CROYDON University Hospital has suffered "significant reputational damage" as a result of infighting among directors, a newly published report has said.
An independent review into governance at the trust found relationships between directors are "poor and distrustful" and morale among staff is low. It said that even with "exemplary" leadership it would take time for the situation to improve.
It called for a high-profile "relaunch" to avoid a "spiral of decline".
The report was commissioned by Mike Bell, interim chairman of Croydon Health Services, after the resignation of his predecessor Michael Parker in December last year.
Mr Parker stepped down after less than a year in the job amid reports he was opposed to interim chief executive John Goulston being given the job on a permanent basis.
But anyone who hoped the review would shed light on precisely what happened will be disappointed.
Relationships had suffered because of the events of the past 12 months, the report said, and then been "severely damaged" by what occurred in December 2012.
When asked whether the 16-page document was deliberately light on detail in terms of what happened and why, Mr Bell said: "It's a fair assessment.
"It will be no surprise to your readers that relationships at the top table have not been good for some time.
"My priority was to look forward rather than what has gone wrong over the last 12 months."
Mr Bell's report blamed the structure of the board and urged the trust to reduce the number of committees.
"Part of the problem was the system," Mr Bell told the Advertiser. "There wasn't a clear line of reporting and expectations were unclear.
"When I arrived I was shocked to discover there were nine separate sub-committees of the board. Directors were required to attend so many meetings and do so much paperwork, no one had any time to get on with their jobs."
When asked what had led the board to fall out, Mr Bell would only say: "I'm not of the view that everyone needs to love each other, but there needs to be respect. Some of the board weren't behaving as you would expect professionals to behave.
"So we're creating a new structure where people can perform to their full and behave with respect to each other."
Though the report highlights infighting damaged the trust's image, causing low morale among staff, Mr Bell insists the issues did not impact on patient care.
"The trust continued to function in spite of the differences at the top table," he explained.
"I don't think it had an adverse affect on clinical performance, though had it been allowed to continue then it clearly would have done."
The report said the biggest impact had been on the trust's reputation.
"As the majority of staff live locally, adverse publicity has impacted negatively on staff morale and may cause the trust difficulty in recruiting and retaining excellent staff," it said.
"In the worst case, there is a possibility of a spiral of decline in which reputational damage both makes it more difficult to address the problems and persists even after the underlying problems have been resolved."
The review recommended a "high-profile communications programme designed to restore confidence and reputation".
Mr Bell, who has drawn up an action plan to address the report's recommendations, said: "This won't be a fluffy PR exercise. It's about changing the reputation of the trust by promoting the things we are doing to improve quality of care."
Mr Bell admits that Croydon University Hospital's latest bid for Foundation Trust status has little more than a 50-50 chance of being successful. All hospitals must achieve the status, which grants more independence and accountability by March 2014 – or face being merged with those that do. Mr Bell said the trust's application faces significant financial and clinical obstacles but that it was moving in the right direction. "We're in the process of finalising the final timeline for the bid," he told the Advertiser. "We're still going forward on the basis that we will become a Foundation Trust. "The review, action and plan and other things which are going on make me confident we should be in a position to make a good application before the deadline. "However, I accept the hospital faces a number of challenges. "Some relate to the overall level of financing available within the local health economy. The trust also has to take robust action around the quality of care, patient experience and the way the board functions. "But I wouldn't have taken a role at Croydon if I didn't think we had a more than even chance of becoming a Foundation Trust. "I can't guarantee, hand on heart, we will cross all the hurdles. What I can say is that we are getting the right people in place to develop the system to make sure it happens." Two other attempts to be awarded foundation status, in 2006 and 2008, both failed due to concerns about the trust's finances and standards of care respectively.