The state of NHS provider communications

Good communications sits at the heart of how the NHS engages with its patients, communities and staff. The leadership and expertise provided by 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 – not least in terms of the need to engage effectively with an often sceptical public when it comes to much-needed changes to local services.

Moving from a service-level to strategic function

But despite this, the NHS communications profession is still not universally regarded as a strategic function and is considered by many to have ‘second class’ status compared to other board-level positions.

As the NHS approaches its 70th birthday this July, it is a good moment to take stock of where the NHS communications profession sits and what it must do to move beyond the perception that some still have of it being a service-level function.

Our new report provides some important insights into this question. The centrepiece is a survey of 130 communications leaders working in hospital, mental health, community and ambulance service trusts. More than half (56%) of NHS trusts in England took part in the survey.

The report paints a picture of both hope and concern.

Leading edge communications practice

Hope is provided through the innovative work NHS communicators are leading on a daily basis – whether that is by 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 critical role that communications can play.

However, the report shows there is a way to go before the profession 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 those, only 2% are full voting board members).

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This is not unique to the NHS – a recent survey of local authority communicators by the Local Government Association revealed that just 35% report in to their chief executive. This is about more than line reporting arrangements but many NHS communications leaders report into roles beyond those in the traditional ‘C-suite’.

More worryingly, as with other NHS staff, we are seeing a highly pressured and over-worked profession, with fewer staff, too many demands and not enough opportunities for professional development.

These factors present both opportunities and challenges for NHS communicators, including several that require particular focus in 2018 and beyond.

Demonstrating strategic value and return on investment

There is a strong temptation to make cuts to communications when every penny not deemed to be spent directly on patients is increasingly scrutinised. Communications leaders need to develop a compelling narrative on how and where their work improves the patient experience, as it invariably does.

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 much 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. Communications leaders, with support from the national bodies, need to make better use of formal evaluation frameworks to show how their activities lead to tangible returns on investment.

Finding creative ways of plugging skills and capacity gaps

Some trusts are starting to share communications capacity and expertise on a more informal basis, which is helping to plug skills gaps and deliver better outcomes. This may become an increasing feature of NHS communications, with leaders in trusts working more closely with their neighbouring trusts and with other NHS organisations.

This will need to extend to effective working between NHS and local government communicators as both face up to the challenge of engaging the public, staff and other stakeholders ahead of the changes to local services that will flow out from sustainability and transformation partnerships.

Investing in the communications leaders of today and tomorrow

We know that budgets for training and development for NHS communicators are being eroded. We need to find creative ways of enabling more staff to benefit from training – whether that is through more online learning and sharing of best practice, or more regional workshops (backed by Continuing Professional Development Accreditation). Both approaches would enable more communicators to benefit from training and development at minimal cost to the NHS.

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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.

The need for more formal career pathways

Part of the answer lies in developing a clear career structure and pathway for communicators at all levels. Despite the strategic importance of what communications professionals do, there is no requirement for professional qualifications for most roles. If the profession is to be taken as seriously as we want it to be, then developing formal career pathways is an important step in the journey.

The NHS communications profession has made much progress and perceptions of its strategic value are changing for the better. But the success communications leaders have in responding to the challenges outlined above will go a long way towards fully elevating the profession into the strategic function it aspires to be.


A version of this blog first appeared in PR Week on 24 January 2018, alongside a news story on the NHS Providers report.

Read the full report.



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