NHS 75: Professor Shafi Ahmed VR, AI and the Metaverse in Healthcare

Summary

Professor Shafi Ahmed, named among the top ten surgical pioneers in history by the Royal College of Surgeons of England, is interviewed as part of Blue Lozenge’s NHS 75 communications series. Ahmed discusses the role of technology in scaling medical education, drawing on his experience streaming live surgeries to tens of thousands of students across more than 100 countries using virtual reality, augmented reality and social media. He addresses the emerging role of the metaverse in patient care and clinical collaboration, and examines how artificial intelligence and large language models will shape NHS communications, diagnostics and patient empowerment. Ahmed emphasises the need for NHS communications to be fast, accurate, trusted and increasingly data-driven.

 

In the third part of our series of interviews with leading figures in UK healthcare communications to celebrate NHS 75, we spoke with Professor Shafi Ahmed. Recently named as one of the top ten surgical pioneers in history by the Royal College of Surgeons of England, amongst other accolades, Shafi has used virtual and augmented reality to stream surgeries to students across the globe. 

Here’s what he has to say about health tech as a communications tool, the potential of the metaverse and how the NHS can incorporate AI and LLMs into its practice. 

Q1: Why should the NHS care about strategic communications? 

Shafi Ahmed: I think communication is so vital in medicine. The NHS has to have an effective communication strategy to allow patients to understand their treatment options, the plans for the health system and how to access some of these services across the UK; as well as [a communication strategy] for the providers who will be treating patients on a daily basis to understand the requirements and how they communicate better some of their policies and ideas around treatment strategies. 

Q2: How should the public’s expectations be managed with regards to concepts and ideas being realised (or not) within the public health system? 

SA: The way healthcare is changing with new ideas about therapies, treatment [and] prevention for example, in clinical practice would mean a different way of working for not only doctors and healthcare workers, but also for patients to access that healthcare system. As we move to more personalised healthcare system with patients being responsible for their own health and being more autonomous and having freedom of choice and being independent, I think it’s absolutely vital that this information is passed effortlessly through the system. 

If you look at secondary care, primary care and the end user/the patients – social care – this breadth of the NHS needs to be more integrated so that information passes freely and it’s as accessible as possible. We’ll look at the patient journey. It’s always been difficult sometimes when there’s friction through a system – there might be a miscommunication and there also might be a struggle in terms of language barriers etcetera. So it’s essential that, when we bring out new ideas, those are conveyed in a way that the patient understands them. [It] might be different languages, it might be for example across television, across radio and across of course information leaflets that might be handed out at primary care services. 

And I think it’s essential that that communication is done properly to ensure compliance and to bring the patient on that journey with the system. Otherwise you get non-compliance and bad outcomes. Ultimately, better communication improves the patient’s journey experience and improves the outcomes. 

Q3: You’ve done a lot of “firsts” during your career. What drives you do push boundaries in this way and have you achieved what you envisaged? 

SA: One of the great things about the NHS is its role in innovation and implementing new ideas – that could be technology – into the healthcare system to allow patients to have better experiences and outcomes. From my experience as an innovator and a futurist, for example, when I did the world’s first Google Glass operation, streaming live across the world or indeed doing the first operation in virtual reality, is to ensure that we were scaling the ideas to a large population. 

For me, it’s about how do you educate a lot of people rather than one or two people that might be close to you? How do you scale and teach hundreds and thousands of people around the world to allow us to improve global health [and] improve access? And so I felt that technology would allow us the way to improve access across the world. 

I think innovation lies at the heart of medicine. Over the last many centuries, there’s always been innovations in healthcare to drive change, whether it’s cancer care, diabetic care [or] cardiovascular care, we’ve always brought new interventions in, such as stents in vascular surgery for example which replaced open heart surgery, we’re now using virtual reality for training the future generation of nurses and doctors. 

It’s absolutely necessary that the NHS maintains its foothold in innovation and becomes a leader around the world in showing how we can implement these changes and new ideas into clinical practice rapidly. And the COVID pandemic has actually forced us to think differently, has asked us to innovate much more quickly and what I’m pleased about is that the healthcare system and the NHS is ready for change finally. And that’s only going to be good for the patient. 

When I streamed the live operation back in 2014, that’s nine years ago, I streamed to 14,000 students across the world – these are medical students and nursing students in 118 countries simultaneously using a smartphone and a streaming app. Immediately that showed the scale that you could connect with people across the world, in any part of the world. Running the virtual reality operation, I trained 55,000 people in 140 countries of 4,000 cities simultaneously showing again the benefit of connecting people across the world. 

And when I did the operations for example using social media, we connected over 56 million people across the world. So using kind of [these] tech solutions, the low cost, high-tech solutions allow everyone in the world to benefit from knowledge of clinicians from other parts of the world. So it’s about equity, it’s about access and also makes healthcare and education more affordable. That’s been my ambition — how do I use my knowledge to [reach] a much wider audience and leave that legacy for future generations. 

The NHS has now embraced what’s called extended reality. That includes augmented reality, virtual reality, mixed reality and over the last few years has now put aside funding to allow new training methods to be developed using virtual reality and augmented reality. And now we are training nurses, doctors, surgeons, medical students across the UK using these latest technologies. And I think that adds some value from traditional models of learning like books and e-learning platforms. We’re just moving seamlessly onto the next generation of tools that allow us to learn better, faster, quicker, and retain more facts. It shouldn’t be replacing traditional methods. It should be supporting or augmenting what we use already to improve people’s experiences with education. 

Q4: You’ve streamed surgeries on a number of platforms. Has VR as an education tool taken off in the way you imagined? Are there other ways that the NHS should be using technology to engage with staff better? 

SA: Virtual reality has now found its place in medical education and also medical therapy. We’re now using virtual reality to treat patients. For example, in the US they treat patients with chronic back pain with VR therapy showing an outcome that’s improved. In terms of education, we are now seeing medical schools, nursing schools [and] postgraduate training programmes in virtual reality as well as interactive platforms allowing people to now engage with avatars that look like patients, for example, using other technologies to allow them to improve their communication, to improve diagnosis and improve the clinical outcomes. 

So now we’re seeing a huge change in the way that the future generation of students are being taught and also for people who are health workers who are now looking for postgraduate training or continued professional development, using these tools for further learning. 

Q5: You’re a believer in the metaverse – how do you see that being used in health and care in the future? 

SA: The Metaverse is clearly in its early phase, we call it the 3D of the Internet. It’s a number of technologies coming together to create a kind of immersive experience. And what I think the Metaverse as being is an additional way of interacting with patients in a virtual environment. Also for education purposes: it might be that patients can learn about drug therapies or which drug to take and the complications and see graphic representation in a 3D virtual environment.  

We see also a way of collaborating. For example, doctors around the world could collaborate for a multidisciplinary team meeting [to] talk about patient care. We also see it for example in education, for example. Anatomy teaching in the future could be based around different specialists coming together with students around the world connected with 3D objects, animations letting you train people virtually. 

So the metaverse is certainly an interesting concept. I think it will find its place over the next few years as people look for other ways of accessing their healthcare system, their doctors and nurses, and also different ways of learning and have [improved] experiences of the healthcare system. But hopefully it will also improve outcomes. So I do see the Metaverse being rolled out at some stage in the next few years, maybe as pilots initially and maybe then a wider rollout. 

At the moment we have conventional face-to-face which is amazing and it’s still the right way of seeing our patients. As a cancer surgeon of course there’s that physical contact, the closeness that’s very important when breaking bad news for example. We’ve now moved to telephone calls and Zoom calls and remote kind of ways of seeing patients which adds value and puts patients at the centre. 

[They] control their healthcare because it’s that their convenience at their time at home, that’s been a game changer for all of us. And the last bit is where do you go with that? The metaverse adds the additional way of being virtual and seeing people in different environments. So it’s going to be a natural fit at some stage offering patients the choice of how they’re seen, where they’re seen and how they get their education and treatment. 

Q6: Do you see any future role of AI or LLMs in public healthcare communications? 

SA: So the current buzzword in medicine and technology is artificial intelligence and large language models, things like ChatGPT and Bard and Google. You can’t open any social media platform without seeing evidence of this. So I think very important in communication. 

First of all, AI will be the powerhouse of the health system — the chat bots, the triage systems work in the background to allow us to see many more patients much quicker [and will] also be used in diagnostics like radiology, X-ray, CTs etcetera being helpful with diagnosis at a rapid pace. So definitely AI would be helping supporting healthcare in the future. 

Also, if you look at the current technologies like the LLMs, we’re now seeing people converse [and] communicate using chat bots [and] give information. You can now ask ChatGPT4 for example around your diagnosis and options for what kind of treatment should you have. You have interactive discussion with ChatGPT. That’s great for patients it will empower them more with the evidence with information they might have. 

It might also help in literature, [with] research articles being written through some of these LLMs. It will help us to define our communication strategies of how you communicate with a patient with X for example, it will tell you about what the framework might be. It’ll make our life much easier as healthcare workers. It’ll help communication and I think it would make things a lot better going forward – much faster and much more rapid. And I think the access to knowledge and information is going to be key. The future of healthcare is data-driven, it’s going to be personalised and I think doctors like me will have more time spent with our patients face-to-face. 

And the question of course, will AI technology make us more human? I think would give us much more time to be human and spend time with the patients as we are trained to be. 

Q7: One of the key themes of NHS 75 is looking forwards. What do you see as the challenges and opportunities for strategic comms within the NHS in the coming decades? 

SA: So the next two or three decades, communication will also have to evolve and change. We have now many different ways of communicating with either clinical staff or the patients. We have, of course, online platforms. We have the news, we have the social media platforms which are now proliferating. We have the social media channels, we have image databases. So you think about where we are now, people want information immediately that’s accurate, that they can actually respond to [and] they want it at their fingertips in a few seconds – one or two clicks only on the Internet. 

Communication has to reflect who we are as people now wanting things immediately fast, reliable and that we can trust. And that’s going to be key going forward. How do you trust information now that we see through those platforms. And as long as we have suitable platforms that we have trust in and that have the background that we kind of can use as a patient for example, I’d want to make sure I can access that information in the correct manner that validated and also that I can rely on to make my own decisions. 

So there’s a huge challenge out there to get it right and I think the communication strategy has to be…it’s almost like a science of its own now, an evolving science, and how do you communicate effectively given the current constraints of the world that we live in to ensure that it’s accurate, reflective and transparent and that’s all that you can do. 

 

You can follow Shafi on X and LinkedIn. For more on our celebration of NHS 75, follow Blue Lozenge. 

NHS 75 – Jude Mackenzie building trust in healthcare

Summary

Jude Mackenzie, a trust and reputation specialist who led the development of the NHS Blue Lozenge branding policy, is interviewed as part of Blue Lozenge’s NHS 75 communications series. Mackenzie reflects on the creation of a single NHS branding framework, the role of consistent identity in building public trust, and the strategic importance of communications across large, cooperative health structures. She addresses the opportunities and challenges presented by integrated care systems, workforce planning, mental health underfunding and social care, and considers the future role of digital services and artificial intelligence in NHS communications. Mackenzie advocates for greater professional development and career pathways for communications professionals across the health and care sector

 

In the second part in our series celebrating the NHS and its leading communicators, we spoke with Jude Mackenzie, and expert in trust and reputation. Amongst many other accomplishments, Jude was instrumental in the re-branding of the NHS’s “Blue Lozenge” logo, which gives us our name. 

Here’s what she had to say about the creation of the NHS logo, the arguments that the NHS has to win, the role of communications in the NHS and much more… 

Q1: Why should the NHS care about strategic communications? 

Jude Mackenzie: I think any organisation can benefit from strategic communications because it’s about dealing with the people issues. If an organisation gets the people issues right then their objectives are much easier to achieve. So the NHS is massively a people organisation, isn’t it? And it’s not only that, but it’s about life and death as well. There are many people [and] groups that are really invested in what’s happening with the NHS. So if the NHS manages to make sure that those groups of people with their various interests have a better understanding of what we’re trying to do, the way the organisation wants to go and how they can improve their own health, then the objectives of the NHS are going to be much easier to achieve. 

I’m making it sound simple, which of course it isn’t. And the strategic side of that is prioritising. Any communications professional can be busy, but being busy and effective is the magic solution. So if you manage the strategic side better, that’s when you are going to be at your most effective. 

Q2: The NHS’s Blue Lozenge is one of the world’s most recognised logos. What roles does branding play in building public trust? And why is it important? 

JM: A brand is always the signature for the service, so it’s a way for people to understand where that service comes from.  So the NHS at the at the time that I was asked to create a single branding policy the government at the time very much wanted to stress One NHS. So having one consistent branding policy was very important for underlining the strategy that they had. 

Actually, one of the challenges we had at the time was deciding which organisations could use the NHS logo and which couldn’t. Clearly there are some in the centre of the service who it’s very clear that they’re NHS, but there are other services around the periphery that we had to really think about “could this service use the NHS logo?” Because if it did, then the then the public would ascribe a set of values and an understanding to that service, which perhaps isn’t true. Is the NHS genuinely accountable for the service that that organisation provides? I also think every public service needs to think about how it’s communicating with its various audiences and it needs to do that as well as it can. A single branding policy enabled us to set pretty high standards for how things like signage etcetera were created for the for the benefit of everybody.

Q3: What lessons did you learn from being involved in the creation of the NHS’s Blue Lozenge logo? 

JM: Loads, yes. I learned a huge number. The NHS logo, the little box actually was already in existence, so it was part of the logo of the NHS Executive, which was the headquarters of the NHS at that time. But we were given the job of taking that existing small logo and creating an entire branding policy for the whole of the NHS. 

Now everybody that works at any kind of head office knows that, particularly with the NHS, you can’t just kind of pull a lever at Head Office and automatically everything changes across the service, so the main lesson was to make sure that people across the service who were going to have to implement the new branding policy understood why we were doing it and were on board with the overall strategy. We did roadshows across England, talking to communications directors and heads who were the people who were going to need to implement it, to demonstrate to them why this single-branding policy supported the overall strategy of the NHS. 

And I think I’ve got to give massive credit to all of those communications professionals that were around at the time because they were the ones that did the hard work in their trusts and health authorities and groups and other organisations to get their own staff teams on board and to make the change happen. So on a big change management level, that was one of the most important lessons. 

On a very practical level, there were all sorts of little things that I learnt and if I did the job again, I probably wouldn’t have used an existing typeface, we would have created our own typeface. I wouldn’t have used that blue because many printers at the time told me it was actually a very awkward blue to print. But we had to do it quickly, we had to do it cost effectively and it has survived the test of time even though those little issues have been there. But yeah, I think we did, we got most of it right. 

Q4: What are the challenges of creating ICSs which are understood, respected or loved by the public they serve in the same way that the NHS is nationally? 

JM: Having spent so many years in and out of NHS management, I think that the larger cooperative structures are the most effective in the NHS and across the social care system for bringing about change. So actually I’ve got a lot of positive feelings about the integrated systems. 

Whether they need to be known and loved by the public, I’m not sure. I think what people want from their health and care services is they just want that local service to work really well for them. And then there are obviously interested parties that really do want to be part of creating the local services or influencing the local services. And the ICSs need to be able to engage with those people properly. And I think part of that is, I guess I would say this, but I do really think that really good communications and engagement at integrated service level is massively important.  

The opportunity to do this well across a bigger geographical patch with cooperation amongst all the different parties, both on the care and health side and in the voluntary sector and in other public services, it offers such opportunities. But I know it’s really difficult to get it right. 

They need to have a consistency to their brand because every organisation needs that and they need to be able to show who they are. So they are cooperative, larger structures or they’re not always organisations in their own right, they are organisations that are working together for the benefit of the public and people need to understand what that is.  

But I definitely think for the vast majority of the general public getting a decent service from their local NHS and their local council and their local voluntary organisations is what really, really matters. So I wouldn’t put the investment into being a highly known brand, I’d put the investment into building trust with the people that you’re serving, but also the people who want to influence the way that those services are provided. 

Q5: What must the NHS do to preserve its place in the civic consciousness for the next 75 years? 

JM: The obvious answer is at a strategic level it has to demonstrate that a single taxpayer-funded service is still the most efficient way to support the health of the population. It has to continue to show that that’s still the case even though populations’ needs are changing etc etc. And I do think the NHS can do that. 

The benefits of scale I think can be massive so long as there’s that cooperation with and advanced planning, strategic planning across the service, I genuinely think that the way that the NHS is constructed is the best way to deliver a health service. 

So that’s at the strategic level. At the operational level, I think the immediate challenges are clearly workforce and workforce planning. Helping people to live healthier lifestyles to make healthier choices. Mental health — probably every government has underfunded mental health. It’s not as politically a hot potato as other services, but the impact that poor mental health has on the total well-being of the society is massive. 

And social care — we’ve seen that over decades if social care doesn’t work very well, then healthcare gets choked up and doesn’t work very well. And the social care crisis is massively connected with the fact that people are living longer and no government knows how to solve that. 

But that doesn’t mean that it doesn’t need solving. We need to continue to work on that, and the ICSs are a part of that. And as is the workforce plan that’s been announced this week and many other initiatives that people are working on to deal with people being able to be looked after at home etcetera. So yeah, some huge kind of massive challenges and also some fairly thorny but immediate problems. 

Q6: One of the key themes of NHS 75 is looking forwards. What do you see as the challenges and opportunities for strategic comms within the NHS in the coming decades? 

JM: In some senses, they’re not going to change in 75 years because strategic communications are always going to be important. Health is always going to be something that people care about and therefore people are going to want to understand what their health service is about and will be engaged in that. Politicians will always be interested in what’s happening in the NHS. So strategic communications is going to have to carry on working with people, engaging people, informing people in the way that it has done for 75 years. So that part doesn’t change. 

I guess the way that the health service is going to deliver its services in the future is what’s going to change. So inevitably we’re going to see far more services delivered digitally, potentially patients who don’t interact with a human being at all, but who interact with a service that’s provided digitally let’s say. And how do we make sure that the communications that goes alongside that is good to give the person confidence to enable them to deal with any issues that come up and to enable them to feel that this is the way that their service should be provided. 

So providing those checks and balances around those developing services I think will be important. AI, artificial intelligence, is going to play a massive role in the future for communications and how we a) embrace the opportunities that that provides but b) also put the necessary safeguards in I’m sure is something that the whole communications industry is thinking about. Everything becomes extremely focused when it’s about health, [it’s] life and death. So those issues I’m sure would be massive for strategic communications professionals. 

I’ve always hoped that communications as a profession in the NHS could have more development, training [and] career pathways and attempts have been made over the years to do that. But I still don’t think we’ve reached a place where the sheer value of having communications around the top table is realised, not just by those positions and jobs existing, but by the fact that that person who’s in that role has been through a process of professional development and career support that enables them to be at their very best. 

I think the ICSs, if I ruled the world, would have brilliant and well-resourced communications and engagement functions. I do genuinely think that having a higher level of expertise across a bigger geography can pay massive, massive dividends. Many, many years ago I saw it a little bit in what were called Regional Health Authorities, and whilst those had their pros and cons, you were able to have a level of expertise there that wasn’t present in every individual trust when those structures were dismantled. So I do think that the integrated systems, whilst at the moment they still feel fledgling — I know that they’ve been around for a long time — but they still in some instances feel a little bit like they’re finding their feet. I do think if they can be made to work then the opportunities are massive, and I would love to see in 75 years’ time a hugely integrated social care and health system, probably integrated further into housing and criminal justice as well, so that the total well-being of the population is the focus. That would be brilliant. 

NHS 75 – Rachel Royall NHS strategic communications

Summary

Rachel Royall, Founder and Managing Director of Blue Lozenge, is interviewed as part of a series marking the NHS 75th anniversary, offering her perspectives on strategic communications across the health and care sector. Royall argues that effective strategic communication supports public engagement, operational improvement, reputation management and behaviour change, and outlines Blue Lozenge’s Heart Model as a strategic framework. She addresses lessons learned from the pandemic, the evolving integrated care landscape, rebuilding public trust, accessibility and representation in communications, and the growing importance of workforce communication. Royall identifies collaboration, inclusive team structures and technology as central to the future of NHS communications.

 

In celebration of NHS 75, the 75th birthday of our national health service, we begin a series of interviews with some of the leading lights in UK healthcare communications. In the series, we ask communications experts across the domains of trust and reputation, changing public health and innovation and technology about the role of communications in meeting the opportunities and challenges facing the NHS.

First, though, we asked for the perspectives of Rachel Royall, Founder and MD of Blue Lozenge…

Q1: Why should the NHS care about strategic communications? 

Rachel Royall: Strategic communication has a massive impact on public service, not just the health and care service. So that’s one of the reasons why I think it’s important. But essentially, I think effective strategic communication can help with listening and engaging and hearing the voices of the local population. I think it can help in explaining policies and decisions that might be being taken about care. 

I think it can help in achieving operational improvements and excellence in services. It can help in building reputation and it can also help in transforming behaviour. At Blue Lozenge, we’ve developed something called the Heart Model, which is our strategic framework for the health and care sector for strategic communications. 

Strategic communications can also be used as an early warning system. I think for the people who apply effective strategic communications a key part of that is listening to [your audience] and understanding what their concerns are. And I think very often whether or not you work in an acute hospital trust or as part of an integrated care board team, listening to and hearing issues as they develop, if you intervene quickly enough and feed that information and intelligence back into your organisation it can actually help to prevent crises and prevent things before they become big issues. So I think it’s a really key part of reputation management. 

Q2: What have we learnt as communicators from the pandemic? 

RR: The biggest thing that I think we’ve learned as communicators throughout the pandemic is clarity of purpose and vision. I don’t think ever before I’ve seen so many people work towards a common goal and a common outcome. And what I often see when it comes to communication is not that people are trying to do the wrong thing, it’s often that they’re trying to do too many things or they’re trying and attempting for the communication to achieve too many things. And I think the biggest thing that we learn about the pandemic is that once you’ve got clarity of purpose, then funding, finance, communication and tech all work together towards a common goal. We can really achieve amazing things. 

Q3: How is the comms environment changing with the new focus on integrated care? 

RR: I think it’s fascinating. We work with a large number of integrated care boards as well as individual health and care providers and charity organisations and local authorities. So we’ve worked with so many different people. I think it’s fair to say that it’s very much early days. I think we see some really fantastic examples where teams work together, where teams work collaboratively and they work towards common goals. 

But I also think that we also see some behaviours which disappointingly don’t always necessarily put the patient or the citizen first and they still do often put individual organisations’ interests first. So whilst I do see some glimmers of hope and some optimism, I think we’ve got a long way to go on people genuinely and collaboratively working together on communications across systems. 

Q4: Where does Blue Lozenge think the NHS needs to go to rebuild trust and reputation? 

RR: I think there are many ways that we think communication can help the NHS to rebuild trust and confidence. This isn’t about the NHS as anonymous kind of whole or one kind of large entity– we have to acknowledge that the NHS is made-up of lots of disparate parts and lots of individual organisations and therefore as such it’s about setting a culture and a tone around communication.  

First and foremost, I think that communication needs to happen with the interests of patients and the workforce at the heart of it. One thing that’s been in the media recently, for example, is the workforce strategy and how the workforce strategy is potentially being briefed to the media before being talked to the NHS workforce. I think we would go a long way if we invested in internal communications and workforce communication strategically. So I think that’s definitely one big thing.  

The second thing for me is I feel that with the context of industrial action and general unrest, unfortunately I think individuals and organisations have got into a very negative position in terms of being critical of each other. And I think one of the things where communication can add a great deal of value is helping to break down some of those boundaries and some of those barriers. And I think we need people to be positive and optimistic and to kind of remember that they’re on the same team and working towards a common purpose. 

Unfortunately, it’s sometimes exacerbated by social media, but there are very extreme perspectives and points of view which sometimes focus too much on the differences that we have between each other rather than the similarities. And I think we should do more on focusing on what we have in common and what we want to achieve in common for our patients and the citizens. 

And then the third thing that I would say — I’ve commented recently on a couple of tech companies that have been very well, one tech company’s been very critical of its competitor on social media and it has decided on a very adversarial communication approach. I don’t think that’s helpful in the NHS. We’re not working in the banking system. We’ve got people that work in the public sector and we’ve got people that work in the private sector both again who need to collaborate and work for the collective interests of patients and citizens. 

So those are the big three broad areas that I think if we made some progress on, we could start to rebuild trust and confidence in the health and care system and the fantastic people that work in it. 

Q5: What can the NHS do to improve communication with underrepresented groups and help ensure communications are accessible? 

RR: I think what many providers and more broadly integrated care systems can do is start to look at their populations across a certain geography. Sometimes it’s quite difficult to find the resource to focus on targeted communication. But I think if we collaborated more and if our teams worked more effectively together across the broad spectrum of the workforce that we employ in communications, there are certain people that we can lean on for certain specialist skills. 

And by that we need people who are representative of the local community. I’m a huge advocate for — and one of the things that I think the NHS could introduce for professional communicators — apprenticeship schemes whereby supporting local NHS organisations to introduce rotational roles that better reflect the local community. So there’s something about ensuring that the comms teams themselves have a broad representation of the communities that they serve. 

And then the second big thing for me around this and around accessibility is probably around technology and communication channels and how we use them. Unfortunately we see far too often that many channels are not set up for effective kind of accessibility. Whether or not it’s background settings that are turned to the right format to help people with screen reading, whether or not it’s hashtags not in the right format for people to be able to understand the information that they can receive. So I think there are some fantastic examples [from the] Cabinet Office and government communication, I think we should run more of that out and adopt that within the NHS. 

Q6: The one of the key themes of NHS 75 is looking forwards. What do you see as the challenges and opportunities for strategic comms within the NHS in the coming decades? 

RR: In relation to looking forward and what do I see as the challenges and opportunities for NHS communications, I think the biggest opportunity is 1 where communications and communicators and people working in communication roles can truly demonstrate leadership through collaboration and working together. So that means that we get involved in the really tricky issues that affect people. It means that we’re part of the solution for example around the workforce strategy. It means that we’re supporting the teams around things like recruitment, around employee engagement. 

So I think the biggest opportunity and challenge in relation to strategic communication actually probably relates to workforce communication in its broadest sense. How do we make sure the tone of talking about the NHS is good enough that we want to attract a global workforce? And then how do we make sure that we’ve got the channels in place to bring people into the NHS and to make them feel welcome and loved once they are in the NHS. 

And I think as communicators we have a massive role to play with our HR colleagues to make sure that we make sensible decisions and have sensible insight into things like flexible working, into things like terms and conditions. And I think that’s at a national level in relation to influencing workforce policy from the Department of Health and Social Care and at a local level in local providers. 

I think you can make a difference at all of the different levels of the health and care system.