GMMH’s latest Stakeholder Bulletin (June 2026) opens with Chief Executive Karen Howell reflecting on her retirement after 47 years in the NHS. She writes with pride about the progress made during her time at the Trust and asks colleagues and stakeholders to support her successor, Chris Oliver, in continuing that journey.
No one doubts the commitment Karen Howell brought to the role. But the reality is that she simply wasn’t in post long enough to demonstrate whether the profound cultural changes GMMH requires have truly taken root.
The challenges facing the Trust were never going to be resolved in a matter of months. Years of organisational failure, exposed through independent reviews and the experiences of patients, carers and bereaved families, demand sustained leadership over many years—not just the introduction of new programmes and positive messages.
There are signs of progress, and staff deserve credit for the improvements that have been made. But trust is earned over time, through consistent openness, accountability and safer care—not through stakeholder bulletins or farewell reflections.
Karen Howell asks staff and stakeholders to give the same support to her successor, Chris Oliver.
It is an upbeat farewell.
But it is only one account of her time as Chief Executive.
Many patients, carers and bereaved families will remember a very different period—one marked by independent reviews, failures in care, repeated concerns about openness, and years spent fighting to have their voices heard.
That history cannot simply be closed by a retirement message.
NHS England has recognised improvements, staff have worked tirelessly, and there are encouraging developments across many services. These achievements deserve recognition.
Yet progress is not the same as trust.
The real legacy of any Chief Executive is not measured by awards, strategies or stakeholder bulletins. It is measured by whether patients are safer, whether families are treated as partners, whether concerns are welcomed rather than resisted, and whether the organisation is open when things go wrong.
Chris Oliver inherits an organisation that has undoubtedly improved, but one that still has work to do to rebuild public confidence.
His greatest challenge will not be introducing new initiatives.
Chris Oliver’s challenge is that he inherits an organisation that has begun an important journey but has not yet reached its destination. His success will not be judged by how well GMMH tells its own story, but by whether patients, carers and families begin to experience a genuinely different culture—one where concerns are welcomed, mistakes are acknowledged, and accountability is seen as a strength rather than a threat.
It will be demonstrating that GMMH has embraced a culture where accountability matters as much as performance, transparency matters as much as reputation, and families no longer have to fight to be heard.
That—not the tone of a farewell message—will determine whether this leadership transition represents a genuine new chapter.
Only then will GMMH be able to say that lasting change has been achieved.
One thing I would add to this discussion is that, for me, organisational culture is often revealed not when things are going well, but when someone asks difficult questions, raises concerns or challenges decisions. Those moments provide the clearest indication of whether openness, transparency and accountability are genuinely embedded, or whether there is still more work to do.
Over the last 24 years, I’ve had the privilege of working alongside NHS organisations in a range of public involvement, co-production, education, research and governance roles. During that time, I’ve seen some excellent examples of organisations embracing lived experience and using challenge as an opportunity to learn. I’ve also seen occasions where concerns have been more difficult to navigate.
One lesson I’ve taken from that experience is the importance of how organisations scope their reviews and investigations. If concerns are viewed only in isolation, or the focus becomes resolving the immediate issue rather than asking whether it reflects something wider, there is a risk that opportunities for organisational learning are missed. By contrast, organisations that are prepared to broaden the scope of inquiry where appropriate, welcome constructive challenge and examine uncomfortable evidence are far more likely to build lasting public confidence.
Those reflections aren’t just theoretical for me. They have also been shaped by my own experiences over the past few years as a public contributor living in Blackburn, engaging with NHS organisations on questions of governance, transparency and lived experience. Some of those matters remain ongoing through formal processes, so it would be neither appropriate nor fair for me to discuss them in detail at this stage.
What I can say is that those experiences have reinforced my belief that accountability, openness and meaningful scrutiny are not obstacles to improvement—they are essential ingredients of it. Where concerns are fully explored, difficult questions are answered and organisations are willing to learn from uncomfortable experiences, trust has the opportunity to grow. Where questions remain unresolved, rebuilding confidence inevitably takes longer.
Once those processes have concluded, I hope to be able to speak more openly about my own experiences, supported by documentary evidence and the facts available at that time. My intention will not be to revisit old disputes or criticise individuals, but to share lessons that may help prevent similar situations from arising in the future. If those lessons contribute, even in a small way, to creating a culture where patients, carers, staff and public contributors feel genuinely listened to, where concerns are welcomed rather than feared, and where accountability is recognised as a strength rather than a threat, then I believe that will have been worthwhile.
Ultimately, lasting cultural change isn’t demonstrated by stakeholder bulletins or farewell messages. It’s demonstrated when people can raise concerns without fear, when organisations are willing to look beyond the narrowest interpretation of an issue to understand whether wider learning exists, and when transparency, accountability and compassion are valued just as highly as performance. For me, that is the standard every NHS organisation should aspire to, not because perfection is possible, but because continuous learning and openness are the foundations on which public trust is built.
Perhaps this provides an early and very practical test for GMMH’s new Chief Executive, Chris Oliver.
When I commented here in July following his appointment, I suggested that organisational culture is often revealed most clearly by what happens when difficult questions are asked.
Complaints provide exactly such a test.
I have personal experience of unresolved NHS correspondence involving Mr Oliver from his previous Chief Executive role, including matters in which he had direct involvement. Some straightforward questions remain unanswered.
I therefore hope his arrival at GMMH brings a very clear commitment: that difficult correspondence will not simply be allowed to reach a dead end, particularly where senior executives themselves have been involved.
CHARM’s questions provide an excellent starting point. How many complaints remain outstanding? How old are they? Who sees that information? What does the Board do when cases become seriously overdue? And who holds the Chief Executive to account when the concern involves executive leadership itself?
Publishing those answers would be a relatively simple way for a new Chief Executive to demonstrate from the outset that transparency and accountability are going to mean something in practice.