The NHS is bracing itself for the biggest overhaul in its history as a whole tier of management is swept aside. Swingeing cuts are expected to hit NHS PR budgets and jobs, but the changes may also present new opportunities for PR professionals within the broader healthcare landscape.
The Health and Social Care Bill is certainly causing controversy.
It stalled in Parliament a few weeks ago amid concern over the pace of reform, but its key themes are to remain.
The plan is to scrap primary care trusts (PCTs) and strategic health authorities by 2013 and disperse their functions.
Councils will be given greater responsibility for public health, while newly formed GP consortia will take over local health commissioning. The bill will make it easier for charities, private firms and social enterprises formed by NHS staff to run local health services, as well as encourage greater patient involvement.
According to PROs and agencies working within the NHS, the impending reform coupled with public sector cost-cutting has already caused dramatic cuts to PR budgets. Sarah Wrixon, MD of healthcare specialist agency Salix Consulting and former national comms director of the NHS Working in Partnership Programme, estimates that in London two out of three PCT comms roles have disappeared.
Agency work is also drying up. 'Commissioning has been strangled by the requirement to save money. I have spoken to NHS comms managers who are absolutely overwhelmed by the amount of work they have,' says Wrixon.
Former NHS strategic health authority director of comms Martin Carter, now a director at PR agency Ashford Carter, says as well as redundancies in NHS PR, 'many are looking to jump ship before they are pushed'.
But not all NHS organisations are making savage cuts to PR, says Jo Yeaman, chair of the Association of Healthcare Communications and Marketing (AHCM). Hospital trusts, for example, will not only survive the NHS reforms but are set to increase their remit in areas of community health.
'It depends on the financial health of the trust and the importance it places on comms. A number of comms director posts are going and are being replaced with assistant director roles. But this will not happen everywhere, as some trusts want to keep that senior level role,' says Yeaman.
She adds that despite the largely bleak picture of NHS PR, the reforms present opportunities for savvy PROs in both agency and in-house roles (see overleaf).
For Linsey Henshaw, director of healthcare at Bell Pottinger North, the bill's focus on patient involvement presents the biggest opportunity for agencies.
She says: 'I can see a lot of work around surveying patients' views, and the bill presents a clear need for the emerging organisations to ensure they are engaging with local patients.'
Wrixon anticipates that PCT PR professionals facing redundancy by 2013 will be snapped up by PR agencies because of their NHS expertise. In-house roles with councils and emerging organisations such as GP consortia are other options, says Yeaman.
The AHCM is now in talks with other public sector comms groups such as LG Comms to develop joint training packages to help health PROs better understand the changing structures in the NHS.
'The NHS may be changing, but comms skills will be needed as long as those involved are ready to adapt,' says Yeaman.