A leaked report says a "toxic" feud between two rival camps of surgeons at a heart unit contributed to an increase in patient deaths.
The unit at St George's Hospital in south London was consumed by a "dark force" and patients were put at risk by a dysfunctional team of surgeons, the report is quoted as saying.
It said there was inadequate monitoring of deaths and "tribal-like activity" among surgeons.
The damning report was written by former NHS England deputy medical director Mike Bewick following high mortality rates at the hospital.
The facility had a cardiac surgery death rate of 3.7% – above the 2% average – and internal scrutiny was "inadequate".
St George's is now under pressure to allow a full external audit by the Royal College of Surgeons.
Professor Bewick's review was quoted by The Times as saying: "Some felt that there was a persistent toxic atmosphere and stated that there was a 'dark force' in the unit."
It added: "In our view the whole team shares responsibility for the failure to significantly improve professional relationships and to a degree surgical mortality."
Professor Bewick's interviews with 39 staff revealed they were shocked by the death rate but "most felt that poor performance was inevitable due to the pervading atmosphere".
He wrote: "The surgical team is viewed as dysfunctional, both internally and externally."
The report says stronger leadership is needed and the current surgical team should be broken up.
St George's Hospital is one of Britain's biggest teaching hospitals. The trust that runs it was put into special measures in 2016 after inspectors criticised the quality and safety of care and its management.
A spokesman for the hospital said recommendations from Professor Bewick's report were being implemented, including the immediate relocation of all cardiac surgeons to a single-speciality practice.
The review was commissioned in June after the National Institute for Cardiovascular Outcomes Research (NICOR) put out an alert in response to the unit's surgery survival rates.
The hospital spokesman said: "We would like to stress that the cardiac surgery service we provide for patients is safe.
"However, it is very clear that major and urgent improvements are required, which we are already taking action to deliver."
Guy's and St Thomas's Foundation Trust is to send "on the ground leadership support" in the form of cardiac surgeons, the spokesman added, and officials are also "addressing concerns" about how surgery data is managed.
A spokesperson for the Royal College of Surgeons and the Society for Cardiothoracic Surgery, said: "Cardiac surgery within the UK is amongst the safest in the world and St George's has always shown that early survival for their patients is within what is regarded as the UK standard.
More from NHS
"It has never been below the required standard for the UK. All the other hospitals in the UK have shown that early survival after cardiac surgery is at the required standard, with only St George's triggering the early warning alert over the last four years of surgery.
"Nevertheless the independent review has highlighted serious concerns so it is still crucial that St George's address the findings of the report so that patients can be sure they are receiving the best possible care."
[contf]
[contfnew]
Sky News
[contfnewc]
[contfnewc]
