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Dido Harding, NHS Improvement: “I’m shocked at the lack of basic people management skills in the NHS”

BMJ 2018; 361 doi: (Published 18 June 2018) Cite this as: BMJ 2018;361:k2657
  1. Tom Moberly, UK editor, The BMJ
  1. tmoberly{at}

Better leadership training in the NHS would increase staff engagement and tackle bullying, the chair of the NHS trust regulator tells Tom Moberly

Since she joined watchdog NHS Improvement as chair in October 2017, Dido Harding has been struck by the ways in which the health service falls short in the treatment of its staff. “I am quite shocked at the lack of some of the basics of people management that I would expect to see,” she says.

“That’s not to say that there are not pockets of complete brilliance—of course. there are. I’ve seen examples of some of the best people management and leadership I’ve ever seen. But it is unbelievably inconsistent.”

Harding joined NHS Improvement, which regulates NHS trusts in England, after a string of senior jobs in the private sector, most recently as chief executive of telecoms company Talk Talk. Speaking at the Health Foundation annual event in London on 22 May, she says that, coming into the NHS as an outsider, she can’t get her head around the prevalence of bullying among health service staff.

“It’s awful,” she says. “The percentage of staff saying that they have been a victim of or have witnessed bullying is three, four, fivefold more than you would see in other organisations.”

The high levels of bullying seen in the health service arise, she believes, from shortcomings in management skills across the NHS. “I suspect it’s a real indication of an immaturity in the whole system in what good management looks like,” she says. “Good management isn’t soft and fluffy—good …

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