This week NHS communicators have been getting to grips with Equity and excellence: Liberating the NHS, the government’s NHS white paper.
The writing was on the wall for SHAs, and it was obvious that the number, size and role of PCTs was going to reduce. But there is shock over the news that PCTs will cease to exist at all. PCT and SHA comms leads I’ve been speaking to have been grappling with trying to brief staff in the absence of much detail, while trying to make sense of the personal and professional impact the changes will have on them and their teams.
PCTs and SHAs have a massive job on their hands. They need to now implement the changes, alongside delivery of the QIPP plans so crucial to ensure the NHS remains sustainable. To do this, they will need to maintain focus and morale against a backdrop of huge personal uncertainty for staff.
Many of the aims and aspirations of the white paper are laudable: greater patient empowerment (‘nothing about me without me’); a focus on outcomes; and greater integration with local authorities. But, as always, the devil is in the detail. There is a long way to go before it becomes clear where the changes will take us and how we will get there.
For communications, the future is very unclear. There are big questions that will need to be addressed. Two immediate ones come to mind:
1) Who manages the reputation of the NHS?
The growing professionalism and capacity of NHS communications over recent years has contributed to greater public satisfaction and confidence in the service. Explicit in World Class Commissioning was the PCT’s role as the local leader of the NHS, responsible for managing the reputation of the health service in each health economy. But without PCTs, where does that role sit?
Will GP consortia take it on and, if so, will they have the necessary skills? Will it be the responsibility of the national commissioning board or one of its regional entities? Is that realistic, given that we know localised communications are more trusted and effective than national or regional messages?
Providers will continue to manage their own reputation – and increased public data about the success rates of consultants and their teams will throw up opportunities and threats – but who will ensure that this is not at the expense of an NHS competitor down the road?
Getting rid of ‘NHS spin doctors’ is always going to be a popular move. But what government, especially one that campaigned on being the ‘real party of the NHS’, will want to leave the NHS’s reputation unprotected?
2) Who will be responsible for leading engagement on service reconfigurations?
Regardless of how commissioning is organised, there is still a desperate and urgent need to reconfigure some hospital services. PCTs have a statutory obligation to consult now, but who will be responsible for making the case and leading engagement in the future? And what happens in the meantime? With the need to find £15-20bn efficiency savings now, the NHS cannot afford reconfigurations be stalled until new commissioning arrangements are in place.
GPs seem reluctant to take on the role. The BMA is quoted in today’s HSJ as saying GPs would not allow themselves “to be set up to be the bad boys”.
If local authorities are expected to lead engagement they will be on a hiding to nothing. The public don’t trust them to collect their bin often enough as it is, so they’re hardly likely to believe the local authority when they try to explain that shifting services from their local hospital is the right thing to do.
PCTs and SHAs may have their faults, but there is a wealth of expertise and experience among their communicators. In the longer term, the government would be foolish to let this be lost.
Where do reforms leave NHS comms?
This week NHS communicators have been getting to grips with Equity and excellence: Liberating the NHS, the government’s NHS white paper.
The writing was on the wall for SHAs, and it was obvious that the number, size and role of PCTs was going to reduce. But there is shock over the news that PCTs will cease to exist at all. PCT and SHA comms leads I’ve been speaking to have been grappling with trying to brief staff in the absence of much detail, while trying to make sense of the personal and professional impact the changes will have on them and their teams.
PCTs and SHAs have a massive job on their hands. They need to now implement the changes, alongside delivery of the QIPP plans so crucial to ensure the NHS remains sustainable. To do this, they will need to maintain focus and morale against a backdrop of huge personal uncertainty for staff.
Many of the aims and aspirations of the white paper are laudable: greater patient empowerment (‘nothing about me without me’); a focus on outcomes; and greater integration with local authorities. But, as always, the devil is in the detail. There is a long way to go before it becomes clear where the changes will take us and how we will get there.
For communications, the future is very unclear. There are big questions that will need to be addressed. Two immediate ones come to mind:
1) Who manages the reputation of the NHS?
The growing professionalism and capacity of NHS communications over recent years has contributed to greater public satisfaction and confidence in the service. Explicit in World Class Commissioning was the PCT’s role as the local leader of the NHS, responsible for managing the reputation of the health service in each health economy. But without PCTs, where does that role sit?
Will GP consortia take it on and, if so, will they have the necessary skills? Will it be the responsibility of the national commissioning board or one of its regional entities? Is that realistic, given that we know localised communications are more trusted and effective than national or regional messages?
Providers will continue to manage their own reputation – and increased public data about the success rates of consultants and their teams will throw up opportunities and threats – but who will ensure that this is not at the expense of an NHS competitor down the road?
Getting rid of ‘NHS spin doctors’ is always going to be a popular move. But what government, especially one that campaigned on being the ‘real party of the NHS’, will want to leave the NHS’s reputation unprotected?
2) Who will be responsible for leading engagement on service reconfigurations?
Regardless of how commissioning is organised, there is still a desperate and urgent need to reconfigure some hospital services. PCTs have a statutory obligation to consult now, but who will be responsible for making the case and leading engagement in the future? And what happens in the meantime? With the need to find £15-20bn efficiency savings now, the NHS cannot afford reconfigurations be stalled until new commissioning arrangements are in place.
GPs seem reluctant to take on the role. The BMA is quoted in today’s HSJ as saying GPs would not allow themselves “to be set up to be the bad boys”.
If local authorities are expected to lead engagement they will be on a hiding to nothing. The public don’t trust them to collect their bin often enough as it is, so they’re hardly likely to believe the local authority when they try to explain that shifting services from their local hospital is the right thing to do.
PCTs and SHAs may have their faults, but there is a wealth of expertise and experience among their communicators. In the longer term, the government would be foolish to let this be lost.