NHS at 70: Ten difficult conversations for communicators
The latest edition of #FuturePRoof published today explores the role of communication in the NHS. It calls for strong professionals to lead difficult conversations.
The third edition of #FuturePRoof celebrating the NHS at 70, has been developed at a time when the organisation is in crisis. It’s a fact that several of the contributors including former NHS Trust chairman Roy Lilley, are quick to point out.
Arguably everyone in the NHS, from porter to surgeon, and midwife to Trust chairman, works in communications. Every member of staff has a role to play in public engagement. Therein lies one of greatest opportunities for the NHS.
In her analysis upfront #FuturePRoof founder and editor Sarah Hall pulls no punches. There are no easy answers, just tough conversations.
“The NHS is striving hard to modernise as it navigates the through the toughest challenges of a lifetime, challenge that can only be overcome if it embraces an honest dialogue with the public,” she says.
“An aging population with complex health needs, underfunding, political agendas, privatisation, parochial self-interest, healthcare that doesn’t meet quality standards and questions over the type and location of delivery, are just some of the huge questions that its leaders face.”
Sarah has spent the past six months working with a team of academics, journalists, politicians and NHS staff, to arrive at this conclusion. It’s the same model that she used for the first two editions of #FuturePRoof.
But while the model for this third edition may be the same as the first two, that’s where any similarity ends.
#FuturePRoof is a challenging and at times uncomfortable read. There’s widespread recognition that the NHS is on a knife edge. The greatest challenge is not how the NHS is funded but how to have an honest conversation with the public about its future.
There are 25 chapters in the book. Here’s what I learnt about the difficult conversations that need to be had about the future of the NHS.
#1 Drive towards best practice
Best practice campaigns in the NHS are based on planning, data and creativity. Campaigns to address breast feeding, attendance at emergency departments, smoking, and strokes are all described within #FuturePRoof. In each instance they use integrated communications to reach their audiences and are measured, evaluated and developed to secure the best possible outcomes.
Kerry Barron-Beadling, head of communications at SFH NHS Foundation Trust, is among numerous contributors calling on NHS communicators to attribute their campaigns to outcomes.
#2 Technology versus community care
The public is wedded to the notion of doctors’ surgeries and hospitals on every street corner. This is not sustainable, nor is it necessarily optimal for patient outcomes. Instead, where appropriate, technology is already empowering online consultations and self-care in the home. Apps focussed on prevention and wellbeing provide access to healthcare at any time in any location.
Caroline Latta, strategic public engagement and communications lead at NHS North of England Commissioning Support describes the NHS Child Heath app aimed at educating parents about common childhood illness and reducing attendance at NHS services.
#3 Media relations vs integrated communications
The recruitment of journalists to fill communication roles has led to a shortfall in planning, integrated communications and reputation management. It's a move that was intended to build relationships with local media but has led to a shortfall in skills.
The State of NHS Provider Communications Report 2017/18 published in January cited the need for communicators to demonstrate the strategic value of communications in order to achieve parity with other professions.
#4 Journalist and communication paradox
Denis Campbell, The Guardian’s health policy editor describes the dance that frequently plays out between journalists and NHS communicators in their attempts to dodge difficult topics.
Liz Davies, head of communications at the South Tyneside and Sunderland Healthcare Group reports, that her team receives calls at the same time each year asking whether the Winter crisis has kicked in.
The paradox is clear. Both are advocates for the NHS and both call for straight talking and honest conversations between NHS communicators and journalists.
#5 Skills gap: capability framework required
Ensuring that communicators have the experience, skillset and ability to engage with management and take on a strategic role is overdue but the shortfall has been identified at a time of greatest need.
Professor Anne Gregory, chair of communication at the University of Huddersfield and a non-executive director at the Airedale NHS Foundation Trust, writes about the implementation of a professional capability framework and continuing professional development for NHS communicators.
#6 NHS staff as advocates
The NHS is the best, safest and most affordable healthcare system in the world according to the Commonwealth Fund healthcare think tank. Its credibility come from the human face of its employees. In short the organisation needs to use its own people to lead the debate about its future.
Louise Thompson, director of communication at Burton Hospitals NHS Foundation Trust, suggests that communicators are the critical bridge between the NHS and the public.
#7 Creating space for cultural graffiti
There’s a related point. You don’t need to be a communication strategist to spot the conversations on social media between NHS staffers calling out management shortfalls.
Julian Stodd, an internationally recognised advocate for social leadership, calls this phenomenon cultural graffiti. Management must listen and engage in these conversations in order to learn and avoid reputational damage.
#8 Patient data discourse
Data privacy is a tricky subject. In the NHS it’s the difference between life and death. However a project in 2014 to promote the sharing of patient data with information from hospital, registries and prescribing databases aimed at providing better care, commissions and research was shelved after a media backlash.
Nicola Perrin, leader of the Understanding Patient Data initiative, suggests that it is another example of the need for a difficult conversation.
#9 Communicating value to the public
The NHS is abused and misused by the public. In South Tyneside and Sunderland hospitals last year there were more than 13,000 inappropriate attendances for emergency care. More than 4,500 people had a sore throat or headache. Educating the public about the cost of care is potentially one solution to reducing non-urgent attendances at A&E.
#10 Fighting for the future of the NHS
If there is a unifying message from #FutureProof it is that its communicators have a critical role to play in ensuring its future. Their leadership will ensure that the conversations highlighted by the project will take place between staff, policymakers and the public. As NHS founder Nye Bevan said 70 years ago “the NHS will last as long as there are folk left with faith to fight for it.”
Get your copy: print, Kindle and a chapter a day
#FuturePRoof: Edition Three: The NHS at 70 with Lessons for the Wider PR Community
Print (Blurb) £23.19
Amazon (Kindle) £4.99
A chapter from the book will be published each day on the #FuturePRoof community website
I’ve watched Sarah develop the #FuturePRoof community over the past three years and work on this project in her spare time since November last year. I couldn’t more proud to call her my partner.
