By Daniel Reynolds
Good communication sits at the heart of how the NHS engages with its patients, local communities, staff and other key stakeholders. The leadership and expertise provided by NHS communicators has a vital role to play in improving the patient experience.
• Some of the greatest challenges facing the NHS require expert communications skills and knowledge but, despite this, the NHS communications profession is often regarded as a service-level function
• Part of the solution lies in communication leaders developing a compelling narrative on why strategic communications must be invested in as well as better measures for demonstrating impact and return on investment
• The success NHS communications leaders have in this will go a long way to helping elevate the profession to the strategic function it aspires to be
PR is a strategic management function
NHS communicators need to be involved at a strategic level if they are to play as effective a role as possible in the running of their organisations.
However, too often communications in the NHS is not regarded as a strategic function and instead considered by many to have a second-class status compared to other board-level positions.
A new benchmarking study published by NHS Providers provides valuable insights into the NHS communications profession and where it sits as we enter the health service’s 70th year. It offers both hope and concern for the future.
There is much to be positive and proud of as it reveals communications professionals at their best – whether that is delivering high profile campaigns that lead to desired behaviour change, leading public engagement strategies as part of initiatives to transform the way care is delivered or providing high quality information to patients.
Progress has been slow but there is a growing awareness among NHS leaders of the key role communications can play.
Getting a place at the top table
However, comments from the 130 communications leaders that were surveyed for the NHS Providers study show there is still a long way to go before the profession rightly takes its place at the NHS top table.
Despite many communications leaders enjoying good access to their chief executive, less than half formally report into the chief executive and less than a quarter sit on the board of their organisation. This is about more than line reporting arrangements as many communications leaders report into roles beyond those in the traditional C-suite.
More worryingly, the report paints a picture of a highly pressured and over-worked profession, with fewer staff, too many demands and not enough opportunities for professional development.
As with other parts of the NHS, communications leaders face budget cuts as part of their contribution to efficiency savings. Many communicators fear this is eroding their ability to contribute most effectively to helping their organisation achieve its strategic objectives.
These funding constraints and workload pressures are forcing some leaders to move towards smaller teams based on more generalist roles and fewer specialists. Again, many fear this will have negative consequences, in particular by leaving their organisations short of specialist expertise.
These factors undoubtedly present both opportunities and challenges for NHS communications leaders. We now have a useful baseline against which we can assess future progress but there are several issues that need to be front and centre of our collective efforts to become strategic advisers and recognised as such.
Investment and support in NHS communications
With the temptation to make cuts to so-called back office functions, especially when every penny not deemed to be spent directly on patient care is increasingly scrutinised, communications leaders need to develop a compelling narrative on why communications must be invested in.
We are not spin doctors and we are not there to simply defend and manage organisational reputation, though that is of course part of the job. What NHS communicators do often has a direct result on the patient experience and, when done well, will help to improve it.
Some of the greatest challenges facing the NHS require expert communications skills and knowledge, not least in terms of managing the engagement challenge presented by Sustainability and Transformation Partnerships (STPs) and the changes to services they will deliver.
We must make the case for communications leaders and their teams to retain the resources they need to play a leading role in helping the NHS to respond effectively to these challenges.
Demonstrating strategic value
One theory as to why communicators do not always enjoy parity with other NHS professions is that, individually and collectively, the profession may not be doing enough to demonstrate strategic value.
There is significant variation in how much time, energy and focus communicators are putting into this, with impact assessment often sacrificed when teams are short staffed and over-worked.
This challenge is made harder by a lack of budgets for formal impact assessment. Communications leaders, with support from the national bodies, need to make better use of formal evaluation frameworks to show their activities lead to tangible returns on investment.
The need for more formal career pathways
Despite the number of communications staff employed by the NHS and the vital role they play, the profession lacks a clear career structure and development pathway for communicators at all levels.
This is regarded by many communications leaders as an increasing barrier to future recruitment.
Despite the strategic importance of what we do, there is no requirement for professional qualifications for most communications roles and staff do not need to belong to a professional body, such as the CIPR, to practice.
If we are to be taken as seriously as we want to be, then developing more formal career pathways is an important step in the journey.
Safeguarding training and development
We know that budgets for training and development for NHS communicators are being eroded. We need to find creative ways of enabling greater numbers of staff to benefit from training – whether that’s through more online learning and sharing of best practice, or more regional workshops (backed by CPD points).
Both would enable more communicators to benefit from training and development at minimal cost to the NHS.
In a welcome development, NHS Improvement and NHS England have renewed their focus on supporting communications development with a new programme. We need to build on this in 2018 and beyond to ensure a generation of communicators now coming through are not deprived of vital developmental opportunities.
Sharing communications capacity and expertise and partnership working
More collaborative working between communicators working in Trusts and other parts of the NHS and social care presents one potential solution to the capacity gaps and deficit in specialist skills that many health organisations are experiencing.
For example, neighbouring Trusts sharing communications capacity and expertise on a more informal basis may help to plug gaps and lead to better outcomes.
As part of this, there is an opportunity to build better links with our counterparts in local councils as focus shifts to an increasingly placed-based approach.
This will be important where Trusts and their local partners need to engage effectively with an often sceptical public when it comes to the major service changes that are likely to result from STPs. And it may well prompt conversations on how we ensure that we have the right communicators with the right skills working in the right places.
The NHS communications profession has made much progress, but the success its leaders have in responding to challenges outlined above will go a long way towards elevating the profession to the strategic function it aspires to be.
Daniel Reynolds is Director of Communications at NHS Providers, the membership body for 99% of NHS Trusts in England. He is a former director of communications at the Nuffield Trust, deputy director of communications at The King’s Fund and started his career as a journalist, including working for Sky News.