FOCUS: HEALTH PR; Doing the prep for a smooth operation

MEDIA MANAGEMENT: Medical authorities invest in preparing for, and

minimalising the effects of, potential crises

ABORTION FURORE: Poor media communications resulted in the aborted twin

affair making front page news

CANCER AWARENESS: Fashion and health awareness has played a major role

in changing attitudes towards tanning

When a health issue flares, the media is always quick to act, which is

why health organisations are discovering the benefits of crisis

training. Lexie Goddard investigates

Prevention is better than cure is the hard lesson NHS Trusts and

pharmaceutical firms are learning as health issues continue to make

front page news.

Media reports of deficiencies in care in the community and healthcare

rationing are typical of the crises which can destroy public faith in

local healthcare management.

John Bowden spent 30 years in the NHS, most recently as chief executive

of Brighton Health Authority, before joining NHS crisis specialist

Merrett Health Risk Management in 1991.

Response from NHS Trusts to Bowden’s offer to assess risks in order to

prevent future crises was initially slow.

‘Nobody knew what risk management meant,’ says Bowden. ‘We marketed the

service for a couple of years, then developed it further and have only

started to sell the service last year.’

The company has now advised 150 NHS Trusts and business has doubled in a

year.

Technological advances has meant rapid breakthroughs in many medical

treatments which the public is demanding access too. But new technology

comes at a price and NHS managers are also under increasing pressure to

juggle limited Government funding and make financial cuts.

The Citizen’s Charter has also boosted patient expectations and turned

their attention to rights many were not previously aware they had.

A key reason, however, for the growing interest in crisis prevention

stems from the formation of the Clinical Negligence Scheme for Trusts

(CNTS) in April last year.

The organisation was set up to pool member’s funds in order to share the

costs of large clinical negligence claims made against NHS Trusts. But,

the organisation insists members undertake their own risk management

training.

‘The NHS is under more pressure than ever,’ says Bowden. ‘To be an NHS

manager is a tough, emotionally charged job. The pressure pot is bound

to let off steam and often explodes into a crisis situation.’

Merrett Health Risk Management teamed up with healthcare crisis

specialists Milton Cater Communications in June to form the Crisis

Management Group.

Designed specifically for the NHS, the group provides 24-hour on-call

support for hospital trusts and health authorities combining Merrett’s

pre-crisis experience with Milton Cater’s actual and post-crisis risk

assessment.

‘The NHS is the largest organisation in Europe and touches the lives of

everyone,’ says Milton Cater, managing director Claire Cater. ‘It is not

surprising that it frequently comes under the spotlight.’

‘There are not more crises happening but they quickly become big

national stories to meet the thirst for health issues,’ adds Cater.

Meanwhile in the private sector, pharmaceutical companies stand to lose

their prized market share when crises hit and the public switches to

competitor brands.

Doing business, therefore, in that most precious area - human health -

means drug companies should be on constant crisis vigil.

Cohn and Wolfe healthcare director Martin Ellis believes the industry is

not being pro-active enough and the ‘ostrich principle of management’

still exists.

‘The client needs to think like a member of the public,’ explains Ellis.

‘It’s ironic, clients want consumer coverage so that patients can go to

GPs and wave editorial under their noses, asking for specific products.

But they forget that patients will do the same when negative articles

appear and demand to come off the drug.’

They seem to think if we raise the problem then people who may not have

noticed will, but journalists respond to reasonable, rational argument,’

adds Ellis.

Bristol Myers Squibb director of public affairs Chris Davies believes

crisis management preparation is essential.

The company undertook an theoretical incident exercise two months ago

and is planning to rehearse a more realistic scenario later this year -

as part of a programme which has been in place since 1994.

In their recent exercise staff from Bristol Myers Squibb’s marketing,

management, production and medical information teams sat round a table

and discussed the threat of product tampering, under the guidance of the

firm’s international issues management team.

John Clare, managing director of Lion’s Den Communications Management,

the healthcare specialist media trainers, admits: ‘It’s not hard to sell

the concept of media training these days.’

Clare has seen a definite rise in business from pharmaceutical companies

over the last few years and has advised Glaxo, SmithKline Beecham, Astra

and PR agencies Hill and Knowlton and Shire Hall.

‘Pharmaceutical companies realise it only takes one negative report to

have a serious affect on its brands,’ says Clare. ‘They can lose their

market share overnight. It is crucial for them to communicate, not just

with patients but doctors, competitors and analysts, as crises can

affect the company share price,’ he adds.

According to Clare, patient groups are also becoming increasingly

active. ‘Sufferers of AIDS, asthma or diabetes now know much more about

their treatment,’ he says.

Discussions between patients on, for example, the Internet over the

treatments can get out of hand, says Clare, with theories ‘gathering

speed like a snowball.’

Clare and his partner Tessa Hopkins, who has held communications posts

at Glaxo and Merck Sharpe and Dohme set crisis scenarios for their

clients to tackle.

An example of such a situation could be receiving a call from a

journalist who has discovered that a famous pop star is suffering from

bad side affects caused by your drug.

Clare says Lion’s Den can also turn out a video news release for the

5.40pm news after receiving a call for help at midday.

But most of the companies’ work is in avoiding crises, for example,

preparing for a forthcoming report in medical journal the Lancet.

Lion’s Den also works with broadcast PR company Medialink, which it uses

as a distributor for its VNRs, under the banner of Medialink Medical.

With operations in 14 countries the aim is to get clients on television

and radio, presenting their cases across the world.

Medialink vice-chairman international services David Davis says

healthcare clients make up around ten per cent of the company’s 5,000

annual projects and the sector is up one third from last year.

‘The service is designed to help pharmaceutical companies launch new OTC

products or promote issues,’ says Davis. ‘But we identified that they

were looking more and more to TV to develop approaches to crises.

Product tampering and side affects can turn up any time of the day and

night and by their nature become public stories,’ he adds.

Case study: Hospitals get the emergency treatment

Disasters like the IRA Docklands and Aldwych bombings result not only in

an influx of patients for hospitals but a press pack hungry for

exclusives.

Guy’s and St Thomas’ Hospital Trust has a six member public relations

team trained to tackle the media frenzy in the event of an emergency.

As soon as a disaster is reported the hospital switchboard contacts

doctors, Accident and Emergency (A&E) staff and the press officer on

night call.

All A&E cases are re-directed to a nearby hospital and a press officer

arrives within 20 minutes. He or she then contracts the remaining five

officers and they prioritise areas with the first member covering the

A&E entrance where the media congregate hoping to catch arriving

ambulances.

‘It can be difficult when there are just security staff at the

entrance,’ explains Guy’s and St Thomas’ head of PR Matt Tee.

‘Journalists become angry or go off and find another way in so my role

is to act as someone who both understands what they are looking for and

the pressures of the A&E department.’

Initially information is shuttled from the doctor in charge to the PR

who feeds it to waiting journalists. The doctor may later hold a

pavement press conference after first being briefed by the press

officer.

The second press officer, meanwhile, is manning the phone lines at the

press office and the first office continues to deal with calls via his

bleeper.

The third press officer sets up a press centre in a room in the hospital

which the media are encouraged to go to in order to remove them from the

A&E entrance. Here they can place interview requests and are fed

information.

Guy’s and St Thomas’ also receive daily calls from the media wanting a

reaction to topical medical matters.

‘Even though we didn’t do the Queen mothers hip operation we had 75

calls from journalists wanting to speak to a surgeon to ask what its

like to operate on a 90-year-old,’ says Tee.

Case study: Aborted twin furore spins out of control

‘I wasn’t expecting to be front page news,’ the doctor at the centre of

the abortion twin furore said last week.

Professor Bennett’s comment must have set alarm bells ringing in NHS

Trust departments across the UK.

Hammersmith Trust’s press advisers were thrown into reactive crisis mode

when Bennett’s conversation with a Sunday Express reporter, in which he

mentioned the case, blew up into a huge national media story.

The article, stating that Bennett was planning to perform an operation

to abort one of twin foetuses, led to widespread debate in the media

between pro-life and pro-choice groups.

When the story hit the headlines on Sunday, Bennett kept silent in a bid

to protect the identity of his patient.

Over the next two days anti-abortion campaigners pledged money for the

single mother concerned and the Society for the Protection of the Unborn

Child successfully lobbied for a high court injunction to stop the

operation.

However, on Wednesday the hospital announced that the operation had

already taken place.

Bennett, who talked to the newspaper journalist without a press adviser

present, believes he made it clear to the Sunday Express reporter that

the operation had already occurred.

The exact sequence of events is still under debate but it has emerged

that the Sunday Express faxed its article to Bennett who changed the

tense from present to past but the paper printed the original copy.

‘The first I knew about it was when I went to my newsagent and opened a

copy of the Sunday Express,’ said Hammersmith’s out-of- hours PR adviser

Jonathan Street.

On arriving home Street received a call from the hospital and he and

staff at his agency, Jonathan Street PR, have been ‘under siege’ from

the media ever since.

Street and Hammersmith NHS Trust’s PR and communications manager Nuala

O’Brien have received hundreds of calls from local paper through to CNN.

Street says media training is available to doctors at the group of

Hammersmith hospitals through his agency but none have taken up the

offer.

Although Street says Bennett is now ‘well aware’ of its usefulness he is

sceptical of the prospect of encouraging doctors, many of whom speak to

journalists all the time, on to media training courses.

‘Journalists like doctors as they get good copy from them,’ he says.

However Street adds: ‘Simply offering media training is not enough in a

case like this where the story was of legitimate public interest and

bound to attract the media’s attention.

‘If you were doing it by the crisis manual you would have found plenty

of things that could have been done differently,’ he says.