NHS comms still has 'second class' status compared to board-level positions - and that must change

Good communications sits at the heart of how the NHS engages with its patients, communities and staff.

There is a way to go before comms rightly takes its place at the NHS ‘top table’, says Daniel Reynolds
There is a way to go before comms rightly takes its place at the NHS ‘top table’, says Daniel Reynolds

The leadership and expertise provided by communicators has a vital role to play in improving the patient experience.

Some of the greatest challenges facing the NHS require expert communications skills and knowledge.


Also see: Slow trend towards recognition from the top for NHS Trust comms chiefs, survey finds


But despite this, the NHS communications profession is considered by many to have ‘second class’ status compared to other board-level positions.

As the NHS approaches its 70th birthday this July, it is a good moment to take stock of where the NHS communications profession sits and what it must do to become the strategic function it aspires to be.

A report to be published tomorrow by NHS Providers – informed by a survey of 130 communications leaders – provides some important insights into this question.

The report paints a picture of both hope and concern.

Hope is provided through the innovative work upon which NHS communicators are leading on a daily basis – whether that is by delivering high-profile campaigns that lead to desired behaviour change, leading public engagement strategies as part of initiatives to transform the way care is delivered, or providing high-quality information to patients.

Progress has been slow but there is a growing awareness among NHS leaders of the critical role that communications can play.

However, the report shows there is a way to go before the profession rightly takes its place at the NHS ‘top table’.

Despite many communications leaders enjoying good access to their chief executive, less than half formally report into the chief executive and less than a quarter sit on the board.

More worryingly, as with other parts of the NHS, we are seeing a pressured and over-worked profession, with fewer staff, too many demands and not enough opportunities for professional development.

These factors present both opportunities and challenges for NHS communicators, including three that require particular focus in 2018 and beyond:

Demonstrating strategic value

There is a strong temptation to make cuts to communications, when every penny not deemed to be spent directly on patients is increasingly scrutinised. Communications leaders need to develop a compelling narrative on how and where our work improves the patient experience, as it invariably does. We need to make better use of evaluation frameworks to show how our activities lead to tangible returns on investment.

Plugging skills and capacity gaps

Some trusts are starting to share communications capacity and expertise on a more informal basis, which is helping to plug skills gaps and deliver better outcomes. This may become an increasing feature of NHS communications, with leaders in trusts working more closely with their neighbouring trusts and with other NHS organisations. This will need to extend to effective working between NHS and local government communicators as both face up to the challenge of engaging the public, staff and other stakeholders ahead of changes to local services.

Investing in the leaders of today and tomorrow

We need to find ways of ensuring communicators are not deprived of developmental opportunities, given training budgets are being eroded. NHS England and NHS Improvement are ramping up the support they provide. However, more is needed and part of the answer lies in developing a career structure and pathway for communicators at all levels. Despite the strategic importance of what we do, there is no requirement for professional qualifications for most roles. If we are to be taken as seriously as we want to be, then developing formal career pathways is an important step in the journey.

The NHS communications profession has made much progress, but the success its leaders have in responding to these challenges will go a long way towards elevating the profession into the strategic function it aspires to be.

Daniel Reynolds is director of comms at NHS Providers


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