Warring between two surgeons at Great Ormond Street Hospital could put patients at risk, a review suggests.
A board paper released by the leading children's hospital said a "fractured" relationship between two consultants in the paediatric surgical urology team was affecting the service last year.
It said the problems had an impact on the whole team, creating the potential for longer waits for sick children.
The London hospital said steps were being taken to resolve the problems.
This has included mediation and mentoring.
Great Ormond Street said it took the issue "extremely seriously".
The surgical urology team treats more than 3,000 children a year from all over the country, operating on everything from kidney to bladder problems.
'Lack of trust and respect'
The board paper from a meeting in November set out the findings of a two-day inspection by the Royal College of Surgeons last May.
The college was invited in by the trust itself after reports of problems.
The summary of the report said there were "significant difficulties" between two surgeons in the team.
It described a "lack of trust and respect" which meant they did not work collaboratively and led to significant competition for work.
If this continued it would have the "potential to affect patient care and safety" as well as longer waits for surgery, it said.
'Dysfunction' affected whole team
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