News Analysis: What now for the NHS IT revamp?

The NHS's much-maligned IT overhaul has lost its top communicator. David Singleton looks at the comms strategy and how PROs can rebuild faith in the project.

‘The best computer system in the world,’ is how one PR professional breathlessly describes the potential reality of the Government’s Connecting for Health programme. If successful, the Department of Health’s multi-billion-pound plan to digitise patient records could revolutionise the NHS, according to Michael Smeeth, associate director at Quintus Public Affairs.

‘You could live in London but fall over in the street in Abergavenny, and the local hospital would have all your records,’ he enthuses. ‘It would know what you’re allergic to. Your records would follow you around, there would be no lost paperwork. In real terms, it was going save people’s lives.’

Alas, this glowing vision has not been successfully communicated to the British people. Instead, the public have been bombarded with stories about spiralling costs, technical setbacks, and concerns over the impact on civil liberties.

There is also brooding resentment from within the NHS, where many doctors feel that a huge and complex project has been pushed on them without consultation.

GP cynicism
The scale of the opposition was outlined last November in a Guardian poll of more than 1,000 GPs. It found that half of those questioned would con­sider refusing to put patient records onto a new national database.

‘I’m afraid its reputation is tarnishing rapidly,’ says Dr Paul Cundy, a spokesman for the British Medial Association.

Indeed, last week it looked as though even the programme’s top PR professional had finally had enough. Director of external affairs James Herbert will leave his post in March after three years, despite the DoH’s best efforts to persuade him to stay (PRWeek, 19 January).

‘I’m surprised he stayed as long as he did,’ says Cundy. He speculates that Herbert may have chosen to leave in advance of the scheme being wound down under a Gordon Brown premiership. But Herbert, a former head of group media at Shell, flatly denies this. In a statement, he told PRWeek last week:‘With experience of comms in government, energy, IT and health, I’m looking to strike out on my own.’

Herbert may not be replaced, but the programme is not lacking PR support. In 2005, it appointed Porter Novelli (PRWeek, 21 January 2005), before calling in Good Relations last Nov­ember in a fresh attempt to salvage its reputation (PRWeek, 22 Nov 2006). In total, the Government is believed to be spending around £1.5m on PR agency help.

Tony Collins, executive editor of Computer Weekly, says: ‘They tried to have a clear strategy of targeting certain parts of the media – for example, they separated national, local and trade media. That would look great sitting in an office in Whitehall, but those journalists who were excluded from certain press conferences felt quite aggrieved.’

So where has it all gone wrong? One agency source claims that the PR teams have always been hamstrung by government officials, who insist on signing off every bit of communications activity. ‘Their hands are tied,’ claims the source.

For Quintus’s Smeeth, the main problem is that the PR professionals involved have been unable to get away from the idea that the project is ‘essentially a great big computer system’, rather than a revolution in the way in which patients are treated.

He adds: ‘People never really engaged with the idea of what this was going to deliver. The project was never really explained in terms of what it would enable you to do.’

Smeeth believes the DoH must clearly explain how the programme will benefit both staff and the public. ‘I think it means going back to the basics of explaining the reasons behind this: taking it away from being IT and painting a picture of what it really means for me if I’m a GP sitting in my surgery; what it means for me if I’m an NHS manager in a big hospital; what it means for me if I’m a receptionist; and what it means for me if I’m a patient – getting those real human-interest case studies out there.’

Convincing the doctors
Others say the lack of support among many doctors is the key problem that needs to be tackled. Alasdair Liddell, a former director of planning at the DoH, now working as an adviser to Bell Pottinger Public Affairs, is adamant that this is where the PR operation must begin. ‘That would be the prime target and that’s true of any kind of in-house communications service. If you can’t convince the staff then you won’t convince the public.’

He adds: ‘A lot of doctors I speak to would be delighted to have a good information system. They’re just a bit frustrated that it’s taking so long and it doesn’t always work first time. So I think people need to understand the scale and complexity of the scheme itself, but probably also need to be reminded of the benefits and be given a clear timetable for how it’s going to affect them.’

As PR challenges go, Connecting for Health appears up there with Jade Goody and Heather Mills-McCartney. But is the tide finally starting to turn? Liddell claims that some doctors are warming to the plans, and he cites one major provider – Nottingham University Hospital NHS Trust – that ‘has really got excited about this’.

Nobody is holding their breath, but if more hospitals follow suit then a positive message could finally be communicated to the public.

Liddell says: ‘If the CEO is passionate about this, then he can tell a good story locally. He can show that the programme is going to be transformational in improving the NHS.’

Connecting for Health: key dates in the PR battle

June 2002 Ministers unveil plan to upgrade the NHS’s IT infrastructure. Department of Health establishes unit, later renamed Connecting for Health.

January 2005 Porter Novelli is appointed to publicise the public’s right to opt out of the scheme to store all NHS patient records on an electronic database.

November 2006 Good Relations is called in to salvage the reputation of the scheme following incessant criticism by the media and opposition political parties.

January 2007 James Herbert, director of external affairs at Connecting for Health, confirms plans to leave his job in March.

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