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.

NHS Public Relations Part II: Media Demands

Summary

David Powles, a former regional newspaper editor and Blue Lozenge associate, provides an assessment of the current UK media landscape and practical guidance for NHS communications professionals seeking press coverage. The piece examines trends across print, digital, social media, television and radio, noting declining audiences in several sectors alongside sustained demand for content. Powles advises communications teams to produce fully packaged, case study-led stories, cultivate relationships with relevant journalists, position organisational spokespeople as expert commentators, and consider commissioning data or surveys to generate coverage opportunities.

 

In the second of a two-part series on public relations in the NHS, our associate David Powles, who has worked in newsrooms across the UK for 23 years, appraises the current media landscape and offers some tips on understanding what the media demands and how to get your stories noticed.

In my previous post I talked about the importance of celebrating the NHS, in particular the people working within it, and why getting people’s stories out there matters so greatly.

However, I am fully aware that at times it must be incredibly frustrating trying to do that. No doubt your calls and emails often get ignored and it is increasingly hard to work out the best way to work with a media industry that has fewer staff, more to do and is in a real state of flux.

Having recently left my job as editor of the Eastern Daily Press, I was asked to host a breakfast with Norfolk charities to discuss how to make the most of their content.

The feedback was positive, so I thought it might help our Blue Lozenge network, with a particular focus on health stories.

Current media landscape

The media industry is still very much at a crossroads. Although the internet is no longer the new kid on the block, many media outlets are still struggling to work out how best to adapt their long-term model so they can have a sustainable future.

One thing is certain, a thirst for news hasn’t changed and the public are still accessing news in their droves. However, what has changed, is that people prefer to get their news in many different ways to before – and they have no end of options from where to get it.

For the established media this has had the following impact…

Print – At both regional and national level, print figures are in decline. For some regionals that is particularly bad, we’re talking 20 percent drops year on year. However, it’s important to remember that those remaining readers, many of them aged 50-plus, could be the key demographic that your trying to reach. Print media remains influential and I predict will do so for many years to come.

Digital – After year upon year of substantial growth, many news outlets are seeing a bit of a flatline in their audiences. That said the potential audience on some websites, especially the national ones, is staggering. However, it’s important to remember digital audiences won’t read every story and are traditionally less engaged with what they’re reading than those reading hard copy, watching television or listening on the radio.

Social media – Of the mainstream social media outlets, Facebook, Instagram and LinkedIn are currently the most effective for news outlets in terms of audience gained. X, the platform formerly known as Twitter, is declining in its reach potential. Most news organisations are now seeing TikTok as the next serious player to emerge – so it’s worth thinking about how you integrate that into your campaign planning.

Television – Amid the growth of online audiences, television news has remained relatively stable and people’s interest in round-the-clock news does not appear to be on the wane. Resources are challenged due to declining commercial revenues, but it’s worth keeping an eye on the BBC and ITV who have big plans around digital growth.

Radio – In many ways the radio landscape echoes that of print. Most radio stations, nationally and locally, are suffering from declining audiences – yet their older demographic may appeal to the brand you serve and watching how radio interacts with audio devices like Alexa in your home could change the shape of radio.

What’s next in print media?

Despite the many challenges facing the printed media, it will be around for a long while yet and the nationals still have a great influence in the UK. In terms of the local media, it seems likely that more newspapers will fall by the wayside, or that the bigger titles might reduce to two or three days a week.

Where this leads digital remains to be seen and several commercial models are currently being trialled to see which ones, if any, stick. Some outlets continue to offer their content for free, relying on large scale audiences and the commercial revenue that brings, whilst others are trying a paid-for model, with fewer adverts and smaller audiences. I believe that has potential – but the quality has to remain and that is the challenge facing any newsroom where budgets are being squeezed.

It’s worth keeping an eye on some of the new products that are emerging, however, especially at a local level. Nimble, quirky and campaign-led brands such as the Bristol Cable in Bristol, and The Mill in Manchester might just have found that balance between producing quality journalism that enough people want to read to pay for it.

Challenges and opportunities

All the above no doubt presents a massive challenge to our sector. Many newsrooms, across all platforms, have smaller teams, producing more content across an ever-growing number of platforms.

They are under increased pressure and probably find it harder to devote time to maintaining relationships. There is a higher churn, they are harder to contact and harder to get to know on a personal level.

Most newsrooms have less experienced staff and as such they are not as consistent as they once were. Stories that would be published one week, simply may be ignored the next.

All of this makes it harder to get your story out there.

Dealing with the modern media can be an incredibly frustrating experience and one in which you have to show patience, determination and no doubt bite your lip a few times.

But all the problems mentioned above, also present a real opportunity. Newsrooms may have fewer journalists, but the demand for content has not decreased. If anything, it will have gone the other way.

If you can get an in with the relevant journalist or news editor and find out what their brand wants – and how it wants it – that creates a massive opportunity.

From my experience, with regards to stories relating to the NHS, human stories remain key. A piece of new data, a new technique or success story is only going to score if it comes with a case study, a human tale that puts it into context and makes the reader, viewer or listener connect with it on an emotional level.

Maximising your story’s potential

There is a really straightforward way to maximise the potential of your story in the current media landscape – make it as oven ready as possible.

It may sound a bit defeatist, but if your release is as fully formed as possible, then that’s likely to find its way onto the pages of the relevant newspaper or website – and possibly even onto the radio or TV.

I would recommend, therefore, really spending time looking at what media outlets are looking for. Yes, it’s a new angle; yes, it’s an exclusive or something that’s never been revealed, but it’s also great words, several quotes and case studies. And more recently it’s also become great pictures and video too.

If you can deliver a quality package that ticks all of these boxes – you’re definitely more likely to get the kind of reach your client is after.

That doesn’t mean journalists have become lazy. They’ll still chase after a great story – but with all the pressures they are now under the bar has probably been raised higher than ever before.

I also believe there are subtle ways many organisations can put themselves into the public limelight beyond just a traditional release.

What is your client an expert in? Can you convince them to be available for comment should that issue emerge in the public eye?

If so, and if you can successfully get that across to the right media outlets, they could become the ‘go to expert’ in their field. What a fantastic way to put across their expertise on the respective subject.

If you are going to do that, however, do make sure that person is on hand when needed as speed is of the essence. If you cannot deliver as promised, media will soon look somewhere else for that relevant bit of analysis.

How often does the organisation you represent curate its own news? Media at all levels love data and love statistics to delve into. If you have the budget to commission a report, survey or some top-level data to release, that really can go a long way in terms of securing coverage.

I know it can be frustrating, but do not be deterred. There are still key media people out there willing to form a relationship, you might just have to work a bit harder to find them and to nurture them. If you are lucky enough to forge a good relationship with the media you need to work with, don’t be afraid to ask them exactly what they want and what performs well for them and their brand.

If you can fully understand the changing demands in the ever-changing world of media – you’ll end up with a much better result for the people you represent.

The value of public relations in the NHS

Summary

David Powles, a journalist with 23 years of regional media experience and a new associate at Blue Lozenge, examines the relationship between NHS communications and the press in the context of record-low public satisfaction recorded in the British Social Attitudes survey. Drawing on his editorial experience, including six years as editor of the Eastern Daily Press, Powles argues that journalists are receptive to positive NHS stories but that the sector must work harder to surface them. He calls on NHS communications professionals to better equip staff with the knowledge to identify and share stories that reflect the organisation’s achievements.

 

In the first of a two-part special blog, our latest associate recruit David Powles reflects on the latest public satisfaction survey into the NHS and gives his view on why NHS comms and public relations (PR) is so important.

Having worked as a journalist in regional media for the past 23 years, and only spent the last three months working in PR comms, it’s probably fair to say I come at things a bit differently to many in this sector. In every single one of the newsrooms I have worked in, in the North-West, West Midlands and latterly East Anglia, the press has often been lambasted by those within the NHS for not being positive enough.

And as editor for the Eastern Daily Press newspaper and website for six years up to last September, this was certainly a regular complaint that would come our way. In some ways it was justified. I’m sure every person reading this will be acutely aware the media will always veer towards stories that could be classed as negative. At times they veer too far into negative territory, at other times that is what holding power to account is all about.

I know many journalists, rightly or wrongly, subscribe to the view that their job is to find the stories PR people want to keep hidden, whilst the PR person’s job is to try and get coverage for the stories they want to be seen.

However, I also know there are plenty of journalists, and I was one of them, who would love to write many more positive stories about the NHS and, more importantly, the people working within the organisation. And, with the latest British Social Attitudes survey showing public satisfaction in the NHS is at an all-time low, now is the time to make sure we shine an even brighter light on the many people doing superb work to help others, in what are very challenging circumstances.

Whenever my old team would write a big, but negative, story about an NHS trust, I always knew that many working within the sector would view it in one of two ways. They could see it as welcome pressure being placed on the powers-that-be, media playing the role that they rightly should in scrutiny and take the view that if the media didn’t highlight these failings, nothing would ever change. Or they might be very protective of the work they and their colleagues do and not welcome the perceived criticism of their sector.

With that in mind, we’d often try to balance out any particularly negative stories by writing in the ‘leader’ (the newspapers’ opinion section), that we understood many of the problems being highlighted were the fault of the ‘system’, not those passionate, hard-working people within the NHS administering the care.

As an editor, I would have loved to have run positive stories, about great people, doing great work and saving people’s lives every single day. And this is where I’m going to throw open the challenge to the sector I’m currently working in. Are we doing enough to shine a light on those amazing NHS achievements? Are we making it clear enough to those working in hospitals that their positive stories are sought after? And just because there has been some negativity journalists understand that it’s not all bad and you have a story worth celebrating? Do management and staff, who don’t have experience in PR, know what to flag-up as positive stories, when to highlight them and how? 

I appreciated it’s difficult. People working within the NHS are very busy people. They might not always have time to pick up the phone or write an email highlighting their or their colleagues’ great work to save a life. Many will also be too proud to even think it is worth highlighting. ‘I’m just doing my job,’ they’ll humbly proclaim. But behind so many amazing life-saving feats within our NHS – are incredible people, with incredible stories to tell.

At Blue Lozenge we try to maintain very close contact with those organisations and staff we’re representing so that, if there’s a story to be told, we know about it. However, I’m still sure there is much more great work going on in the NHS that the public should know about and would like to know about.

We in the sector must work even harder to let NHS staff know what makes a good story and why there’s value in reminding journalists, and therefore subsequently the public, what a phenomenal job doctors, nurses and everyone else in the NHS does day-after-day.

Coming soon – Part 2: The secrets to getting your story told.

Blue Lozenge sponsors Nexus netball team

Summary

Blue Lozenge, a UK healthcare communications agency, has sponsored the Nexus Netball team as part of its social responsibility commitment to supporting the health and wellbeing of women and girls. The Nexus Netball team has operated for over twenty years, competing in division six of the North West Kent league and the premier division of the Whiteoak Netball League in Swanley. The team’s name reflects its focus on connection and community, values aligned with Blue Lozenge’s own organisational ethos. England Netball’s Back to Netball scheme is signposted for those seeking to return to the sport.

 

As part of our social responsibility agenda, we’re committed to supporting the health and wellbeing of our team members and our local community. In particular, we’re passionate about supporting the health of women and girls. That’s why we’ve sponsored the Nexus Netball team.

The Nexus netball team has been going for over twenty years. They are in division 6 of the North West Kent league and in the premier division of the Whiteoak netball league in Swanley. Captain Vanessa Weeks said: “I’ve not only played and trained for many years to stay fit but I’ve made some lifelong friends too. Even on those cold nights, it’s the team spirit that gets everyone out and playing. It’s a great way to stay fit and well physically and mentally.” 

The name Nexus came about because of its meaning, which is essentially all about connections and bringing people together. Very fitting for Blue Lozenge as our ambition is to help the health and care system collaborate and connect through effective strategic, integrated communication.

If you feel inspired to get back to sport or netball check out the England Netball Back to Netball scheme and find a club local to you.

Inclusive healthcare communications

Summary

A communications professional with 20 years of experience, seconded to NHS Nightingale Hospital London during the COVID-19 pandemic, reflects on the underrepresentation of ethnic diversity in NHS communications teams and campaigns. Drawing on observations of Black, Asian and ethnic minority NHS staff, the author argues that inclusive communications require authentic representation rather than tokenistic approaches. Reference is made to the CIPR’s Race in PR Report, the NHS #NurseBehindTheMask campaign, and Barnardo’s Boloh Helpline as examples of effective, audience-centred communication. The author concludes that diverse comms teams and genuine community engagement are essential to reaching underserved audiences effectively.

 

During the height of the pandemic, I was seconded to the NHS Nightingale Hospital London to manage its media function.

It was hard work, but exhilarating to be at the centre of the pandemic and see first-hand how integral black, Asian and ethnic minority professionals – who have been disproportionately affected by COVID-19 – are to the NHS and their communities.

It was therefore important for me as a comms professional to shout about what I had seen and highlight how representing diverse communities isn’t a ‘tick-box’ exercise.

During my 20-year career, I have often sat in on comms campaign meetings where representation is an afterthought, with comments including: “Don’t forget it has to be diverse.”

The result is often a poster of a middle-aged white man with corresponding text in Urdu or another ‘tick-box’ language.

How can an Urdu speaker identify with an image that doesn’t represent them? They’re not being spoken to, they’re being spoken at.

Representation matters, and it is just as important in the field of PR.

The CIPR’s Race in PR Report found a “profession with declining levels of ethnic diversity and insufficient action being taken to address the issue”.

Diversity isn’t widely reflected in comms teams or in leadership positions across the NHS.

Yet a diverse comms team and leaders provide valuable insight, with lived experiences that can help create communications that resonate with target audiences.

A good example is the #NurseBehindTheMask campaign, which celebrated the host of ethnicities that work across the NHS.

It was a moving and thought-provoking exercise, showing NHS communicators there are valuable resources on their doorstep.

I wanted to hear the voice behind the mask. I wanted to understand their experiences of working during a pandemic and how they felt knowing they risked their lives being on a COVID-19 ward, long before we heard even a whisper about the vaccine.

Similarly, Barnardo’s work on its Boloh Helpline, created to support parents and carers from a black, Asian and ethnic minority background during the pandemic, understands how to reach its core audience and implement comms accordingly.

Even the name of the helpline, Boloh, means ‘to speak’ or ‘talk’ in Urdu and Hindi. It has been personalised for its target audience.

They have understood how they need to communicate with their core audience and their comms materials are representative of the people they help.

I don’t believe that communities are necessarily hard to reach, it’s more that we don’t know how to reach them through our communications.

NHS comms teams have just the people to help working in hospitals and health and care settings – your colleagues.

Reach out to them, hear their stories, partner with them in campaigns, understand your core audience and tailor comms to effectively engage with them.

We now need to see, hear and acknowledge the richly diverse make-up of the NHS as well as reflect this diversity in our PR teams in the NHS and across the health and care sector.

The very people we are trying to reach will respond positively when they see themselves authentically reflected in our comms.

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:

Insight

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.

Creativity

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 rachel@bluelozenge.co.uk.

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

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

The power of the Blue Lozenge to unite

Today we’re launching a new company that specialises in strategic communication in health and care. We’re called Blue Lozenge, our ambition is to support health and care leaders with excellent communication and engagement strategy and support. Now let us explain the name.

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. Devolution has posed its own challenges to the unity with Scotland and Wales adopting their own logo and Ireland opting for a new name. But nonetheless, the blue lozenge is synonymous with unified healthcare in the minds of the public.

Too often the power of professional and strategic communications in the public sector is underplayed and devalued. It’s an easy error to make, especially if communication is ill-thought through or poorly executed – people, therefore, perceive that the taxpayer’s pound is better spent elsewhere. The communication profession has a hurdle to overcome as too often communication value is only seen in media relations. The reality is that reputation in the media is an outcome of an organisation’s performance, therefore competent and intelligent communication programmes especially in healthcare focus on how communication and engagement can drive better performance and better care.

People are at the heart of the vision of transformation for healthcare systems, and therefore communication must be too. Effective, actionable insight, engagement with the workforce, public and stakeholders, programmes of transformation and change, managing reputation and risk are core communication capabilities and ones that need to be developed and grown in healthcare. 

We are passionate about the value that excellent communication brings to patients, employees and the population. As integrated care becomes a dominant model for care delivery, our ambition is that the practice and benefits of strategic, integrated communication is bought fully to bear in health and care services. 

We have developed the unifying spirit of the NHS identity into our own identity here at Blue Lozenge. We work on complex projects that require a deep understanding of healthcare and we bring the power of exemplary strategic communication to help achieve success for your projects and the people you serve. If you’d like our help and to talk through your project please get in touch.

Evidence based decision making

Despite the best efforts of local providers, feedback on health and care services can often be disparate and disconnected. Swamped in data there is often a lack of intelligent insight. The vision for Integrated Care Systems (ICS) is to remove traditional divisions between hospitals and family doctors, between physicians and mental health, and between NHS and Council Services. To do this effectively shared insight from patients and the populations they serve will be critical.

A core capability of strategic communication is the ability to listen, gather evidence and develop insight that will then help to inform decision making and affect behaviour change. Insight is the capacity to develop an accurate and deep understanding of our audiences. To unearth a truth that will help to change behaviour and inform the way we communicate.

In healthcare, this is vital – failing to listen to understand and to develop accurate insights from the data we have available to us results in harm! It can also result in costly change programmes that are poorly executed, it breeds distrust and it disengages loyal colleagues and partners. Our challenge is that whilst we drown in data, our insights are inadequate.

ICS boards under the new guidance from NHSE will be required to demonstrate how they use public involvement and insight to inform decision making.

Here are eight major benefits of a systemwide patient and population insight programme:

  1. Safety – insights from patients and residents will identify themes and trends across a whole healthcare system. Analysing trends and data simply at a provider level could fail to pick up systemic issues that fall between the provider cracks.
  2. Governance – clinical leaders need to report to a tapestry of forums and committees, having a systemwide insight approach will help reduce the reporting burden. It will also give executive and non-executive leaders an essential mechanism to give them oversight and the knowledge with which to make informed decisions.
  3. Health inequalities – reducing variation in health and wellbeing outcomes requires data, including data from seldom heard groups. Using this data to develop insights can help to mitigate against exacerbating inequalities and can ensure appropriate steps are taken to improve healthcare.
  4. Value for money – the ability to gather insights at the ICS level will aid targeted decision making, will make the best use of limited resource and will have the biggest impact on patient and resident experience.
  5. Risk management – having the capability to gain accurate and actionable insights at a system level will help to inform early warning systems, identifying issues that can be addressed together, with partners, as opposed to in isolation.
  6. Swift action – being intentional and strategic about how you gather patient insight can mean that you can react collaboratively to feedback and data in real-time.
  7. Service transformations – integrated care is intended to help resolve issues of disjointed provision, gaining information and insight about service transitions will be critical to enhance the patient experience.
  8. Prioritisation of care – different populations have different needs. The premise of ‘place’ based care is intended to give vulnerable people the care they need where they are, through deep insight and understanding of their needs and experience.

Providers are already making progress towards effective, collaborative working arrangements, if you would like a conversation about how effective population and patient insight can help you succeed, please get in touch.