Leading through reputational crisis under intense public scrutiny

The business’s earlier decision to pursue legal action against the NHS became public in a way that immediately triggered strong emotional reaction. Regardless of legal merit, the idea of a healthcare provider taking the NHS to court cut directly across public sentiment. The reaction was perhaps instinctive rather than logical, driven by headlines rather than the nuance of a complex case.

The scale and visibility of the situation amplified the risk. This was not only unprecedented in public awareness of these kinds of cases involving the NHS (which are actually relatively frequent), but also involved two nationally recognised institutions at a time of heightened political sensitivity, where debates around privatisation, capitalism and public service were particularly charged. The risk was less about logic and more about perception, trust, legitimacy and intent.

For the organisation, the stakes were significant: potential loss of trust with commissioners, political fallout, reputational damage across a wider group brand, and internal impact on staff who identified strongly with NHS values and did not feel ownership over the decision itself. The challenge was to manage intense scrutiny and emotion — externally and internally — while operating within the common tight legal constraints around such situations.

I stepped into the role of Head of Communications shortly before the story broke, inheriting a situation that had necessarily been developed through a legal lens rather than a communications one. My immediate focus was to bring clarity, grip and coherence to a rapidly escalating environment.

Working closely with the CEO, I centralised all messaging and stakeholder engagement, agreeing a clear strategic line and holding it consistently. Given legal restrictions, this meant accepting that we could not explain or contextualise the situation in the way many audiences wanted, and resisting the instinct to over-communicate or rebut emotionally.

To manage volume and protect internal capacity, external media handling was streamlined through a fixed statement and tightly controlled engagement, supported by external resource. This allowed internal communications to take priority, as this was where the biggest impact could be had. The core strategy was staff and shareholder first: engaging openly where possible, explaining the rationale and constraints, and demonstrating that the organisation had control of the situation and was acting with intent rather than reaction.

Shareholder engagement was treated as critical. Maintaining trust and alignment at that level helped the shareholder’s team to do their job, to manage the wider brand ecosystem. Internally, communications focused on acknowledging emotion, reinforcing values, and helping people – particularly leadership – separate noise from impact, recognising that some criticism was loud but inconsequential, while other concerns required serious attention.

As the situation evolved, I led discussions about where limited additional context could responsibly be provided, ensuring that any shift in approach was deliberate, agreed and aligned across leadership.

• Reputational impact was contained. Despite sustained scrutiny, the organisation continued to operate, retained commissioner relationships, and subsequently re-won contracts — demonstrating that trust had been preserved where it mattered most.

• Internal confidence was stabilised. Staff concerns around values, pride and personal reputation were acknowledged and addressed, helping teams continue to operate effectively within the wider health system.

• Shareholder trust was rebuilt. Close, transparent engagement enabled constructive working relationships to be maintained, even in the context of disagreement and disappointment around the outcome.

• Operational focus was protected. By managing volume and noise deliberately, leadership attention remained on business continuity rather than being consumed by reactive response.

• Communications leadership was strengthened. The experience reinforced the value of calm, disciplined communications under pressure, shaping a leadership approach grounded in judgement, prioritisation and perspective.

• Longer-term confidence recovered. While recruitment was affected in the short term, sustained employer brand and marketing investment helped restore momentum over time.