Tangled web of NHS online

By Dan Wood | Published: 12 August 2010

Last week’s HSJ reported on a leaked research report for a Department of Health review of NHS websites.  For those of you with an HSJ subscription, you can read about it here. For those of you without, it said, in summary, that the NHS spends around £85m a year on thousands of websites that are often hard to find, badly designed and not wanted by the public.  It claimed that the failings in the NHS digital estate could be undermining the reputation of the NHS brand.

I don’t think the findings are particularly surprising.  The report had found 4,121 nhs,uk websites – nearly twice as many sites as there are NHS organisations.  While there are very good NHS websites out there, my sense is that too few are developed with a clear purpose, target audience or consideration of how, from a visitor’s perspective, they will fit alongside the multitude of other NHS sites.

Websites for projects and initiatives are often set up as a substitute for – rather than a result of – a considered communications strategy.  Many have niche subject matter and narrow audiences that could be engaged more effectively (and cost effectively) through other channels.  

With no clear purpose for many sites, it is not surprising that the report’s authors found performance data difficult to obtain.  But the potential return on investment from websites is huge.  I blogged in March about some research on council websites published by SOCITM (the Society of IT managers) that suggested the cost of dealing with a resident’s query face-to-face was £8.23 compared to £3.21 by phone, but just 39p online.  

Perhaps most worrying was the report’s finding that GPs – the group responsible for engaging people in commissioning in the new world – have the worst online presence.

We need to move beyond websites as vanity publishing for pet projects and repositories for board papers and compliance statements. We must develop and value our online assets as purposeful tools for helping us to do business and protecting our reputation.

This means making sure all websites are overseen, if not owned, by communications teams and that they are aligned with corporate communications objectives and strategies.

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Where do reforms leave NHS comms?

By Dan Wood | Published: 15 July 2010

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.

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Can sponsorship offset comms cuts?

By Dan Wood | Published: 17 June 2010

A headline on PRWeek.com caught my eye today: Public sector needs private help to offset cutbacks.  The gist of it was that £1bn of private sector sponsorship will be sought to support marketing and public relations for British tourism around the 2012 Olympics.

Frustratingly, the article didn’t really elaborate on the headline, and neither did the press notice on the Department of Culture Media and Sport website shed any light on how this might work.  But it got me thinking about the potential of sponsorship to help fund public sector comms as we face a period of serious belt-tightening.

The Government’s Change 4 Life campaign to tackle rising obesity has had massive private support, with big-name brands such as Asda, Flora, Tesco and Unilever getting behind it.  But they aren’t sponsors in the true sense.  They have supported the Change for Life movement once it launched, rather than provided direct funding to the campaign and shaped its development.

The 2004 joint British Heart Foundation and NHS stop-smoking adverts were an example of the private sector pooling resources with a partner – albeit a charity rather than a corporate – on a campaign.  There were benefits to the message coming from a respected charity as well as the NHS, although in this instance I think the lion’s share of the funding came from the NHS.

The signals coming from the new administration suggest we won’t see any more large-scale government-funded health promotion campaigns for a while.  But it is not difficult to imagine such campaigns being funded by the private sector.  A safe-sex campaign funded by a condom manufacturer but leveraging the trust and the NHS brand as well, perhaps?  Or a nicotine replacement product sponsoring a stop-smoking campaign? 

And the opportunities aren’t limited to public health: Think road safety messages, early-reading and climate change campaigns, and so on.  Equally, sponsorship needn’t be for large scale campaigns.  I was working with a foundation trust recently which was seeking sponsorship to cover the cost of its members newsletter.  It’s simple, but many more organisations could be doing it.

I saw an ad on TV recently that gave the impression it was a public health message, directing viewers to a website for help and advice on quitting smoking, which was in fact from a nicotine replacement product.  I’m sure they would have loved to be able to use the NHS brand in their campaign.

And brand is the crux of the issue.  Public sector brands must be careful not to be seen to be giving unfair advantage to one product over another in a competitive marketplace. But where there are powerful public sector brands, such as the NHS, it seems daft not to leverage all the value they have, to achieve their aims, when hard cash is so hard to come by.

Brand-fit is an important factor in any sponsorship.  For every brand that would like to have some of the trust and respectability of the NHS brand rub-off on its own, there is another that would run a mile from the NHS’s perceived failings and ‘nannying’.

When I headed the NHS brand management team at the Department of Health, we carried out some research and published some useful guidance on communications partnerships.  The most important elements for success are having clearly agreed joint objectives from the start and that all important ‘brand-fit’. 

The research showed that people have a ‘gut reaction’ of either comfort or discomfort when they see the NHS in partnership with another organisation based on a number of factors, the most important being how well they think the partner’s business and brand values fit with those of the NHS.  If there was any mismatch between what the NHS and the partner do and stand for, audiences are likely to either question the partnership or reject the communication. So tobacco companies and fast food brads wouldn’t work, but sportswear brands or brands with the appropriate values of care and compassion would.

Then, of course, come the risks of any partnership and the potential loss of control and impact on reputation when you work with any third party.  But the benefits of such partnerships could be well worth it as we seek to carry on delivering vital communications campaigns with far fewer resources to support us.

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NHS needs new approach to consultation

By Dan Wood | Published: 9 May 2010

Expect a spate of announcements of reviews, reorganisations and reconfigurations this week as NHS organisations get on with plans for releasing savings that they have had to keep under wraps during election purdah.

Campaigns obligatory for prospective MPs

Many in the NHS have been looking forward to the end of campaigning.  Whatever the outcome, we know the scale of the economic challenge.  The end of election purdah means we can get on with setting out some of the changes that will be necessary.

But, regardless of which party may have the best policies, this hung (sorry, balanced) parliament is undoubtedly the worst result for the NHS.

Not only does the lack of a clear way forward mean that some elements of purdah remain in place – with the NHS still unable to make major decisions that might be impacted by the policies of the new government, for example, A&E and maternity reconfigurations or capital investment plans – it also means we’re likely to have another election sooner rather than later.  This means parliamentary candidates once again ramping up their obligatory ‘save our local hospital’ campaigns.

A survey of parliamentary candidates carried out by the Health Service Journal (HSJ) and published this week showed that 34% of respondents from the main three parties said that they would never support the closure of an A&E in their constituency ‘under any circumstances’.  So, with too many A&E departments, and the need for dramatic and urgent efficiency savings, the NHS has a tough job on its hands. Further party political campaigning isn’t going to make it any easier.  So what is?

In order to make the changes that are needed, the NHS needs to shift the way it approaches consultation and there need to be changes to the rules governing consultations.

Jeremy Taylor, chief executive of National Voices, a coalition of patient campaign groups, has written in the HSJ this week (here for those of you with a subscription) that the NHS needs to get better at involving local people in reconfigurations.  His group recognises that closures are not just necessary, they can lead to better care for patients, but he argues that the NHS does not have a good track record of making the case for change.  He is right.

Too often the NHS produces a jargon-laden document, defends its proposals at a few public meetings, and then sits tight for 12 weeks before carrying on as planned.

But successful change needs ongoing engagement.  This is, after all, what commissioning is all about.  PCTs I am working with are finding commissioner-led ongoing discussions with local patient, public and stakeholder groups invaluable in finding the best options, creating understanding, smoothing the passage of consultation and generating ideas for further improvements.

Providers are also finding internal engagement equally important.  Involving staff in future service models is not just generating clinical engagement; it is the only way to find the best service models.

With stakeholders understanding, if not fully on board, and with clinicians at the heart of these consultations, the public are reassured and politicians more measured in their involvement.

In addition, while ‘fast track’ is not the right term, we do need a system that encourages overview and scrutiny committees (OSCs) to act as partners in finding solutions, rather than as defenders of the status quo.

Changing the NHS approach and the role of OSCs may not make consultations quicker, but it would cut the wasted time, expense and reputational cost of failed consultations that get referred for review.

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Twitter doesn’t end careers; bad judgement does

By Dan Wood | Published: 10 April 2010

Gosh! How exciting!  Twitter has claimed its first scalp in the internet election!

Stewart MacLennan was sacked as Labour parliamentary candidate for Moray in Scotland after his Twitter feed was found to be full of offensive and abusive comments. 

As you can image, the media are very excited about this.  After telling us all how this is the ‘internet election’ and its going to won and lost on Twitter, they can barely contain themselves now that they can shriek ‘Told you so!’ already.

But having read some of his tweets in the papers, today I’m struck by three things:

  1. What he said in many of his posts really isn’t that bad.  They’re dripping with sarcasm and reflect things that many people would say to each other down the pub.  Comedians get paid for saying things like that.
  2. However, he’s not a comedian.  The fact he posted them, given that he wants to run for parliament, shows he has very poor judgment, or is just plain stupid.
  3. For me, the most shocking aspect is that he actually bothered to post the vast majority of his comments.  They are so banal.  What a waste of his thumbs and the internet.  Who cares what he thinks about Jedward? That he is sat opposite an ‘old bag’ on the train? Or that his banana isn’t very tasty!?
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The ‘internet election’ begins

By Dan Wood | Published: 6 April 2010

The election has been announced. A May 6 election has been expected for so long it hardly seems newsworthy.  But the tightness in the polls and high number of floating voters means the outcome is far from certain.  It promises to be a close and hard fought campaign.

I’ve lost count of how often I’ve heard it described as our first ‘internet election’.  As I’ve said here before, I don’t think we’ll see anything like the levels of sophistication in the use of social media that we did during Obama’s campaign in the US. 

However, there is no doubt that the digital media landscape is unrecognisable to what it was during the last general election.  Civil servants and government communicators leafing through the election guidance issued by the Cabinet Office this afternoon might have noticed that the section on digital media is much changed since 2005.

The document, revised and re-issued at each election, sets out the appropriate conduct of government business to ensure impartiality during the campaign.  Back in 2005, in a section simply titled ‘The Internet’ (how quaint!), it was advised that “webmasters must take particular care” because “official websites are a form of broadcasting… and will be closely monitored by the news media and the political parties”.  It said that “Interactive functions such as discussion groups which allow the public posting of comment or debate should be suspended.”

How things have changed.  In the 2010 guidance, the section on ‘Digital media’ covers websites, social networking and Twitter.  Far from calling for interaction to be suspended, the guidance now recommends that official participation in social media is simply limited during the election campaign to operational (rather than policy) matters and signposting users to existing content.

Public servants whose jobs take them online will be wise to take care during the election campaign.  I certainly don’t think this election is going to be won or lost in cyberspace, but social media is playing a part and politicians, the media and communicators are all finding themselves in new territory.

Take, for example, the Tories recent series of poster campaigns.  No­-one predicted how easily they would be spoofed and mocked; the sheer number of people with a little knowledge of Microsoft Paint and a little too much time on their hands; and the speed with which the spoofs would be circulating and being picked up by the mainstream media.   

The latest Tory posters show they’ve learned from this and are working on ‘spoof-proofing’.  A simple font on a plain background is far too easy for a spoofer to replace with their own witticisms.  In the latest poster, by wrapping the words around the front of the boots in the image, the number of spoofers will be limited to those with the necessary software, design skills and inclination to replace them.

We’re all learning as we go along.  We’re yet to see how the parties will respond to the inevitable gaffe posted on You Tube, or a video from the leader’s debates with an amusing alternative soundtrack dubbed over the top.  The 6 O’clock news is still important, but controlling what they’ll be talking about on the 6 O’clock news isn’t so straightforward any more. 

After so many years of ever-tightening media control by the political parties, it suddenly feels very different.  It might not be pretty, but it’s going to be fascinating to watch it unfold over the next four weeks.

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Council websites miss a trick

By Dan Wood | Published: 11 March 2010

I like IT managers.  Not something you hear very often.  Certainly not in any organisation I’ve ever worked in.

But, hot on the heels of their report about the potential benefits of social media, Socitm, the society for public sector IT managers, is now urging councils to make more use of their websites.

Their annual Better Connected survey of over 400 council websites shows that just 39 per cent of council websites gave enough information to answer visitors’ questions, while only 61 per cent could be relied upon to be up-to-date.

My new friends at Socitm also did some maths and worked out that the average cost of dealing with a resident’s query face-to-face was £8.23. This compared to £3.21 by phone, but just 39p online.

I’m not quite sure how they got those figures, but I don’t doubt there are massive efficiencies in dealing with people online where appropriate.  And where it is appropriate it is often more convenient for the customer too.  It’s win-win.  But despite this, just four in ten of the websites Socitm surveyed allowed people to pay bills or fines online.

At a time when we’re all looking for ways to do more with less it’s crazy that ways of connecting with people that are so well established in other sectors they’re almost becoming passé are still not the norm in the public sector.

In addition to making common transactions possible online, another simple tactic is to monitor the most common queries received over the phone and make the answers prominent on the website.

Many organisations could also do more to promote their website on printed materials, and particularly on answerphone messages or when callers are on hold. 

I don’t think there is any doubt that we need to grasp the opportunities of online channels to improve communications at the same time as driving efficiency.  But I’m surprised that it is IT managers, rather than comms professionals, that seem to be leading the way.

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New government comms roster

By Dan Wood | Published: 16 February 2010

Interesting news this week that the Department for Children, Schools and Families (DCSF) is looking to set up a roster of creative agencies that all government departments can use.  On the face of it, this would seem to be undermining the role of the COI (Central Office of Information) which has run central government’s comms rosters.

However, the COI has welcomed the move and DCFS seem to be keen to stress that their new roster would ‘complement’ the COI’s.  But how will that work?  With 29 COI rosters, now called ‘frameworks’, covering everything from advertising to media buying, research to evaluation, film and online to events and exhibitions, there don’t seem to be any gaps for DCFS’s roster to fill.

So what is driving this development?  Do DCFS and other departments feel that the COI’s frameworks don’t contain the suppliers they want?  Or perhaps they want to break free from COI’s project management.  On major projects the COI’s expertise and strategic consultancy can add great value to departmental comms teams.  But when a department has a clear idea of exactly what they need and simply want to appoint a supplier with the minimum hassle, sometimes the COI processes can feel a little cumbersome and costly.

Government departments have always had their own rosters and have had arrangements in place for other departments to use them.  But in the last efficiency drive, the Department of Health certainly consolidated many of its own with the COI as a way of avoiding duplicative work.  At a time when efficiency is at the fore more than ever, it seems an odd move to have different bits of government setting up similar rosters.  Although it may be that the departments think they can create savings by providing an alternative to COI’s project management or by tying agencies into lower rates.

The one group who won’t see any efficiencies or savings from this move, however, are the agencies who face having to go through another time consuming procurement exercise to get on the new roster.  It will be interesting to see how this works out.

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Safety first for Election 2010

By Dan Wood | Published: 8 February 2010

There’s an interesting debate emerging among public sector and government comms people about the sense – or otherwise – of personal blogging during election purdah. See Simon Wakeman and Steph Gray’s blogs.

My initial reaction was that pudah – the name given to the period in the run up to an election – should make no difference to public servants for two reasons:

Firstly, the actual purpose of purdah is to prevent the incumbent party from using the machinery of government to get an unfair advantage in the election. It’s a government communicator’s job to promote, explain and defend the government’s policies. But once an election is called they’re no longer the government’s policies, they’re the policies of just one of the parties standing for election. Hence no government publicity campaigns, no big announcements, etc. But personal blogs are not part of the machinery of government, so no problem.

Secondly, the need for public servants (certainly those at any level of seniority or experience) to be unbiased and to serve the administration of the day exists all year round. Purdah should be no different. And I’ve not seen any blogs from public servants that stray over that line.

I’m no longer a civil servant, but I’m still acutely aware that I need to exercise great judgement about what I blog on, particularly if it concerns clients – public sector or private. I offer the very best professional advice to everyone I work with, but maintain a level of professional detachment. Just as today’s opposition could be tomorrow’s government, so could today’s client’s competitors be tomorrow’s client.

So no problem there then – everyone carry on as you were! But Simon and Steph point out that purdah is a particularly sensitive time, and as we gear up for our first election with an established social media, no-one quite knows what the rules are.

I don’t think we’ll see the level of sophistication in the use of social media that we saw in the States with Obama’s campaign, where it was used for massive levels of fundraising and mobilising and coordinating grassroots activists. But there’s no doubt the internet will set the agenda far more than it ever has in any previous election. Social media is perfect for mischief making.

Gaffes will be on you tube before they make the 6 o’clock news, and we’ll see doctored, falsified and made up videos and images circulating. The Tory poster of Cameron and his pledge on the NHS was doctored in all manner of ways and doing the rounds within hours of being published. Some of these images and videos will be amusing, but some will no doubt be very malicious. Anything anyone says has the potential to be spun out of context and the immediacy and lack of verification on the web makes that potentially very dangerous.

So while you can exercise the greatest judgement over your posts and tweets, you can’t be sure who is following you, and how they are using what you put out there. I think Simon and Steph are right to exercise caution, no one will want to be the first social media casualty of Election 2010.

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IT managers see social media benefits

By Dan Wood | Published: 31 January 2010

In one of my first blog posts, back in July last year, I bemoaned the negative attitudes towards social media displayed by so many public sector organisations.

Public organisations are so well placed to benefit from the ability of social media to help increase their accountability and engage with their various publics, yet many seem to dig their heels in.  In my experience the resistance comes most often from IT managers.

So I noted with interest a recent report from Socitm, the society of public sector IT managers, calling for its members to lead their organisations in embracing social media.

The report found that many councils currently take a cautious view of social media, with some 90% restricting access in some way. Two thirds have a total ban on staff use of social media, enforced either through policy or by a software block.

In contrast, the report points out, a survey by Reed suggests only 20% of private organisations block access.

The report argues, quite rightly, that social media may help address looming budget issues by providing economical ways of engaging citizens, delivering services, and by empowering and supporting employees.

So, if you’re struggling to implement an enlightened social media strategy in your organisation, you may want to deploy this report as another weapon in your armoury.

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