Listen local, act local

In the new health service, it's the opinions of GPs and their patients that will count the most.

Sarah Wrixon is managing director of Salix Consulting

GPs fought long and hard to have the right to develop and commission services on behalf of their patients and, after nearly three years of debate, Clinical Commissioning Groups (CCGs) take full responsibility for public health services in England this week.

The NHS has spun on its axis. The health service will now be shaped by those on the front line, working with their communities to improve the health and wellbeing of local people, encouraging them and enabling them to manage their health and helping them get better when they are ill.

The vision is simple but, as the report by Robert Francis QC into the appalling care failings at Mid Staffordshire NHS Trust shows, a service as all-encompassing as the NHS cannot afford to be complacent.

We should demand, and expect, the excellent care that comes from motivated, trained frontline staff with good training and humane working conditions, who listen to patients and are not afraid to speak up when they spot a problem.

And it is precisely this bottom-up revolution that CCGs could achieve through a new model, which is clinically led and patient centred, and encourages peer-to-peer accountability in an open environment, where effectively implemented comms has never been more important. If patients are to be at the heart of healthcare, and motivated staff at the heart of delivery, everything comes back to their views and opinions.

It is this common thread that runs through our work with both commissioners and providers. Engagement with health professionals, patients, carers, the public, communities of interest or geography, Health and Wellbeing Boards and local authorities are starting points, whether for a large CCG or for a provider of infomatics, telehealth or pathology services.

Once we have gathered a range of views, we use them to inform our comms strategy. From a commissioning perspective, it should be evident how the views of patients translate into commissioning decisions and how the voice of each practice population will be sought and acted on. From a provider perspective, it should be evident that the commissioner's needs are fully understood and embraced.

Our work with NHS Alliance, a leading voice for clinical commissioning, gives us valuable insight into the requirements and mindsets of the GPs, practice nurses and managers that comprise CCGs.

As the Association of the British Pharmaceutical Industry's NHS partnership manager Kevin Blakemore rightly says in the opening article, going in with a product and three key messages isn't going to work anymore. Hard-pressed GPs and their teams are more interested in pragmatic solutions to improve their work and the lives of their patients.

For us, the strategic partnership approach described in the same article, supported by appropriate media work, is the most effective form of engagement with commissioners and purchasers. It works best when linked to CCG performance expectations, around the management of long-term conditions, for example. The lead driver for CCGs is to move services away from the expensive hospital setting to the community.

This is where partnership opportunities arise. As Boehringer Ingelheim's Duncan Cantor points out, the new NHS is all about localism and one size won't fit all. Providers who work with CCGs to understand their communities are creating a valuable starting point for co-production.

Expect to see comms get granular - schools, religious centres, even the local hairdresser could provide valuable insight and messaging platforms that will help support an NHS that is sustainable for patients and providers alike.


How are the NHS reforms changing your work?

We've moved from broad PR strategies to ones that include direct stakeholder engagement. Approaches that include advocacy and peer power and harness community assets are more relevant in a locally-led commissioning world.

Give us an example of how technology is aiding patient education

Telehealth is a technology that could transform the lives of people living with long-term conditions at home. With Appello, a telehealth provider, we worked to establish a national Telehealth Forum, bringing in health professionals, patient groups and policy makers to develop an educational programme.

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