Doing more with less: How NHS comms teams are responding

By Ross Wigham

When it comes to the fallacy of working life, the phrase ‘you must do more with less’ is probably up there with the very best. But now that teams across the NHS are facing up to the same financial challenges that other parts of the public sector have been struggling with since 2008, a more useful saying might be ‘less is more’.

You’ll learn:

• How to deliver value in a way that’s meaningful to your organisation
• Where to focus your efforts in a difficult financial climate
• How to think about adding real value to local NHS services

Increased demand versus a reduction in funding

Having worked in local government previously the scenario of shrinking teams and smaller budgets, coupled with rising demand and increasing expectations, is a familiar one.

The troubling challenge for communicators is around a dichotomy of fewer people and resources to do their work while coping with a huge rise in demand for NHS services at a time when patients and families have a thirst for more information than ever before.

We know that the modern media landscape is voracious and multi-faceted, requiring a range of different skills to meet the needs of a public who seek out information from a range of different channels often in real time.

Getting to grips with this demand and making sure day to day business like robust crisis communications are in place can be a daunting task. 

Why are we here?

It’s easy to come to a nihilistic conclusion to this sort of question (especially at a time of cuts) but before you reach for the Camus or Nietzsche, think about why your organisation needs communications and PR in the first place. Strip back everything else and take the time to ask yourself what your team can add to the overall strategic aims of the organisation.

This is the starting point for understanding how you can add value, what you should be focusing on and where you could be cutting back. It’s always better to start from the beginning and rebuild your strategy, rather than hacking away at your existing one looking for savings every year – that’s death by a thousand cuts.

Once you have this razor sharp focus on what’s important to the organisation and the senior people driving it, then you have a place to work from and a set of realistic objectives.

Delivering value

It’s worthwhile thinking about what we mean by value, in terms of what you can add to the organisation and also in the sense of value for money. Too often people conflate value with the cheapest possible option which is totally counter-productive. 

Your communications strategy should be able to demonstrate the value your team can add to the organisation and then look at how much that costs in terms of people and budget. The cheapest option is almost never the best one.

When you take a hard look at everything the comms team traditionally delivers try and think about what adds genuine value to the whole organisation, what is ‘nice to have’ and what gets done just because it’s always been that way.

When I first joined the NHS someone with lots of experience told me “don’t go native too soon” which for me meant thinking hard about the reasons why we do things and how much value they really add. 

One good exercise is to make a list of every single task the team does, compare it against your new objectives, then think about what you should start, stop or reduce to achieve them. In terms of value the patient should be at the absolute heart of everything, so consider why each piece of work would matter to them.

A focus on the things that matter

By focusing solely on the things that matter you can really see the benefit of ‘less is more’, although it will also mean managing expectations across the organisation. 

Identifying and publicising the key communications priorities for the year gives the space to focus properly on delivering some results and stopping the activity that isn’t essential to meeting these objectives. 

This, of course, means saying no to some people and delivering a smaller service than before which is difficult and can often feel counterintuitive to comms people who have spent years building up relationships.

This new approach needs to be signed off from the top to be successful and also needs input and approval from the key movers across the organisation so it’s accepted as a way forward. Make sure the vision is crystal clear and published in a way that’s really easy for everyone in the organisation to understand. 

The power of brevity

Create a ruthless focus on time management that avoids being drawn into meetings or writing lengthy strategies and reports that have no tangible value.

I’m all for flowery language and over complicated syntax and I’m not suggesting for a minute that all plans should read like a Donald Trump tweet, but there still seems to be an overriding attitude of ‘never use one word when 50 will do’. Surely the opposite should now be true with less time, fewer staff, shorter attention spans and time at an absolute premium.

Sadly, the NHS can be arch offenders at this and trying to reduce wasted time or effort is vital in becoming more efficient.

Plans should be crisp and focus on the idea of the elevator pitch with a close focus on the USP and key messaging – there’s plenty of room for background details as an appendix. That’s not to say robust planning isn’t critical (it is) but I’m reminded of another saying that goes “strategy without action is a daydream, but action without strategy is a nightmare.”

Deliver results

The pressure point with this approach is that once you’ve stopped some areas of work to save time and money by focusing on the key priorities then you really need to deliver on them.

This should come naturally because in theory there will be more time and space to deliver results but the key point here is to ensure everyone knows about the value that each successful project adds. Regular updates for the board, monthly monitoring reports, case studies and awards applications are all great ways of hammering this home.

Traditionally PR hasn’t been great at doing its own PR so make sure you take the time to tell your own story loudly and clearly. Don’t assume people have seen that great social media campaign or piece of broadcast coverage – make sure they get to see it and understand the value it delivers to the organisation.

It’s also important to talk the language of the boardroom and ensure your updates have the right tone and focus. 

The power of leadership

If you look closely at every organisation you’ve worked in, the difference between good and bad performance is so often to do with leadership. Certainly when you look across the NHS and the public sector more generally the most successful organisations are the ones which are really well led.

For me there are two key challenges for PR people: working out how to lead your own teams, but also providing strategic leadership around comms for the whole organisation.

All teams now need to be multi-skilled and it’s never been more important to know a little bit about everything. Learning and development is often one of the first things to be cut when money is short but that is a mistake. Building skills is even more important when you have fewer people but it also builds new capacity and keeps people motivated. 

Most importantly this is a change management process that will impact on people, requiring the leadership skills to navigate what is ultimately the very definition of a people business.


Ross Wigham is Head of Communications and Marketing for Gateshead Health NHS Foundation Trust. He has previously managed communications as well as other teams at one of the country’s biggest local authorities. In 2012 he was named ‘Public sector communicator of the year’ at the UK Public Sector Communications Awards and ‘Professional communicator of the year’ at the Golden Hedgehogs. Ross is also an experienced journalist and blogger, having spent a decade in London working for top trade publications as well as producing content for firms such as Sony, HSBC and Business Link.

Twitter: @rosswigham