Doctors more trusted than NHS managers

By Dan Wood | Published: 8 July 2011

It’s certainly not a new finding, but pollsters Ipsos MORI have produced a useful reminder of the value of clinical voices in NHS communications.

Their annual Veracity Index measures the public’s trust in a number of professions and has been running since 1983. In this time doctors have always been top of the index, with 88% of people this year saying that they trust doctors to always tell the truth. This compares with only 40% who say they trust NHS managers to always tell the truth.

Quite simply, messages from NHS organisations are more likely to be believed by the public if they come from or are endorsed by clinicians. Something we’ve all known for a long time, but don’t always act on.

At least NHS managers can console themselves that they are more trusted than politicians. They are only trusted to tell the truth by 14% of the public. The trust differential between doctors and politicians is significant, as Andrew Lansley has discovered at great cost in recent months.

See the full computer tables in Ipsos MORI’s Veracity Index for the data on NHS managers.

Leave a comment

Health reforms offer opportunity to improve comms

By Dan Wood | Published: 15 April 2011

Here’s my latest PR Week column for the CIPR Local Public Services Group Committee.  Originally published by PR Week, it is reproduced here with kind permission of  Haymarket Media.

NHS communicators have their hands full. While grappling with the structural changes of the government’s reforms, they also need to help deliver £15-20bn of savings over the next few years.

 

At the time of writing, the government is announcing plans to pause the progress of the Health Bill (until after the local elections, conveniently) for a ‘listening exercise’. But this will offer no respite for NHS comms leads.

 

HS communicators HS communicators.

Regardless of the state of the public finances, NHS spending cannot continue increasing as it has in previous years. A growing and aging population, living with more long term conditions, has meant that the NHS needs massive funding increases every year just to stand still.

 

Separate from the government’s reforms, the NHS has been identifying ways to provide services more cost effectively while improving outcomes for patients at the same time. These changes need to be implemented urgently and on a large scale.

 

The problem for NHS communicators is that, although there are examples of how this can be done, it sounds counter intuitive. For example, while people can see and feel reassured by their local hospital, they don’t notice the team of community nurses helping patients to enjoy healthier lives at home. Any shift in services from hospitals to the community is perceived as a cut, even though it can result in better health for local people and frees up funding for other services.

 

With public satisfaction in the NHS at an all-time high, the public don’t see the need for change. And with everything viewed through the current prism of public sector cuts, it is not surprising that any changes to the NHS are perceived the same way and met with fierce resistance.

 

The challenge is to navigate through all this to develop local narratives that reassure the public, build the support of stakeholders and engage staff. Getting staff on board is crucial as they not only need to make the changes happen, they are also the most effective communications channels the NHS has with its patients and the public.

 

While the government’s reform plans may feel like an unwelcome distraction, they do offer some potential opportunities that might make the task easier.

 

Firstly, as GPs become more responsible for the NHS budget and local decision making, they will need to lead the public debate about change. This puts the voice of clinicians at the heart of the discussion, so often lacking in the past.

 

With doctors regularly topping the list of the most trusted professions (and ‘bureaucrats’ near the bottom) they can make a big difference to public support. Emerging GP leaders need to be helped to understand their public role and to develop their channels for local engagement.

 

Secondly, proposals for increasing local authority and councillor involvement through health and well-being boards could help bring local stakeholders together in a partnership based on the joint ownership of problems, rather than a relationship based on scrutiny. This could deliver much more effective engagement with local people and help stem a common source of local opposition to change.

 

None of this will be easy and there has never been a greater need for senior communications expertise at the top table across the NHS. But, amongst the challenges, there are opportunities to communicate and engage more effectively and to help deliver a better NHS.

 

The CIPR Health & Medical and Local Public Services Groups are co-hosting an evening for local government and health communicators to meet and discuss public health communications in the new NHS landscape on Thursday 12th May from 6pm at CIPR headquarters. Contact Spink Health for more information, tel. 01444 811099, email sophie@spinkhealth.com.

 

Leave a comment

CIPR event: Public health communications in a ‘new’ NHS environment

By Dan Wood | Published: 15 April 2011

12 May, 6pm, CIPR HQ

The CIPR Local Public Services Health and Medical and Groups are co-hosting an evening for local government and health communicators to meet and discuss how they might work together, with emerging GP consortia, to deliver effective communications strategies and improved public health outcomes.

Free to CIPR members, £25 to non-members, for more details see: bit.ly/ffSZ4r

Leave a comment

A tale of two conferences

By Dan Wood | Published: 26 October 2010

Public sector communicators met in Brighton last week for the CIPR local public services conference. At the same time, in a conference hall in Birmingham, Andrew Lansley gave GPs a tricky communications challenge – to which I shall return later.

The brilliant sunshine wasn’t enough to lift the spirits of local authority communicators in Brighton. They began gathering on Wednesday afternoon, shortly after George Osborne had finished announcing cuts of 26% to the local government grant in the comprehensive spending review.

The handful of NHS communicators at the conference had no more reason to be cheerful, despite the government sticking to its pre-election commitment to protect NHS spending. With PCTs and SHAs axed in the move to GP commissioning, and interim reductions in management costs of a third to be found by next year, redundancy notices will be flying before Christmas. All against a backdrop of continuing uncertainty about what comms will look like in the new NHS of the White Paper.

There was much discussion around whether cuts should best be managed by creating unified communications functions working across a range of public services in a location; much smaller teams, with much more work outsourced as and when needed; or middle-sized teams where all specialisms are covered in house. And the questions were underpinned by the perennial points about proving our worth and ensuring a seat at the top table, both reinforced by speakers Alastair Campbell and Paul Mylrea.

There was an interesting presentation from Tom Stannard, Director of Policy and Communications at Blackburn with Darwin Council. You may recall hearing that they were the first council to combine with the local PCT, sharing a chief executive and a merged comms team.

The merged comms team claims some impressive results, having achieved significant cost savings and delivered creative and effective public health and safety campaigns. But there was something missing for me. There’s much more to local NHS comms than public information campaigns and the leaflets in GP surgeries. Although, post-PCTs, it’s difficult to envisage exactly what needs to be done, and by whom. And that’s where Andrew Lansely comes in.

He told GPs at the National Association of Primary Care conference in Birmingham on Friday that the new GP consortia would be responsible for ‘rationing’ services and explaining their decisions to patients. As you can imagine, many GPs aren’t too keen on this idea. Not least because it represents a fundamental shift in their relationship with patients. With NICE, the body that currently decides which treatments the NHS should and shouldn’t provide, becoming known as a ‘death panel’ in the recent US healthcare debate, you can understand their reluctance.

Navigating this challenge effectively is a problem that requires a communications solution. The commissioning consortia, whether they like it or not, will need to develop a corporate voice, work to build trust, engage with local people to involve them in decision making and leverage relationships with stakeholders to generate support. Unless they get this right from the start, they will face a relentless series of criticisms that will whittle away their reputations.

But I’m not sure how many GPs realise this yet. Or whether shared public service comms teams are the right people to help them.

Leave a comment

Lessons learned from successful reconfiguration

By Dan Wood | Published: 6 October 2010

Earlier this year I worked with the East and West Sussex PCTs and Sussex Partnership NHS Foundation Trust on a service reconfiguration consultation, reducing the number of inpatient beds and improving services in the community.

A few weeks ago the local Health Overview and Scrutiny Committees (HOSCs) approved the recommendations that resulted from the consultation, bringing the work to a successful conclusion.

I produced a report setting out how the consultation was approached and delivered and reviewing the lessons learned, with the aim of being a useful document for other organisations looking to consult on service changes.

Key elements of the approach that were felt to have contributed to its success were:

  • Effective and close joint working, with a dedicated lead to co-ordinate across all partners
  • Clinical engagement and leadership, with clinicians fronting the proposals
  • Extensive engagement between commissioning leads and patient / public groups
  • Strong relationships with the HOSCs, involving them as partners throughout.

 The organisations involved were:

  • NHS East Sussex Downs & Weald
  • NHS Hastings & Rother
  • NHS West Sussex
  • Sussex Partnership NHS Foundation Trust

Names of those involved are included in the report if you want to get in touch with any of us for more information.

Leave a comment

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.

Leave a comment

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.

Leave a comment

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.

Leave a comment

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.

Leave a comment

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!?
Leave a comment

  • Recent blog posts

  • Tags

  • Categories

  • Blog archive