A damning review has found there have been serious lapses in care for patients during surgery at the Queen Elizabeth Hospital.

The findings are so serious that all general surgery at the QEH is now operating under the clinical leadership of surgeons from the Norfolk and Norwich University Hospitals, as part of a new mandated service.

Bosses have issued an “unreserved” apology to patients and families impacted by the inadequate care, admitting that governance failures meant concerns were not identified sooner.

The critical report, published today by the Royal College of Surgeons (RCS), was commissioned by the QEH following concerns raised in two whistleblowing letters and by hospital staff.

The RCS reviewed 17 clinical cases – eight original operations and nine complication or return-to-theatre cases – and eight were judged to have involved care below the expected standard.

An immediate need for improvement was deemed necessary in recognition of deterioration, timely return to theatre, surgical decision-making and escalation, handovers, consultant accountability, team culture, and governance.

Weaknesses in teamwork and learning systems were also revealed, which meant problems were not recognised or addressed early enough.

These findings relate to general surgery, involving abdominal operations such as bowel, gallbladder, hernia and colorectal cancer procedures.

Professor Lesley Dwyer, leader of the new Norfolk and Waveney University Hospitals Group (NWUHG) which the QEH is part of, said: “We are deeply sorry for the lapses in care at the QEH identified in this report and for the governance failures that meant concerns were not identified sooner.

“Our apology to affected patients and their families is unreserved. We are in touch with each of them directly to offer our support.”

Chris Bown, interim executive managing director at the QEH, said: “On behalf of the hospital, I apologise profusely for the fact that some general surgery patients did not receive the care they should have expected, and our staff want to give. We have acted to change that.

“Some of the issues raised are deep seated and have been long lasting, predating the hospital’s current clinical and managerial leadership.

“I am extremely glad the RCS has been so thorough in bringing all these issues to light, so with our group colleagues, we can act and put them right and critically, support our colleagues and this vitally important general surgery service.”

The decision to mandate new leadership, oversight and service arrangements was made swiftly following consideration of the findings of the report, received in October.

The new mandated service arrangement began last Friday (December 12), and will see the Norfolk and Norwich University Hospitals (NNUH) team support the QEH with clinical leadership and enhanced clinical oversight.

There will also be mandatory consultant oversight of all emergency surgery, as well as the development of aligned standards across both hospitals.

This is the first time the NWUHG has used its step-in powers to support a struggling member.

It is not known if the underperforming surgeons will face any disciplinary action, although they are all still working at the hospital – albeit within “enhanced frameworks”.

South West Norfolk MP Terry Jermy said he is “deeply concerned” by the report and will be monitoring the situation closely.

He said: “Behind each of the eight clinical cases that were found to have been provided care below the expected standard is not just a patient, but a person – and their family – who were failed.

“It is crucial that patients receive the safest and highest standards of care, and to learn of eight instances in which this didn’t happen is distressing.

“I am pleased the QEH recognises the seriousness of the findings, and the urgency with which they are working to bring about meaningful and impactful improvements, including support for enhancing clinical governance and oversight.”

Dr Tim Leary, former deputy medical director at NNUH, is now providing additional on-site leadership, while a review into clinical governance arrangements will be taken with support from NHS England.

The review did not identify evidence of widespread harm, and mortality outcomes were within expected ranges.

Cllr Rob Colwell, who represents the Gaywood ward where the hospital is located, said it is “alarming” that the NWUHG has had to make its first intervention at the QEH – but “reassuring” that it has done so swiftly.

“For this to come to light via whistleblowers does however surely raise questions as to the previous leadership and oversight at the hospital,” he added.

“I hope this will be investigated in due course and that processes are being reviewed generally.”

Cllr Jo Rust, who has spearheaded the Save the QEH campaign group in recent years, has slammed the findings of the review, saying it sheds light on a “toxic culture” at the QEH trust.

She says the report is “a serious concern”, and while she will not blame the Labour government, she will call on Health Secretary Wes Streeting to “immediately release significant funding to alleviate the financial crisis that the trust is in and to invest in some significant training and development”.

“In addition, the lack of handover policy and process needs to be addressed as a matter of urgency,” Cllr Rust added.

“Our local hospital has, for too long, had an under-investment. This needs to change immediately if we are to have any faith in the NHS service we receive.”

Professor Dwyer said: “We acknowledge all the issues the report raises, however our top priority has been to ensure the safety and sustainability of this vitally important local service at the QEH for its patients, and be able to assure local people with confidence, that this is so.

“We can do so, because of the new mandated support arrangements from the NNUH now in place. They provide strong clinical leadership, increased support for QEH consultants, enhanced independent oversight and ensure a second opinion is sought and received for out of hours and emergency operations.

“The NNUH general surgery team are happy to be working alongside their QEH colleagues and support them in making the service as safe, supportive and robust as possible.”

Mr Bown added: “It is very important that in learning the sharp lessons we have received from this report in respect of one area of our service (now corrected), that we do not forget that, or fail to recognise the highly valued, caring contributions made by all our staff on behalf of the NHS, its patients and our communities.”