Excelling in evaluation in healthcare communication

We’ve been working with the Public Health Wales Communication Team. They recently commissioned a review of their communication plans and practice. They are keen to emerge from the Covid-19 crisis in a position of strength and they identified that one of their improvement areas was communication evaluation.

At Blue Lozenge we developed a tailored programme of evaluation training that would not only build their individual capability but that would enhance the capability of the whole team. We reviewed comms strategies and plans and conducted a skills analysis to tailor the content.

Building on the International Association of Measurement and Evaluation in Communication (AMEC) and Government Communication Service (GCS) models we developed the ‘Excelling in Evaluation in Healthcare Communication’ programme. The programme covers evaluation theory and practices for corporate strategy, campaigns and channels, setting the foundation for developing a comprehensive dashboard tailored to their organisational strategy and that will meet the needs of reporting to internal and external stakeholders.

If you’d like to discuss how your comms team can benefit from the ‘Excelling in Evaluation in Healthcare’ programme please get in touch.

You can also check out our Blue Lozenge services on our website.

Susan Belfourd, Public Health Wales

“Our team has been lucky enough to have some training on evaluation by Blue Lozenge. Honestly one of the best training courses I’ve been on in ages, it was insightful, engaging and practical.”

James Field, Public Health Wales

“Loved the course: flexible, focused on our needs and work, gave constructive criticism and will form the basis for a new organisational approach to evaluation.”

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 rachel@bluelozenge.co.uk.

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

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

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

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

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

What does collaboration mean for you?

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

What obstacles did you overcome in establishing the NHS brand?

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

What leadership qualities were required?

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

How did you succeed in getting consensus?

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

How did you deal with the critics?

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

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

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

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

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


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

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

Image credit: Robbie

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.

Intelligent insight to inform integrated 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.