Big ears and small mouths

This week NHS England and Improvement published the Integrated Care Systems Design Framework. At its heart is the aspiration to improve health outcomes for all of us, to tackle inequality and improve the productivity of the NHS. The strategic role of communication and engagement, as a management capability, will be central to its success. We’ve identified 7 critical communication capabilities that can really add value for health and care leaders:


ICS leaders are going to need big ears and small mouths. We have two ears and one mouth for a reason. The article image is what we need our ICS leaders to look like! Communications is so much more than broadcasting messages and media relations. An accurate and deep understanding of populations and the workforce at a local level and across organisational boundaries will be essential to design services and to inform the best communication strategies and approaches. Communication professionals can set up the right mechanisms to listen, gain insights and provide excellent analysis to inform recommendations and action plans. Working effectively their analysis and data will be a key input into the cross-system intelligence cell.

Purpose and vision

The vision of what integrated care systems are intended to achieve could be easily lost as the NHS system and local government structures navigate their way through the legalities and detail of complex governance structures as they try to explain the triple and quadruple aims (as brilliant as the work of Don Berwick is). The power of storytelling and narrating a vision that truly puts patients and local populations at the heart and that inspires the health and care workforce to transform will be critical.

Language and tone

There has always been an irony that ‘the duty of candour’ was chosen as the concept to convey openness and transparency in the NHS. We doubt it’s a word that the majority of us use at the dinner table. As the system evolves into something new there is an opportunity to get the language and tone right from the start. We need a language that is equitable and accessible to all and stops wasting time (and therefore money) on creating and explaining the endless list of acronyms. The principles and guidance need to be communicated in a simple, compelling and clear way.

Partnership working

Stakeholder engagement is a core capability for effective partnership working. From stakeholder audits through to engagement activations that develop productive partnerships. When deployed to full effect, an excellent stakeholder engagement plan ensures that all of the tactics in the communication toolbox are used efficiently and targeted on the right job. In a complex system, a strategic understanding of your partners and stakeholders and how best to engage them will make the best use of valuable leadership time and effort and support you on a path to consensus and progress. This needs to be powered by effective behaviours that drive objectivity, transparency and build trust.


We’re biased but the best communicators are natural creatives. Whether it’s the development of place-based communication campaigns that drive behaviour change or employee engagement programmes that support clinicians in the transformation of services for local people – creative communication is going to be crucial. Whether creativity is used to cut through the noise, innovate content and channels or provide a PR solution that would be a huge marketing cost to any other global brand, comms creativity is a hard asset, above and beyond the icing on the cake (or the polish on the turd).

Digital capability

As the pandemic hit everyone hard and as society moved to a virtual way of survival, communication teams up and down the land valiantly put in place digital communication channels at a pace that was incomprehensible 12 months before. Overcoming years of institutional naysaying and scaremongering from people who would have banned the use of Twitter a decade earlier. Continuing to innovate and include communication professionals in digital transformation will reap huge rewards in relation to engagement and value for money. In the new world, they are uniquely placed to inform the single-coordinated offer of digital channels for citizens across the system working alongside their clinical and tech colleagues.

Collaboration is the new Pantone 300 (NHS Blue for non-believers). Collaboration needs to be as synonymous and recognisable to the world as the blue lozenge that is found in every corner of every service that provides care for each and every one of us.

Collaboration and co-design

Collaboration is the new Pantone 300 (NHS Blue for non-believers). Collaboration needs to be as synonymous and recognisable to the world as the blue lozenge that is found in every corner of every service that provides care for each and every one of us. Whilst there is a whole other chapter that needs to be written around the patient and public involvement and engagement – co-design and collaboration need to be ‘the way we do things here.

What have we missed? We will all be the recipient of the new way that care will be delivered – in what other ways can communication and engagement add value so that the changes reflect our needs and the needs of our loved ones?

If you have any thoughts please DM us, join the conversation on Twitter or email

You can view the strategic communications and engagement services that we offer at Blue Lozenge here.