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It appears that Baroness Dido Harding’s relatively brief but intense stint in NHS leadership is coming to an end.

HSJ revealed today that once she has served out a four-year term as NHS Improvement chair in October, and having become something of a pantomime villain for her role heading Test and Trace during covid, she will not be seeking reappointment.

While working as an extremely executive chair of T&T, it dawned on Baroness Harding, a former senior business executive including as TalkTalk chief executive, that she didn’t really much like being a chair after all.

So she applied (very publicly) to become NHS England chief executive, yet was knocked out even before the final round – perhaps, it has been speculated, because Sajid Javid, the new health and social care secretary, did not champion her as his predecessor might have done.

The Conservative peer refused to give up her party whip when Jeremy Hunt appointed her to NHSI in 2017, and her arrival attracted widespread scepticism, along with political criticism. But she impressed more NHS leaders than was expected, bringing very energetic but also inclusive leadership to work on an NHS people plan. Sadly she hasn’t also been able to bring with it the necessary funding for training.

She knocked heads together to knock NHSI together with NHS England. This included the departures of two of their most senior executives, Ian Dalton and Matthew Swindells. That paved the way for the recruitment of Amanda Pritchard, and by all accounts the joint NHSE/I top team was working much better than it had before (then Ms Pritchard went on to beat the baroness to the NHSE chief crown).

Covid changed everything, with Baroness Harding going to lead Test and Trace in May and soaking up titanic levels of criticism – some justified but not all for what was a task no one wanted – along with much unpleasant abuse. There were also major tensions between T&T and NHSE/I, as well as other parts of the health service.

NHS England gets a statutory makeover in April next year, formally merging with NHSI. The term of Lord David Prior, current NHSE chair, terminates next year. If the post of NHSE chair is advertised, Baroness Harding could in theory throw her hat back in the ring, but this is now thought to be terribly unlikely.

One, two, three

The landscape of the NHS in Sussex is likely to look very different by this time next year compared to where it was in March.

A new megatrust – University Hospitals Sussex Foundation Trust – was formed in April from the merger of Brighton and Sussex University Hospitals Trust and Western Sussex Hospitals FT. Now it seems likely that the tiny Queen Victoria Hospital FT will merge as well after the boards of the two organisations agreed to work on a full business case.

Governors at the QVH are expected to battle to maintain its independence but it would be surprising if they succeeded – despite them appearing to have the upper hand, with legislation requiring mergers and acquisitions to be approved by the council of governors.

This will leave just two acute trusts in Sussex – East Sussex Healthcare Trust is the other – and Surrey and Sussex Healthcare Trust serving communities in the north, such as Crawley. Sussex as a whole has a population nudging 2 million but is split between three top tier local authorities and three clinical commissioning groups, with a single integrated care system holding it all together.

Three or four years ago this was a health system causing regular palpitations at the centre, with trusts facing financial and quality issues and no sense that there was a shared vision for the future. That vision now seems to be clearer but details of what it could mean for individual services is still to come.