10 Minutes with — The Godmother of the NHS brand, Jude Mackenzie

The NHS blue lozenge was first used in the 1990s. Following an intelligent rebranding exercise in 1999, the new identity brought together over 600 different variations, unifying communications for the public and patients who use the service. Today it is claimed the brand has an impressive 95 per cent recognition among the general public. And thanks to the dedicated people who provide care and other essential services, it has become a potent symbol of national pride.

As is often mistakenly the case, the value of the NHS rebranding exercise was initially called into question. However, the NHS blue lozenge identity and brand, has undoubtedly played an important role in unifying the health service, and in becoming the UK’s most identifiable and relevant brand.

We spent 10 minutes with Jude Mackenzie, the ‘godmother’ of the NHS brand, the comms lead who masterminded its implementation to get her thoughts on collaboration and communication in health and care. Whilst lots of things have changed since 1999, we wanted to hear about the collaboration that resulted in the NHS blue lozenge that we so fondly recognise today.

What does collaboration mean for you?

Collaboration is, in most cases, the best way to get things done if you want them to last beyond you walking out of the room! As comms professionals, most of our work is about marshalling different groups of people towards a common goal.  This means listening, responding and usually compromising and recognising that good collaboration can achieve much more than any of the individual agencies on their own.

What obstacles did you overcome in establishing the NHS brand?

I was asked to achieve a single identity for the NHS without it becoming a huge media scandal, as so many rebranding exercises are. This meant getting people on board, not spending much money and not creating a single diktat moment that everyone could hang their objections on. The government’s strategy at that time was ‘One NHS’ so it was straightforward to explain that meant one identity. It would take me too long to list all the obstacles but one big one was that there was no real boundary of what is and isn’t ‘NHS’. We had to create that ourselves, which was a challenge!

What leadership qualities were required?

We had to create momentum and an inarguable case for a single identity that would result in the people within the NHS taking up the cause for the change and making it happen within their organisations. And we also had to create a new identity with our design agency, The Team, and write a policy that would affect every part of the NHS.

How did you succeed in getting consensus?

The first job was to stop 400 new ‘primary care groups’ from creating their own logos for 1 April. So, we gave them their free identity and that set down a marker for the future. Our strategy for the rest of the NHS was to work through the comms heads/directors and we did talks and presentations across the country at their meetings. I have to say that they were absolutely great. They understood that the brand needs to follow the strategy and they then did the difficult job of bringing their own boards and management teams on board. I remain hugely grateful to them.

How did you deal with the critics?

Our biggest ‘protection’ for what we were doing was the amount of money a single identity would save. We also made sure that whenever a single organisation wanted to keep its crest/bird/tree, or whatever their logo was,  we worked with them to understand that if we allowed that for them, we had to allow it for everyone so brought them into the inside of shaping the policy. For example, we had a workshop for the trusts that were mostly children’s hospitals or services to come up with a single policy for how to make our identity child friendly.

You’ve written a book about the role of communication – how does communication add value for CEOs and leaders in healthcare?

My book is for people on the board, or senior management team, who are responsible for comms, either directly or indirectly. It isn’t about the practical stuff such as how to grow your social media following, it’s about how to use comms to achieve change and avoid a reputational meltdown. It gives strategies and advice on how to do this in various ways and in various settings. Healthcare is a people function, surrounded by many groups who have a high vested interest in how it is run. No healthcare CEO can achieve change without doing the ‘people’ issues well. One of my mantras is ‘it’s not sufficient just to be right’ (or to think you are!) Managing the (many) people issues properly will make running a healthcare organisation easier – that’s the bottom line.

As healthcare leaders move from legislation that rewarded competition towards a model that is focused on collaboration, what advice would you give them?

My observation from 30 years working in not-for-profit, with lots of time in the NHS, is that healthcare leaders lean more naturally towards collaboration than they do towards competition. Collaboration is nearer to our hearts. My advice would be to do the groundwork well on establishing good relationships with the main influential stakeholders, and keep those relationships strong – even when work pulls you in other directions. It will pay dividends when things get tricky, and it will enable you to achieve progress faster.


Jude Mackenzie formerly worked at the Department of Health and Social Care, where she led the team that rolled out the NHS brand. She then went onto become a strategic communication adviser in Downing Street, Jude has extensive experience advising boards in health, social care, government and charities. In 2019 she published her book Managing Communication – a guide to managing communication in organisations.

If you have a complex project and you’d like to find out more about how Blue Lozenge can help you collaborate in healthcare please get in touch.

Image credit: Robbie