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I thought bullying was being clamped down on in the NHS or perhaps the Shelford group hadn't heard. There is no doubt that specialist services cost more and this is already reflected through tariffs and top ups. However it is also the case that where most DGHs have cut to the bone the Shelford group still has a long way to go in dealing with the waste that most of us have tackled.
Separately there are probably other teaching hospitals that would dispute the use of the word 'leading'.