Leading through reputational crisis under intense public scrutiny

A legal dispute involving the NHS had gone public — not through a press release or a planned announcement, but because a journalist spotted a reference buried in the accounts of a public body. Regardless of the merits, the optics were brutal: a private healthcare provider taking the country’s most trusted institution to court, at the height of the privatisation debate. Cases like this are actually relatively frequent, but this one landed differently — two nationally recognised names, at a moment of heightened political sensitivity.

The stakes were significant: commissioner trust, political fallout, group brand reputation, and internal confidence among staff who identified strongly with NHS values but had no ownership of the decision. The challenge was to manage intense scrutiny — externally and internally — while operating within tight legal constraints on what we could actually say.

I’d been in the role for a matter of weeks when this landed. My introduction to senior leadership was defending an organisation in a dispute involving the NHS — the country’s most trusted institution — in the middle of a politically charged debate about privatisation. It was, to put it mildly, not a gentle start.

The hardest part wasn’t the media. It was the gap between what had actually happened and what was being said. The story became a magnet for everyone with a view on private companies in the NHS, and the facts got lost in the noise. We had legal constraints on what we could say, which meant watching a narrative run away from us and knowing that responding would only make it worse.

Working closely with the CEO, I centralised messaging and stakeholder engagement, agreed a clear line, and held it — even when the instinct was to rebut, correct, or defend. The strategy was staff and shareholder first. External media was managed through a fixed statement and tightly controlled engagement; internal communications took priority, because that was where we could actually make a difference.

Inside the organisation, the focus was on acknowledging emotion without amplifying it, reinforcing values, and helping people — particularly leadership — separate the noise from what actually mattered. Some criticism was loud but meaningless. Other concerns needed real attention. Knowing the difference was most of the job.

As things evolved, I led discussions about where we could responsibly say more, making sure any shift was deliberate, agreed, and wouldn’t create new problems. The goal throughout was to protect trust, maintain credibility, and keep moving forward without making things worse.

• We contained the reputational damage. Despite sustained scrutiny, the organisation kept operating, retained commissioner relationships, and re-won contracts. Trust was preserved where it mattered most.
• We stabilised internal confidence. Staff concerns around values, pride and personal reputation were acknowledged and addressed. Teams continued to operate effectively within the wider health system.
• We rebuilt shareholder trust. Close, transparent engagement maintained constructive working relationships, even in the context of disagreement and disappointment around the outcome.
• We protected operational focus. By managing volume and noise deliberately, leadership attention stayed on business continuity rather than being consumed by reactive response.
• We eventually said more. When the moment was right, I led the push to put more context on the record. That conversation went all the way to the top — the man at the very top — and the decision to speak more openly helped close the chapter.
• Longer-term confidence recovered. Recruitment was affected in the short term, but sustained employer brand and marketing investment restored momentum over time.