The Trust runs Bristol's Southmead and Frenchay Hospitals

A review was ordered by the Avon, Gloucestershire and Wiltshire Strategic Health Authority after a financial crisis at North Bristol NHS Trust emerged this year.

Executive members of the Trust were criticised for "dysfunctional, unco-ordinated" conduct and concentrating energies on "saving their personal positions".

Trust chairman Professor Phyllida Parsloe was one of a number of high-profile employees to resign after disclosure of deficits.

Several Trust staff have indicated that they did not have the opportunity to discuss issues or to report concerns Independent report

The year-end deficit of �44.3m was attributed to six causes, including �10.2m overspend each on nursing budgets and on unachieved planned savings.

Other areas of concern included excess cost of meeting waiting list targets - �9.5m - overspend on non-nursing directorates, contract overperformance and unrealised income targets.

The review also found there were serious governance and performance issues in the Trust's running but no evidence of fraud or deliberate concealment of information.

'Dysfunctional'

It stated: "Our findings suggest that the executive group was, for long periods, conducting its business in a dysfunctional, unco-ordinated manner.

"We have been informed that the management culture, particularly during the period of the last chief executive, who left the Trust last December, was not conducive to effective team-working at executive level."

"Individuals are reported to have concentrated their energies on saving their personal positions rather than sharing problems as a corporate executive group.

'Not encouraging'

"Several Trust staff have indicated that they did not have the opportunity to discuss issues or to report concerns, as they felt the Trust was not an encouraging environment to do this."

The debt - thought to be the biggest ever run up by a health trust - has already led to the use of private nursing agencies being banned in the area, and it is thought cuts at its two hospitals will follow.

Without drastic action, it is feared the deficit could grow to �80m by next March.

The Trust wants to pay off the �44.3m gradually over the next five years.