Supporting service change in the NHS

Background and objectives

In early 2023, North Middlesex University Hospital (North Mid) embarked on a large-scale service change, bringing Enfield Community Services (ECS) from Barnet, Enfield and Haringey Mental Health Trust (BEHMHT) to North Mid.  

North Mid’s leadership’s primary concerns were to make sure that:

  • the incoming team of dedicated health and care professionals felt properly welcomed
  • that patients and families who are looked after by these teams understood the changes
  • and that senior leaders of the transition could be confident the communications and engagement supporting the programme was as smooth as possible

We had three core objectives: 

1. Achieve operational effectiveness 

We wanted to understand and meet the information needs of ECS staff, give managers the tools to be able to answer their queries directly, and communicate the vision and benefits of the change. 

2. Reassure and advocate among the community 

We wanted to assure patients and the local community that there would be no interruption to their care and to establish a sound foundation for ongoing conversations so that local residents and patients would understand the overall vision of the transfer, its benefits, and to advocate for the change. 

3. Secure reputation among stakeholders 

We wanted to secure the confidence of stakeholders in the planned and supported transfer of community services, while enhancing the reputation of community services and avoiding noise around the transfer.  


Our first priority was to establish a core narrative that focussed on making ECS colleagues feel welcomed and valued and clearly explained the process of the transfer and the benefits it would bring. We used this narrative consistently, both internally and externally, and developed key messages for each audience group. This provided reassurance about delivery of care and working environment. 

We developed a welcome booklet for all ECS staff members to provide them with crucial information about their new employer and developed welcome boxes for all managers to ensure ECS services had the relevant products for the transfer and felt part of North Mid. This was all designed in line with North Mid branding to further the feeling of welcome and identity for ECS staff. 

We provided support to the North Mid communication team for their regular employee engagement events so that there were robust mechanisms for feedback. It was also important that this feedback was captured in the narrative and staff FAQs. We co-ordinated site visits from ECS leaders to allow for face-to-face engagement with transferring staff to address queries or concerns. 

Externally, we made sure clear and consistent updates were published on the North Mid website and content was co-ordinated with BEHMHT. This meant there was no confusion for stakeholders or the public regarding the transfer and service delivery. We also provided regular updates to key stakeholders. 

During our work with the North Mid communications team, we identified stakeholder and community engagement as a weakness/skills gap within the team. We worked at pace to deliver a workshop with North Mid colleagues so that community engagement could form a key strand of the transfer communication plan, as well as their ongoing business as usual. In this workshop, we explored best practice and the context around North Mid. We worked through activities to establish what excellence in the community should look like in North Mid by identifying priorities and mapping channels and stakeholders.


Through our support to North Mid, we ensured the successful integration of ECS into the trust and achieved our key objectives.

We met our first objective of “achieve operational effectiveness” by delivering a core narrative that prioritised welcoming and valuing ECS staff, delivering crucial information through welcome booklets and boxes, and establishing feedback mechanisms.

For our second objective, “reassure and advocate among the community”, we ensured clear and consistent communication both internally and externally and addressed a skills gap in community engagement. On the latter, we ran a workshop that allowed North Mid to incorporate community engagement into the transfer communication plan, ensuring a successful outcome for the local community and a bright future for co-producing future campaigns

Lastly, the site visits we conducted and regular updates we distributed ensured reputation amongst stakeholders was secured.


“We spent a couple of months feeling that we were muddling through a fast-moving, and slightly formless, period of change. We needed additional resource working at both high-level risk-aware support, and hands-on content development and deployment, in order to ensure we maximised the opportunities that our transfer of community services offered for our workforce, organisation, and local population. 

“Although it was just a week before the Christmas and New Year holidays kicked in, Blue Lozenge helped scope a proportional and affordable package of support, and mobilised this very quickly, so that by the first working days of January, we had a dedicated and clear plan that secured buy-in from stakeholders throughout the transfer programme, both in our trust and across the sector. 

“As the named workstream lead for communications and engagement, I felt really well supported and that Blue Lozenge colleagues were a genuine extension of our in-house team. Their support was responsive, high-quality and well executed. 

“Our chief executive has very high standards and ambition for our trust, its service, our people and our local community.  

“In nearly two years, I have not seen or heard my CEO stop a meeting mid-flow and call out a brilliant comms job, and I know that the input of Blue Lozenge was instrumental in achieving this, so wanted to pass on the thanks and compliments”.

Georgie Agass, Head of Communications, Engagement and Fundraising


If you need help managing the communication of a major organisational change, get in touch with Blue Lozenge at

Project details


North Middlesex University Hospital NHS Trust

Project type

Internal communication and engagement

Change management

Stakeholder and community engagement