Bosses at hospitals where police are investigating dozens of deaths have been criticised for “bullying” and fostering a “culture of fear” among staff in a damning review by the Royal College of Surgeons. The review focused on concerns about patient safety and dysfunctional working practices in the general surgery departments at the Royal Sussex County hospital in Brighton and the Princess Royal hospital in nearby Haywards Heath. But the reviewers were so alarmed by reports of harassment, intimidation and mistreatment of whistleblowers that they suggested executives at the University Hospitals Sussex trust may have to be replaced. They concluded: “Consideration should be given to the suitability, professionalism and effectiveness of the current executive leadership team, given the concerning reports of bullying.” The report comes as Sussex police continue to investigate allegations of medical negligence and cover-up in the general surgery department and neurosurgery department, involving more than 100 patients, including at least 40 deaths, from 2015 to 2021. The investigation was prompted by concerns from a general surgeon, Krishna Singh, and a neurosurgeon, Mansoor Foroughi, who lost their jobs at the trust after blowing the whistle over patient safety. The findings of the review, which was conducted last year and published in the trust’s board papers, suggest problems at the hospital have continued beyond the timeframe of the investigation. They will increase whistleblowers’ concerns that treatment at the trust remains unsafe. The reviewers were “particularly concerned” about the “culture of fear … amongst staff when it came to the executive leadership team”. They added: “There were concerning reports of bullying by members of the executive leadership team, with instances of confrontational meetings with individual consultant surgeons, when they were told to ‘sit down, shut up and listen’.” The review found staff felt “intimidated” and reluctant to raise concerns for fear of reprisals. It recommended support for whistleblowers “so that they feel psychologically safe in raising concerns”. “Staff reported being reluctant to put any concerns in writing, as they would then worry about being victimised, referred for regulatory action and/or dismissed, as they believed this had happened to colleagues,” the review said. “This ‘culture of fear’ was said by some to exist in association with a number of chief executives, with their ‘tactic’ being to reportedly pick on someone in the department who spoke up and then to dismiss them.” The current chief executive, George Findlay, and his predecessor, Marianne Griffiths, who retired in 2022, were praised by the former health secretary Jeremy Hunt for building “the best learning culture I saw anywhere in the NHS”. The review heard reports of bullying in the surgery department, including where two trainees were “physically assaulted by a consultant surgeon in theatre during surgery”. It called on the trust to “address fractured relationships within the department in order to restore unity”. The report raised a series of concerns about patient wellbeing, including high cancellation rates and long waiting times that could be dangerous. It found cancellations often happened on the day of surgery “after patients had been waiting for up to seven hours, having prepared for surgery, for example, by not eating and/or drinking”. Emergency admission for colorectal cancer patients was running at 54%, far above the national average of 20%. Mortality rates for abdominal surgery were also higher than the national average, posing a “threat to patient safety”. The reviewers were alarmed by a high volume of complaints from patients, with 45 open complaints at the time of the review. But it noted improvements in the way the trust was learning from past errors and found staff were “extremely engaged, open and helpful”. Findlay pointed out that he had commissioned the review to help tackle “huge challenges” in the surgery department. In a statement he added: “Long-term problems cannot be solved overnight but significant strides are now being made. We all want to further improve patient care, so the job of building a stronger structure around the team, and stronger relationships, remains an absolute priority.”