The purpose of this research is to gather information on the state of communications practice within the 232 NHS trusts and foundation trusts in England. Collectively, these trusts account for around £74bn of annual expenditure and employ more than one million NHS staff.

The centrepiece of the report is a survey of senior communicators working across all hospital, mental health, community and ambulance service trusts. This has been supplemented by a number of interviews with leading NHS trust communicators. The survey and interviews have provided thought leadership on the future of NHS communications, as well as a wide range of benchmarking data on, for example, team size, capacity and budgets. 

The interviews with trust communicators were carried out in December 2017 and January 2018. The online survey was open to trusts from 14 to 28 July 2017. As a key purpose of the research is to provide accurate benchmarking data for trust communicators, we targeted the most senior communications professional (or their deputies) within each trust.

We received responses from 130 trusts, which is more than half (56%) of the NHS provider sector. All types of trust, from across England, were represented.

While the report will be most relevant to communications leaders working in trusts, we hope the findings and messages will be of value to communicators in other parts of the health and care system.

Background: the work of NHS trust communications teams

NHS trust communications teams undertake a range of activities, although there is some variation depending on team size and other factors. The following outlines some of the most common activities undertaken:

  • producing high quality information on health and care services for patients and service users via a range of communications channels, such as websites, social media and printed publications
  • running targeted campaigns that raise awareness among local communities of specific services – for example, to boost uptake of flu vaccinations
  • leading public engagement exercises as part of initiatives to transform the way local care is delivered
  • ensuring effective internal communications between trusts and their staff
  • playing a lead role in ensuring effective communication between a trust and its local communities and staff at times of crisis, for example during the cyber attack in 2017 which affected more than 40 NHS trusts
  • providing media relations services for regional, trade and national media to engage with.


This report would not have been possible without the time and effort that 130 NHS trust communications leaders took in completing the survey, which forms the centrepiece of the report. We are also grateful to the small group of trust communications directors who have provided guidance throughout the project, both in terms of inputting to the design of the survey and providing comments on earlier drafts. More generally, we are grateful to the communications directors, and their colleagues, from NHS England and NHS Improvement who have engaged with the project and who continue to support the development of NHS communications.