Shamed NHS trusts in PR fightback following Dr Foster report

NHS trusts media crisis How the worst-performing NHS trusts in Dr Foster report responded.

Media storm: story covered across the nationals
Media storm: story covered across the nationals

NHS trusts recently branded 'the worst in England' have spent the past few days attempting to salvage their shattered reputations.

Up to 12 trusts have been forced to mount a PR fightback following a report in which they were criticised for 'significantly underperforming' on standards such as patient safety and infection control.

The report by Dr Foster, a private company that works with the NHS, dominated national headlines over the weekend and continued to gain national and local coverage throughout this week. But many local NHS PR teams were on the back foot, having been told the story was embargoed until Monday.

Lewisham NHS Trust head of comms Simeon Baker said: 'We found out last Wednesday from The Observer when it asked us to comment that we were in the bottom 12 - we hadn't been told that in advance by Dr Foster, which I think is mainly because we don't buy its package.'

He added: 'It wasn't until the Friday that we actually had a press release from Dr Foster - the only thing we ever received - under embargo until 12.01am Monday. But by Saturday night it was lead story on Sky News and spiralled on from there. We felt rather sabotaged.'

Baker added subsequent media responses were 'limited to a statement - that's all we can do until we have a better understanding of the data'.

Some other NHS trusts went into PR overdrive. South Manchester NHS Trust communications manager Laura Parker said: 'We've been very proactive. We gave a written statement when others refused. We're the only trust to put the chief executive out for interview.'

Blackpool, Fylde and Wyre NHS Trust head of comms Caroline Hastie said: 'We have been honest, open and upfront, and taken every opportunity to get our side across. We've been proactively contacting people, especially local media.

I think being proactive and inviting the media in to speak to us does work rather than waiting for them to come to us.

'They may have already written the story by then so we would only have an opportunity to put a couple of lines at the bottom of the story. We wanted a first shot at it.'

Other trusts appeared reluctant to talk about their PR. The worst rated trust in the country, Basildon and Thurrock, was one of a handful that failed to return PRWeek's calls.


30 November: Dr Foster PR team sends out basic information on Twitter

29 November: The Observer and The Daily Telegraph cover the story. Key bloggers including Iain Dale are contacted by Dr Foster

28 November: Channel 4 News and ITN cover the report

27 November: Press release sent to regional media and NHS trusts. Nationals including The Telegraph break story about Basildon NHS Trust being investigated

13 November: Trusts are sent all the information that will appear on the site

October: Trusts are informed of where they will be in the table

June: Questionnaire sent out

- 12 trusts in England were criticised for underperforming

- 27 further hospitals were found to have unusually high mortality rates

- 5,000 deaths were considered to be avoidable last year

- 39% of trusts are failing to investigate unexpected deaths or serious harm


Dr Foster's data moved the story on to a debate on NHS regulation with the hospitals as case studies, so local comms should now be the priority. Particularly for Colchester and Basildon, a reputation-building strategy must demonstrate real change, to guard against falls in patient referrals and income.

Financial trusts are accountable to local communities so this is an extension of existing work. Complex and emotive league tables make for tricky comms, and trusts can console themselves that Dr Foster lost control of their positive messages - but the real challenge is to hospital managers. High death rates make headlines, and you can't blame PROs for that.


The main focus needs to be on local PR - get that right and the trust can develop a positive reputation.

At this stage the trusts need to focus on their users and local stakeholders to assure them that actions are being undertaken to sort the issues out, and spell out what those actions are. It's the three key messages of 'where are we now? Where are we going to? How will we get there?'

If they get the local media wrong there is only one way that the national media will go.

However, get the local media right and it gives them a solid platform to start developing a positive reputation on a regional and national scale in the medium term.

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