Trusts are leading, and contributing to, the development of sustainability and transformation partnerships (STPs), as well as accountable care structures. At the heart of these initiatives is, and will be, the need for effective public engagement and consultation on plans for changes to the ways in which services are organised and delivered. This survey sought to understand how much time, energy and focus trust communications leaders are investing in supporting their local STPs.
Time spent on STPs
Despite the findings in the previous section pointing to a shift in priorities towards a greater focus on stakeholder and public engagement as local trusts ramp up their transformation activities, eight in 10 communications leaders and their teams are spending less than a day a week on STP-related communications and engagement activity. There was some variation by trust type, with mental health trusts spending more time on this activity and ambulance providers less time. In terms of any regional difference, communicators working for trusts in the north reported spending less time than those working in other regions.
Some STPs are still at an embryonic stage so it is likely that the amount of time that trust communications teams devote to STP-related work will increase over the next year and beyond (and it is likely that these findings will have been an improvement on the situation a year ago). Given the importance of STPs, and the communications talent working within the provider sector, it is vital that trust communications leaders and their teams have the time and space they need to support these initiatives.
Relationships with communicators working in other organisations
Respondents were most positive about their relationship with communicators working in local clinical commissioning groups (CCGs) and least positive about their relationship with the Department of Health. Although this option was not included in the list, many communicators described their strongest relationships as being with communicators working in neighbouring NHS trusts.
Given the 2012 Health and Social Care Act sought to distance the Department of Health from day-to-day operational management of the NHS, it is perhaps unsurprising that very few trust communicators said they had good relationships with the Department of Health’s communications department. For most trust communicators the relationships were non-existent, for example one said: “Due to changes in the DH team I don't feel as well connected as I would like to – it is difficult to build a relationship when you do not have a reason to be in contact regularly.” Another commented more strongly: “DH comms is invisible.”
Respondents were more positive about their working relationships with the national bodies, though many said their engagement with NHS England and NHS Improvement is most likely to be reactive and in times of crisis.
One said: “I don't feel we have much of a relationship with NHSI and NHSE and we only engage with them when we have regional approaches from the media or in big crises such as the cyberattack. They are always helpful when we do speak to them, though.” Another commented: “NHS England provides little support at times of crisis and often hinders rather than helps, for example with lengthy teleconferences during severe pressure. We rarely hear from them aside from during crisis situations. They don't keep us in the loop. NHS Improvement team locally do their best to support us and I appreciate their hands are often tied but they do make an effort to keep us updated. We rarely hear from the DH unless they want us to facilitate a visit.”
However, there was a lot of support for the quality of relationships trust communicators have with their opposite numbers working in the regional teams of NHS Improvement and NHS England. One said: “NHS Improvement North West England team is very supportive and helpful.” Another commented: “Our relationships are very good with the NHS England London team.” Another respondent said: “The NHSI regional comms team are clearly making efforts to be much better at this; something both valued and appreciated.” However, a small number of respondents said that their respective contacts in the regional teams can at times be ‘overbearing’, for example: “Our regional NHS England team is also controlling – requiring sight of letters we're sending to patients about issues for example.”
Relationships with STP communications and engagement teams – some of which are led by trust communicators – are clearly at an embryonic stage. One respondent said: “STP comms and engagement is only just getting going and there is only one person rather than a team.” There was support among many communicators for working more collaboratively with communicators in other organisations through their STP, for example one said: “The trust straddles at least three CCG/local authority areas, so the STP provides the most useful forum for advancing trust-wide relationships.” However, for many trust communicators relationships with their local STPs are very underdeveloped, for example: “STP feels very detached/irrelevant when working in a large acute, particularly when the chances of major change to the way you work is unlikely at most. There is a lack of energy and clarity in STP comms – no clear timescales for what's happening, and platitudinous descriptions of what changes will look like.”