FOCUS: HEALTHCARE PR; Educating communities on local hospital needs

Hospital treatment is a highly charged, ultra-emotive issue. The NHS is a cherished institution. And the British public has come to expect high- quality hospital treatment as its tax-given right.

Hospital treatment is a highly charged, ultra-emotive issue. The NHS is

a cherished institution. And the British public has come to expect high-

quality hospital treatment as its tax-given right.

Having paid for the privilege of ‘free’ treatment, it is little wonder

that the public usually responds negatively to stories of rationing or

hospital closures. Change to the way treatment is delivered, even if it

is for the better, raises the ire of the man in the street.

Consequently, providers of hospital services have to take great pains to

communicate change and provide reassurances that the standard of care

available is not being diminished. That applies to both NHS Trusts and

privately-owned facilities.

With the latter, there is also the need to overcome antagonism from some

sections of the community who view private healthcare as divisive,

offering first rate treatment to those who can afford it while the less

affluent have to make do with public sectors services that are being run


Harvard Public Relations associate director Barbara Rayner, who

represents both NHS Trusts and private clients such as the Evelyn

Hospital in Cambridge, argues that the core task in undertaking PR for a

private hospital is to establish it as ‘part of the fabric of a local

community’. This is seldom easy as most communities have over the years

built up a strong loyalty to their NHS general hospital. ‘The key

message is that private healthcare gives the consumer choice. It is not

about private versus NHS,’ says Rayner.

Those working in private hospital PR need to prove that their facility

is not a threat to the NHS and that it is not limited to a tiny elite of

users. This may be done by explaining the benefits of services such as

fixed price surgery to show that it is not out of reach to the vast

majority of the general public.

David Freeland, managing director of Southampton marketing

communications agency The Partnership, has also worked for both private

and public sector health clients.

‘In the private sector the scope of PR work is rather more limited

because it is driven by business generation rather than social

responsibility,’ he says.

In the NHS much of the recent communications work has been to explain

the reforms of its management structure. These have seen the creation of

single area purchasing authorities through the merger of the Family

Health Services Authorities (FHSAs) and the District Health Authorities

to become simply local health authorities. At the same time, the 14

semi-autonomous Regional Health Authorities (RHAs) have been replaced by

eight regional offices of the NHS Executive under the direction of its

Leeds headquarters.

Most of these changes have been effected ahead of the deadline of 1

April this year. But among the public there is still a great deal of

confusion about the divide between purchaser and provider. And while the

role of the providers, eg Trust hospitals, is clear many people are less

sure about what the purchasers and regional offices do.

‘There has been some central Government funding for purchasing agencies

to improve their communications with the public but I suspect a lot of

that has been spent inappropriately because of a shortage of PR

professionals and consultancies with a real understanding of how you

effect programmes that aren’t just about health education, closure

battles, fund raising or marketing support,’ says Kinross and Render

chief executive Sara Render.

‘The challenge can be summarised as creating the means for on-going

dialogue with the public in a period where your own future is uncertain

- and at next to no cost.’

The point about communications expenditure is valid. The NHS still has

tremendous problems justifying PR costs when the expectation is that the

maximum amount of money available will go into the provision of


This situation has persuaded many healthcare consultancies to keep their

NHS work to a minimum and pursue more lucrative pharmaceutical business

instead. Yet clearly it is vital for the NHS to communicate with public.

If it doesn’t, setbacks beckon.

A case in point is offered by Manchester health commission which last

November saw its plan to shut down Booth Hall Children’s Hospital and

centralise services at the Royal Manchester Children’s Hospital

ignominiously defeated. Although the proposal had the overwhelming

support of clinicians it was defeated by an alliance of local MPs and a

public petition.

Neil Goodwin, the commission’s chief executive, went on record as saying

it is ‘increasingly difficult’ to bring about change within the NHS and

wondered whether it would ever again be possible to completely close a

district general hospital - such was the strength of public enmity

directed against the closure.

HSMU, a healthcare management and academic health policy unit based at

Manchester University and chaired by ex-NHS chief executive Sir Duncan

Nichol, has teamed up with Hill and Knowlton to form a joint venture

offering communications consultancy in the medical sector.

Jill Pooley is the head of health policy for the joint venture, which

will provide advice for pharmaceutical companies on how to deal with the

new NHS structure; giving the drug companies access to key personnel in

the NHS and assisting in establishing joint ventures such as disease

management projects.

Nick Samuels, policy co-ordinator at the Institute of Health Service

Management advises health service managers to ‘tune themselves into is

the political and media environment in which their decisions will be


But it is NHS Executive head of communications Helen McCallum who has

had the unenviable task of trying to improve communications through the

regions. She concedes: ‘There’s still a long way to go until the NHS

takes its full share of communicating.’

But she also argues that the NHS has made a lot headway in understanding

how to communicate effectively. A good thing too - there are a lot of

people out there who get very upset about any threat, perceived or

actual, to their local treatment centres.

Smear scare: Countering the panic

When the Daily Express contacted Kent & Canterbury Hospitals NHS Trust

on 2 February this year about rumours of problems with its cervical

smear test procedures, its management team went into crisis handling

mode. The Trust’s own internal quality controls had highlighted a need

for improvement and the hospital was considering what course of action

to take when its hand was forced.

On that same afternoon the Trust hired specialist healthcare agency

Elliott and Cater to help it formulate a course of action, enabling it

to air its point of view before speculation began appearing in the

media. E&C advised bringing forward the announcement that a review was

to take place concerning the screening given to 70,000 women at the

hospital between 1990 and 1995.

It was decided to make an official announcement about the situation on

Monday 5 February and an 11-strong team of senior Trust managers worked

throughout the weekend to prepare.

A leaflet was drawn up advising patients on the state of affairs and

50,000 were sent to doctors’ surgeries. E&C put together a press pack,

copies of which were also sent to GPs so that they had all the material

to hand to answer patients’ questions.

At the same time a telephone helpline, manned by trained nurses was set

up and made operational from the moment the story was released to the


All through Monday, the Trust’s chief executive Edward Pearson made

himself available for interview by the media. As did other key Kent and

Canterbury staff members including clinical director of obstetrics and

gynaecology Michael Milligan.

‘The whole team worked together from Saturday morning to Monday evening

without really leaving the hospital,’ says E&C managing director Claire


Although the smear scare was quite a big story on the Monday and

Tuesday, the press began to lose interest by the middle of the week.

There was, of course, the odd sensationalist headline such as the Daily

Telegraph’s ‘Helpline Staff Struggle to Prevent Smear Test Panic’. But a

lot of the coverage was balanced, pointing out that the problem had been

picked up by the hospital’s own quality control system.

The helpline received about 1,300 calls on the first day - nowhere near

the deluge anticipated. An indication, perhaps, that the hospital had

got its message across succinctly through well-briefed doctors.

There’s no such thing as a good crisis. But this one was assuredly well


Case study: One stop healthcare in Soho

Parkside Health is one of the largest NHS trusts in the country, serving

an area that runs from Fleet Street on the edge of the Square Mile out

as far as Harrow, taking in much of central London on the way. In 1990

it acquired the building formerly occupied by the Soho Hospital for

Women which has been largely empty for the past nine years.

Instead of selling off this prime Soho Square site to property

developers, the Trust decided it would refurbish the listed building,

turning it into the first one-stop community care centre of its kind in

central London. The scheme is known as Soho Centre for Health and Care

and has an estimated cost of pounds 5.2 million.

Harvard Public Relations was brought on board two years ago to assist

Parkside in launching what is essentially its flagship project. The

centre will offer integrated health and social care services under one

roof including dentistry, paediatrics, gynaecology, care of the elderly

and disabled and - potentially more controversially - care for those

with mental health problems.

‘We’ve taken on board the lesson that although what we’re offering may

be very good, it’s still necessary to communicate it better than we have

in the past,’ says Parkside director of corporate development Bashir


‘People might question why we have a PR agency. But it’s very important

that public services communicate better with the community and PR helps

us do that.’

The first stage of the communications process was to find out what the

local residents and business community wanted from a health centre in

Soho. To this end, Parkside carried out focus group interviews,

including qualitative research with representatives of the large

Chinese community in the area to find out their specific wants and


Harvard organised a community relations campaign that included one-to-

one meetings with key interest groups such as the Soho Society to listen

to any concerns and provide updates on developments. The consultancy

also co-ordinated a series of public meetings where local people were

encouraged to air their views. Parkside speakers were given presentation

training to ensure they delivered their messages effectively.

The Trust also took a stand at the annual Soho Festival in July, from

which leaflets and other material were handed out to local residents.

On the whole, the response of local residents and businesses has been


‘The challenge has been to ensure that local people feel they have

ownership of the project,’ says Harvard associate director Barbara


The communications campaign has also had a media relations element, with

coverage gained in professional publications like NHS Magazine,

Healthcare Today and dental magazine The Probe as well as in the local

press. The media relations programme will continue during the


The project received the planning go-ahead on 3 November 1995 and

development work is expected to start shortly.

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