The Royal Cornwall Hospitals Trust is facing a projected �31m deficit and having to cut up to 300 jobs.

Price Waterhouse Coopers said the trust lacked transparency in its reporting of the scale of cash problems.

The report also called into question the role of board members and managers. The trust said it accepted the report and was trying to balance its finances.

The causes of the overspending are now well understood Royal Cornwall Hospitals Trust

The report said risks were not monitored or tracked and the financial outlook deteriorated rapidly. It said that stronger leadership was needed.

The finance committee in particular was singled out as failing to cover significant issues and questions were raised about whether the trust board and managers had the necessary skills to deal with problems.

The report also said a change in culture was needed if changes were to be effective.

The trust is currently working on a turnaround plan, but up to hundreds of jobs and some services will have to go.

The Royal Cornwall Hospitals Trust said its financial position had been well publicised and no attempt had been made to deny responsibility on any aspect of it.

The trust said: "The causes of the overspending are now well understood. The board has fully accepted the recommendations in the report and its responses are set out in the action plan which will be closely monitored by the trust in partnership with the Strategic Health Authority."