NHS comms pros hit back at ‘insulting’ TaxPayers’ Alliance

New research by the TaxPayers’ Alliance into the amount spent on NHS comms, set in the context of record waiting lists, has been lambasted by health comms professionals.

The think tank says that £57m was spent by NHS organisations last year on comms, with 1,000 comms staff on salaries of up to £108,000.

Its findings were covered by The Sunday Telegraph. The article included a quote from John O'Connell, chief executive, TaxPayers’ Alliance. “A bloated bureaucracy of middle managers and administrative staff is pulling resources away from vital services. While public health messaging is important, it shouldn't take a thousand-plus staff to deliver clear, concise communications," he said.



The TaxPayers’ Alliance has influence at the heart of government, with former chief executive Matthew Sinclair now the chief economic adviser at No 10.

"Deeply insulting"

Responding to the coverage, which linked comms spending with record waiting lists, Michael Carden, head of media and corporate communications, Guy's and St Thomas' NHS Foundation Trust, tweeted: “This is deeply insulting to all #NHSComms staff who work hard to provide staff, patients, the public & yes, the media, with all the information they need. If anything, comms is under-resourced in the NHS and to spuriously link our roles with the waiting list crisis is offensive."



Speaking to PRWeek, Kristina Fox, ex-assistant head of external comms at NHS Digital, and managing director, Gifted Media Relations, condemned the story as “misleading at worst and condescending at best”.




Jessica Pacey, chief executive, 67health, said: “As a company that has worked directly with very lean NHS Trust comms teams on private-public projects in the past, it seems reductive and unfair to suggest that the number of communications professionals is excessive across what is effectively hundreds of individual organisations, or that their efforts are drawing resources away from frontline healthcare professionals.” 

Bigger picture

Daniel Reynolds, director of comms, NHS Confederation, commented: “Far from pulling resources away from ‘frontline’ services as the TaxPayers’ Alliance claims, the NHS communications profession continues to offer vital strategic and operational support to NHS organisations up and down the country. And in areas that make a real and lasting difference to patients and local communities. As a profession, we must never tire of saying so.”



The comms team at the NHS attempted to counter the negative article by putting comms staffing levels into context. 

An NHS spokesperson said: “The NHS in England employs more than 1.4 million staff working across more than 800 hospitals and many more local health services. It remains one of the most efficient health services in the world, spending a far lower proportion on administration costs than comparable countries, to ensure we deliver maximum benefit for patients for every pound of taxpayer funding.”

They added that NHS comms teams “played a vital role in the national response to the Covid pandemic”.

Industry view

PRWeek has canvassed current and former NHS comms staff for their views on the research by the TaxPayers’ Alliance and how this kind of negative coverage can be countered. 

Ranjeet Kaile, executive director of comms, stakeholder engagement and public affairs, South London and Maudsley NHS Foundation Trust

Ranjeet Kaile, executive director of comms, stakeholder engagement and public affairs, South London and Maudsley NHS Foundation Trust

 
“The argument that you need less communication in the NHS is short-sighted. Long before the Covid-19 pandemic, the link between good communication, staff satisfaction and patient safety has been well evidenced.

Over the past two years, NHS communications teams have worked tirelessly, at all levels, across all organisations to help keep staff up to date with the latest information on infection control measures and entire communities safe from the full impact of Covid-19.

Strong and effective communication is the backbone of any large-scale and complex business – this is even more important when people's lives can be put at risk by a lack of information, awareness or misinformation.

The NHS spends less than 0.1% of its budget on communications. As an NHS communicator and an NHS patient – I know that every pound spent is helping to make a difference to people's lives.”

Kristina Fox, ex-assistant head of external comms at NHS Digital, and managing director, Gifted Media Relations

Kristina Fox, ex-assistant head of external comms at NHS Digital, and managing director, Gifted Media Relations

“In order to function and indeed thrive, our NHS needs professional, hard-working communicators. It also needs professional, hard-working journalists to hold truth to power, however uncomfortable that truth is. The uncomfortable truth about this Telegraph article is it’s misleading at worst and condescending at best.

I’m not aware of a robust statistical analysis of the impact of communication officers – or indeed journalists – on NHS waiting lists, as much as I would find that fascinating and implausible in equal measure. I am, however, aware of official national statistics about the NHS workforce that I had the pleasure and responsibility to communicate to journalists, accurately and devoid of spin, for many years.

So, if we are trying to draw a degree of context about these 1,000 dreadful, awful human beings, known as communications officers, with specialist skills, bills to pay and families to support, they appear to represent a small proportion of the 1.3 million NHS workers in England. 

NHS communicators will be too busy supporting colleagues and patients through enormously testing times (one of the only accurate points of the article) to bat an eyelid at being labelled spin doctors in political parlance that is as unrepresentative as it is amusingly archaic.

Members of the public, however, may have taken the time to read this piece and form a view based on very little substance, which is as damaging as it is disappointing.”

James Mole, ex-deputy director of comms, NHS England, and a director at Hanover

James Mole, ex-deputy director of comms, NHS England, and a director at Hanover

“It is absolutely legitimate for the NHS to put a premium on patient and public comms. For the NHS, this means taking every opportunity to help somebody somewhere to get the care they need when they need it.

The ultimate example of this was during the Covid pandemic, where comms helped to deliver a fast and precise vaccination programme, and was an important tool of public health.

Comms professionals in the NHS already deliver high-quality public advice and crisis management.

But, as Amanda Pritchard, the NHS chief executive, said over the weekend, 'part of our duty is to spend every pound of public money wisely'.

For comms teams this means not only using their own budgets responsibly, but also challenging decisions elsewhere in the NHS.

This will help ensure that colleagues in different parts of the service are mindful of showing the media, stakeholders, and most importantly the public, how finite resources are managed.”

Rachel Royall, former executive director, NHS Digital, and founder of Blue Lozenge

Rachel Royall, former executive director, NHS Digital, and founder of Blue Lozenge

“We should be celebrating an increase in spending on communication and engagement in the NHS, not criticising it. Improving communication and managing reputation gives clinicians more time to care.

Patients die because of poor communication. Brilliant staff leave the NHS because of poor communication. Time is wasted because of poor communication. Services are designed badly because of poor engagement.  

If citizens don’t get vaccinated, give blood, donate organs, use ambulances appropriately (substitute for a number of behaviours) people die. Communication is business critical in healthcare.

Painting the NHS as overmanaged is a tired trope that simply doesn't stand up to any proper analysis. By the TPA's own figures, communication staff make up less than 0.1% of the NHS workforce. The suggestion that people working in communications are spin doctors couldn't be further from the truth and shows how out of touch the TPA are with our health and care system. The TPA's 'research' is another in a long line of cynical attempts to cause division in the NHS workforce at a time when the whole system is under immense pressure. Journalists reporting this nonsense do know better and should act ethically to improve care not hinder it.”

Daniel Reynolds, director of comms, NHS Confederation

Daniel Reynolds, director of comms, NHS Confederation

“That the TaxPayers’ Alliance has chosen to focus on management costs, and NHS communicators in particular, should come as no surprise. For those that want to denigrate the profession, it’s easy to construct an argument that NHS communicators contribute little to helping the NHS reduce lengthy waiting lists or ensuring quicker access to GPs. But that would be to fundamentally misunderstand the vital role that NHS communicators play.

…Far from pulling resources away from ‘frontline’ services as the TaxPayers’ Alliance claims, the NHS communications profession continues to offer vital strategic and operational support to NHS organisations up and down the country. And in areas that make a real and lasting difference to patients and local communities. As a profession, we must never tire of saying so.”

Laura Skaife-Knight, former director of comms at Nottingham University Hospitals NHS Trust. She is deputy chief executive, The Queen Elizabeth Hospital King’s Lynn NHS Foundation Trust

Laura Skaife-Knight, former director of comms at Nottingham University Hospitals NHS Trust. She is deputy chief executive, The Queen Elizabeth Hospital King’s Lynn NHS Foundation Trust

“Never has it been more important to have strong communications and engagement teams working across the NHS. The role of communications professionals is both extensive and critical – spanning internal (staff) communications and engagement, local community and patient communications and engagement and managing external relationships, including the media, to give just a few examples.

Like many corporate and behind-the-scenes functions, communications and engagement can be overlooked and yet these teams (that are typically small in size in the NHS) are vital cogs in the wheel.

It is no coincidence that high performing organisations tend to have high performing communications and engagement teams. The proof is in the pudding if you look across every level of the NHS, and therefore articles that that we have seen over the weekend are patronising, unhelpful and demoralising to all of the communications professionals up and down the country who work so hard and play a key role in further improving the experience of patients and staff in the NHS.”

Antony Tiernan, director of communications, London Ambulance Service

Antony Tiernan, director of communications, NHS75 at NHS England

“Communications professionals are a key part of the NHS team and it’s vital that we invest in them. We just need to think of the global Covid-19 pandemic, when, prior to the arrival of vaccines in late 2020, public communications was one of the few ways in which we could help protect the population from the devastating illness, encouraging people to change their behaviour and save lives.

We know our staff are tired after a challenging few years and I encourage my NHS communications colleagues to continue to focus on supporting them, sharing their stories and assuring their local communities that, despite the challenges we face, the NHS is – and will continue to be – here for them.”

Simon Wright, former director of communications at Coventry & Warwickshire Health and Care Partnership, and principal of Blabla PR

Simon Wright, former director of communications at Coventry & Warwickshire Health and Care Partnership, and principal of Blabla PR

“High quality communications are obviously vital when it comes to the effective delivery of healthcare on a national scale – the critical role communications played in the management of the Covid-19 pandemic was the best ever proof of that.

But the reality is that 90 per cent of all NHS messaging is strategised, produced and controlled by a centrally located national communications team. There is rarely an opportunity for local, brilliant, often large teams employed by and embedded in NHS Trusts all over the UK to materially influence that messaging, much less compose their own. In fact, those local teams are actively prevented from doing so – a dynamic that can foster frustration as well as have a detrimental impact on cost-effectiveness.”




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