Whether the desired breadth and depth of ‘alignment’ is adhered to or ignored by ALBs, not forgetting the hundreds of local health organisations further down the food chain, will likely rest on whether central requests compromise or contradict communications about care and patient safety in the real world; you know – the one where people just want to see a doctor or get their medication.
NHS England, created of course to stop the NHS being used as a political football (cough), hasn’t been afraid to bite back when short-term political ambition is detrimental to long-term planning or funding.
The level of influence ALB leaders exert here and abroad will be a factor, as will their appetite to act now and seek forgiveness later from the politicians.
Ultimately, they’re the ones accountable for communications that may miss the point or worse when it comes to the realities of a no-deal Brexit for patients, services and staff.
You’d need to unleash a fairly major act of obvious defiance – like a proactive statement at direct loggerheads with the government line – to get more than a severe dressing down or at worst a shuffle of deckchairs.
ALB leaders are also the ones walking the tightrope with stakeholder and frontline care bodies, third-party suppliers and their own staff and board.
Watch this space for 'accidental' breaking of the rules, which I’d imagine relate to not cancelling planned activities and comms if they are important for ‘operational reasons’ or, everyone’s favourite, the public interest
Kristina Wilcock, former assistant head of external comms at NHS Digital
ALB leaders are also the ones walking the tightrope with stakeholder and frontline care bodies, third-party suppliers and their own staff and board.
Add civil servants and ministers to the mix and you might wonder – given the extraordinary goings on in Parliament – quite where Johnson, Cummings, Hancock and co stand in the pecking order.
Health ALBs arguably have one of the toughest Brexit briefs going because of the sheer size and complexity of NHS governance and operations.
That’s before you consider acute public reliance on services, coupled with credible health sources raising concerns about the impact of Brexit; on medical supplies and staffing for instance.
I can’t imagine any ALB will argue night is day with its stakeholders if it wants to retain trust and operational integrity.
One might argue the incumbent government (as of Tuesday anyway) and the surrounding political circus doesn’t inspire loyalty or any particular fear of major consequences for not toeing the line.
Watch this space for "accidental" breaking of the rules, which I’d imagine relate to not cancelling planned activities and comms if they are important for ‘operational reasons’ or, everyone’s favourite, the public interest.
That might be around telling patients and those who help care for them what they need to know as Brexit approaches in some shape or form.
Or more pointedly, it might be not telling them something prescribed by a spad in pursuit of votes, with little regard for reality.
Kristina Wilcock is the former assistant head of external comms at NHS Digital and founder of Gifted Media Relations
Now read: 'Micromanagement on steroids': comms pros react after NHS told to toe Government's Brexit line
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