NHS Forth Valley has been placed into special measures by the Scottish Government amid concerns over "leadership, governance and culture".
Health Secretary Humza Yousaf said the decision had been taken to escalate the health board to Stage Four with immediate effect amid particularly poor performance in areas including A&E waiting times and GP out of hours services, and a failure to make required safety improvements at Forth Valley Royal following criticism by inspectors.
Stage Four means that the Government will have "direct formal oversight" in the running of NHS Forth Valley through an Assurance Board, which will be chaired by Christine McLaughlin - the Scottish Government's chair of population health.
READ MORE: Tayside, Forth Valley, and the truth about Scotland's 'best' and 'worst' performing A&E departments
Mr Yousaf said the Scottish Government had been "engaging with NHS Forth Valley for some time on a range of performance-related issues", but that "ongoing concerns" about safety had been highlighted during a number of unannounced inspections to Forth Valley Royal in Lambert by Healthcare Improvement Scotland.
Mr Yousaf said: "HIS have escalated their concerns to the Scottish Government as they have not seen the required improvements at Forth Valley since the initial inspection."
A report on the most recent inspection of the hospital is expected to be published by HIS "in the coming weeks", said Mr Yousaf.
The most recent HIS report, published in June, highlighted problems including a fifth bed being added to some four-bed bays to increase capacity and the use of treatment rooms as non-standard care areas for inpatients.
Inspectors said clinical teams "expressed feelings of frustrations at staffing levels and the senior leadership decision-making...which they believed left wards short of staff and unsupported".
Vacancies were also high - at over 10 per cent for registered nurses and nearly 14% for doctors.
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Mr Yousaf said the Government was also concerned about the "sustainability and integration" of GP out of hours services in the region; "consistently poor A&E performance" against the four-hour standard; and "issues relating to the integration of social care".
He added: "While poor performance in any of these discrete areas is of concern, I expect effective governance and strong leadership and improved culture to deliver sustainable change.
"Unfortunately I've not seen the necessary leadership required to drive improvement in these areas of concern."
It comes after recent reports that five respiratory consultants had resigned from Forth Valley Hospital within two weeks of each other.
The Royal College of Nursing (RCN) and Unison reported "very serious concerns" over "unsafe practices and a culture of intimidation" to the health board in November.
An independent review subsequently commissioned by NHS Forth Valley found that staff in the hospital failed to report mistakes amid a "culture of fear".
The emergency department at Forth Valley Royal is consistently the poorest performing in terms of the four-hour standard, with fewer than 40 per cent of patients in recent weeks being dealt with within the target time.
The health board has continued to prioritise elective care, however, and has much shorter waiting lists for planned operations than most of NHS Scotland.
A spokesperson for NHS Forth Valley said: "We welcome the additional support being provided and are committed to working closely with the Scottish government to deliver any changes or improvements recommended by the assurance board."
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