croydon.
It is the third time the SHA has installed interim directors in Croydon within the space of nine months.
The continued instability at the top has stoked fears the hospital will continue to struggle longer than is necessary in getting its house in order after a turbulent year of resignations, questionable decisions and damning reports.
A spokesman for health watchdog the Care Quality Commission (CQC) said: "Poor or inconsistent management can have an impact on patient care."
A shortlist of applications for the permanent chief executive role will be drawn up in the coming weeks.
Out-of-hours care in Croydon has been thrown into uncertainty with its present providers preparing to consider 'the future viability' of continuing the service. Patient Care 24, which provides care for those needing a doctor in the night or at weekends, sent a letter to borough GPs, seen by the Advertiser, declaring it has they have lost contracts in neighbouring boroughs Sutton and Merton, meaning it they may not continue in Croydon. The letter adds there is 'no guarantee' that potential changes as a result will be 'risk free' to patients. Local NHS commissioners had not issued a response as the Advertiser went to press about making sure that a provider is found should the present providers pull out. Patient Care 24 also said it may be forced to mount a 'rigorous challenge' against those who commission NHS services in Croydon. The letter states: "For our part, we have requested an urgent debrief with the procurement lead within the next few days and will use this information to decide if the process has followed NHS standards. "Where this is not the case, rest assured that we will mount a rigorous challenge." Patient Care 24 lost the contract in Sutton and Merton by 1 per cent, according to the letter signed by its chief executive, Alan Kennedy. The service for the neighbouring boroughs will now be provided by Bristol-based company Frendoc, the Advertiser understands.