Children’s Hospital bosses said an action plan was already addressing a catalogue of problems raised in the report.

But Medical Director Dr Charles Ralston said he wanted to reassure families that no harm had come to any child over the issues in the investigation.

Dr Ralston said management was already working on adding around 25 more beds and introducing suggestions by consultancy firm KPMG to “streamline processes, introduce new ways of working and effectively redesign services” to free up a further 45 beds.

He said the hospital, which gained independent Foundation status in February, 2007, and has 2,600 staff including 150 consultants and 220 beds, was still held in high regard by Birmingham people judging by letters of support he had received.

“We accept that some concerns were raised,” said Dr Ralston.

“I am not going to speculate on why Mr O’Connor left the trust. Improvements have been made and UHB and the Children’s Hospital are working together well.”

Sarah-Jane Marsh, Interim chief executive of the Children’s Hospital, said: “The quality of care for our young patients is our top priority. In some ways, we have been victims of our own success. As our services have grown ever more popular we have been faced with the challenge of meeting that demand and have been carrying out a great deal of work to make sure we do.”

“Whilst we acknowledge that the issues raised were significant, the clinicians involved at the time managed all situations expertly. I sincerely regret any distress

caused to children, young people and their families during this time.

“We are extremely fortunate to be able to count on specialist consultants with an international reputation from University Hospitals Birmingham to help us to provide our specialist services. We are working very closely with them to make sure that they are involved as we increase and improve services.”

Birmingham Children’s Hospital has been working closely with local health commissioners to develop the action plan to address the issues raised. Given increased demand for paediatric services, a wider review is being carried out by the commissioners to design future services.

* The investigation at Birmingham Children's Hospital by the Healthcare Commission was triggered after a series of complaints and observations.

* January 25, 2008 – A renal transplant surgeon from University Hospital Birmingham Trust in Edgbaston (UHB) complained about Children’s Hospital staff assisting the consultant in performing transplant operations.

* June 6, 2008 – Chief executive officers and medical directors of the Trust and UHB met to discuss broad concerns.

* June 2008 – South Birmingham Primary Care Trust chiefs became aware of the concerns about the trust through meetings UHB chief executive. The trust wrote a formal response to UHB, asking for evidence of the concerns.

* July 2008 – Surgeons at QE raised concerns to Heart of Birmingham Primary Care Trust which commissions services at the Children’s Hospital.

* August 2008 – A meeting was held on August 21 between the trust, UHB and commissioners with each of the relevant specialist groups to confirm whether there were any unresolved issues. Agreed to undertake a long-term planning exercise to scope the emerging demand, trends and sustainability of children’s specialised services.

* September and October 2008 – Series of meetings between management and consultant staff at UHB. ‘Paediatric Tertiary Services Commissioner Review’ was written by staff at UHB.

* October 16, 2008 – Action plan agreed for trust by PCTs. South Birmingham PCT discussed the report with Heart of Birmingham Teaching PCT and agreed that it was not suitable for wider circulation.

* November 2008 – Monitor was first made aware of the concerns raised by UHB clinicians, just before the report was published in the media.

* November 9, 2008 – Media reports raised concerns about the quality of services provided by the trust.

* November 10, 2008 – Healthcare Commission received a letter from NHS West Midlands, which included concerns over effectiveness of partnership working between the trust and UHB.

* December 1, 2008 – Health Secretary formally wrote to Healthcare Commision asking for preliminary enquiries into the concerns and the UHB report.

* March 2009 – Chief executive Paul O’Connor resigned two weeks before Healthcare Commission report was published.