An integrated future beckons for councils and the NHS

Health and social care integration is the next big theme for public services and comms will be key for bringing stakeholders together, writes Polly Cziok.

The future is integrated, writes Polly Cziok
The future is integrated, writes Polly Cziok

Public services are in a constant state of flux. No sooner has the dust settled on the last major NHS reorganisation, than suddenly everyone’s talking health devolution, Accountable Care Organisations, health and social care integration.

Local government has only just absorbed public health res­ponsibilities but it is starting to think about handing them over again to new structures responsible for delivering the whole health and social care package. 

Why is this happening? Of course it’s about money. 

Making resources go further. Joining things up. Efficiency. Ideally, it’s also about patients and residents, about delivering more holistic services, focused more on the needs of the individual, and less hindered by organisational boundaries.

The challenges for communicators in both local government and the NHS are huge. 

First, there is the internal comms challenge. Change is wearying and can be demotivating for staff. For those on the frontline in health and social care, the seemingly endless tinkering with structures, the constant threat of change can be destabilising, so high-quality engagement with frontline staff will be vital. 

That is a challenge in any organisation during times of change, but when many of those staff are out in the community, it becomes an even greater one.

Then there is the cultural challenge. Local government and the NHS are very different beasts. One is locally accountable through direct democracy, the other an enormous national organisation with hundreds of separate local structures, all ultimately accountable to Whitehall and to the public.

Bringing the two together at a functional level will require serious strategic work, at the heart of which will be comms.

Then of course, there is the challenge of telling the story to the public. We need to start talking to people about change, but so much of what it will mean is still unclear.

Many questions about accountability and leadership are still being developed. How branding might work is still unclear. 

Without those questions answered, the usual building blocks of comms strategy – narrative, brand, ownership – are elusive. 

But communicate we must, and that is the biggest challenge of all. Collectively, we will need to come at this from the bottom up, working towards the formation of strategic certainties rather than deriving our plans from them. 

There are huge amounts that councils and the NHS can learn from each other, in terms of comms. 

Councils, at our best, tend to be good at broadcast comms, at reaching large numbers of people and mobilising communities. 

The NHS has great strengths in user engagement, working closely with patients so they can help shape the services on which they rely. And we’re both pretty good in a crisis.

Wherever this process takes us, public sector comms should be enriched and improved by closer working, and through that the way we all interact with the communities we serve.      

Polly Cziok is head of comms at Hackney Council

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