A DAMNING report which raises grave concern about the behaviour of managers and some top doctors at Aberdeen Royal Infirmary has been published today.

The findings are so serious the General Medical Council, which sets standards for the medical profession, has issued a statement saying they agree the evidence that patient safety and care could have been compromised at the hospital is overwhelming.

Serious shortages of doctors and nurses, a forceful style of management which some described as "bullying" and remote managers who did not appear to be taking meaningful decisions are among the issues raised.

Doctors who may have not trained in emergency medicine have been used to staff the accident and emergency department, according to the report. The authors also make allegations about the behaviour of individual consultants working in general surgery and say this department is "dysfunctional."

The report was published by NHS Healthcare Improvement Scotland, who were asked to conduct a review of the hospital after a consultant raised concerns with previous Scottish Health Secretary Alex Neil.

The Herald revealed the seriousness of some of the allegations being investigated earlier this year.

Niall Dickson, Chief Executive of GMC, said: "The individual behaviours and the systemic failures described in the report are completely unacceptable. And while HIS found no direct evidence of patient harm, we agree with the authors when they conclude that 'the potential for patient care and safety to be further compromised is overwhelmingly evident in the findings of this report."

The summary of the report says patient outcomes at Aberdeen Royal Infirmary are "broadly similar" to other Scottish hospitals and when surveyed, patients are as satisfied with the care they receive as patients elsewhere.

However, the authors continue: "We are concerned that many aspects of the current working arrangements, particularly those dependent upon goodwill, will be unable to meet future demands on the system."

They say there is a need to take effective action now to address "current shortcomings in systems and governance to prevent potential future harm to patients."

Malcolm Wright is currently serving as interim chief executive of NHS Grampian, the health board responsible for the ARI. The previous chief executive, Richard Carey, took early retirement this autumn when the review was well under way.

Mr Wright said the health board took the findings extremely seriously, adding: "The board absolutely accepts the recommendations made and detailed action plans have been drawn up to address these issues.

"We have committed to improving leadership, management and engagement between clinicians and managers at Aberdeen Royal Infirmary and across the organisation.

"We will establish a system of management at Aberdeen Royal Infirmary with clinicians and managers working together at the heart of the care that we provide with clear roles and responsibilities, ensuring that all staff understand what is expected of them."

Shona Robison, the new Health Secretary, is visiting the ARI today. She said NHS Grampian must deliver "urgent improvements across a range of areas".

She added: "While it is important to note that the Healthcare Improvement Scotland report finds that care delivered at the ARI is safe, there are clear failings highlighted that are simply not acceptable in our NHS.

"Not least of these is a failure of leadership, a breakdown of relations with clinicians and the resulting pressures this has placed on frontline staff.

"The Scottish Government acted swiftly in response to concerns raised by staff at NHS Grampian - sending in a team from Healthcare Improvement Scotland to explore the concerns within one week. This resulted in the publication of today's report - demonstrating our absolute commitment to shining a light on poor practice where ever it exists in our NHS."