An NHS England investigation into claims of a toxic culture at a hospital trust has been described as lacking transparency and undermining trust.
The Parliamentary Health Service Ombudsman also said there were "very serious" patient safety issues at University Hospitals Birmingham (UHB).
Criticism is contained in letters seen by the BBC between the ombudsman, the trust and NHS England.
The inquiries, commissioned by the Birmingham and Solihull Integrated Care Board and the local NHS, were begun in response to an investigation by BBC Newsnight and BBC West Midlands which heard from current and former clinicians from the trust, who accused it of being "mafia-like".
One of England's biggest hospital trusts, UHB has been in the spotlight for months after three probes were started following allegations doctors there were threatened for raising safety concerns.
The trust denies this and says its "first priority is patient safety".
The ombudsman, however, said he was sceptical about the reviews' transparency and independence.
His finding of "very serious" patient safety issues at UHB is based on the trust's response to the ombudsman's recommendations and findings, including a case of an avoidable patient death.
Source; BBC News, 14 March 2023
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