NEWS ANALYSIS: Mixed reception as NICE begins a comms review - The National Institute of Clinical Excellence last week embarked on a thorough review of how it communicates to stakeholders. Ed Shelton reports

The news this week that the NHS organisation responsible for

communicating best practice procedure has itself sought PR help might

alarm some. But with the outgoing president of the General Medical

Council Sir Donald Irvine last week saying that patient demands are

increasingly as exacting as those of consumers generally, the

appointment of a PR agency to propagate medical excellence seems

entirely appropriate.

Healthcare professionals have welcomed the news that the National

Institute for Clinical Excellence (NICE) - overseen by chairman Sir

Michael Rawlins - is to undertake a complete review of comms.

NICE has appointed Citigate Westminster and its sister research agency

Citigate DVL Smith, on two separate contracts worth around £150,000. The contracts were won in separate pitches against GCI and Hill

& Knowlton, and Shire Hall and Cohn & Wolfe, respectively.

Between them the agencies are being asked to undertake a complete comms

review, with the strategic aim of helping the organisation better fulfil

its role.

NICE's job is to keep health professionals up to date with the latest

developments in their fields. The organisation was set up in 1999, to

introduce standardisation against a background of concern over 'postcode


Specifically, its job is to distribute information of two sorts:

appraisal of specific technologies such as drugs, devices and

procedures; and clinical guidelines on best practice for treating

specific conditions. It is also charged with promoting the clinical

audit concept within the NHS.

The organisation has grown from two people when it started to around 30

today and as the commensurate increase in activity continues next year

there will be an increase in the rate at which it needs to communicate

guidelines from once a fortnight to twice a week.

NICE says this increase in activity is the trigger for the appointments,

but insists the body has reached a good point to conduct such a


The largest part of the work will be a consultation exercise to

ascertain the success of the organisation's comms strategy so far.

Citigate DVL Smith will carry out this research among a cross-section of

NICE's stakeholders.

The agency will report to Phil Ranson, hired last month as

communications executive for dissemination. He says: 'We need to get out

there among the key stakeholder groups and find out about their

perception of the way we disseminate guidance.'

The work involves quantitative research among 15,000 stakeholders, and

qualitative research among a smaller audience of 30. Among these will be

GPs, NHS management, nurses, hospital doctors, and other primary and

secondary care professionals that make up the organisation's


Ranson says the review is crucial: 'What we know is that our current

strategy is unsustainable. It has created financial pressure as well as

workload pressure. The task is to ensure we effectively disseminate

guidance to everyone and they receive it in a useful format when they

need it,' he says.

'We need to ensure the guidance we publish has the best chance of being

implemented. The more effective the dissemination, the better the chance

of implementation,' he adds.

Currently the organisation uses a lot of paper-based dissemination

techniques, primarily a major direct mail operation. There is also a

website, and the organisation uses other electronic communication

opportunities such as GPs' Prodigy software and the NHS Direct telephone


The signs are that NICE's comms procedures are to be updated. Citigate

Westminster MD Adrian Roxan says: 'There are signs of good practice but

we are finding areas where we can improve things. A lot of material is

published and, in some cases, there may be a better way to do things


At the same time as Ranson's appointment and the review of what is

effectively its B2B strategy, NICE launched a review of corporate comms.

PRO Louise Fish will oversee the work of Citigate Westminster on this

contract, which will account for £50,000 of the total £140,000 budget.

NICE has always had a small corporate affairs function, as Fish says the

organisation recognised from the start the importance of publicising its

work: 'Crucially, we need to ensure organisations know how to get

involved,' she says.

Citigate will review this work and provide PR support for two specific

projects - the launch of six national collaborating centres and newly

revised processes for developing technology appraisals.

There will be both an internal comms audit and a media audit. Possibly

more important, is the general advice Citigate can offer NICE, whose

work has not always been well-received by its target audiences.

The pharma industry, for example, which has suffered with products not

meeting with NICE approval, has been critical. A spokesperson for the

Association of the British Pharmaceutical Industry says: 'We have had a

dialogue with them since inception and we disagree with a couple of

their decisions and have concerns about their role.'

Pharma giant AstraZeneca corporate comms manager Anna Isaacs adds: 'It

is heartening to see communications being taken seriously, but their

communications could be more consistent.'

Even patient groups such as the MS Society, which is dissatisfied with

the organisation's recent work on the MS drug Betainterferon, have

voiced concern.

Part of Citigate Westminster's brief will be to counter such attacks

with positive messages about what the body does: 'Ultimately they would

position themselves as an organisation that people might not always

agree with, but cannot fault their process - that is part of our job,'

says Roxan. It sounds like a PR job after all.

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