I recently blogged about the national communications vacuum which now exists in the NHS. The blog elicited a lively reaction on Twitter, with most comments focusing on the structural organisation of NHS communications and the various roles that the NHS Commissioning Board, Commissioning Support Units and Clinical Commissioning Groups (CCGs) could be expected to play.
This reaction is perhaps not surprising given the misguided and ultimately futile initiative to foist support on CCGs from a national communications organisation. It is to the Board’s credit that this idea was killed off before it got too far, cost too much money or tarnished relations between the Board and CCGs.
Structures are important. Without the right processes, capacity and capability, it is impossible to deliver consistently high quality communications. However, my blog had a more fundamental point: the NHS Commissioning Board’s need to convey its purpose.
Ultimately communications is about setting out what you are for, giving people a reason to engage, support and believe. To date, the Board has not successfully conveyed what gets it out of bed in the morning or what drives its behaviour. And this matters: the Board is led by a generation of people who were brought up in the old system, but who are expected to forge the new. Unless they demonstrate otherwise, stakeholders will assume their purpose remains the same, when it shouldn’t.
In the old world, Sir David Nicholson and colleagues won an admirable reputation as fierce defenders of NHS organisations and people, working hard to protect them from the whims of politicians. Their purpose was to create the space to let the NHS get on with the job. However, that purpose is no longer sufficient. The legal framework and political will (for now) creates this space. Whereas before ministers could position themselves as being on the side of patients and the NHS leadership could be on the side of NHS organisations, this no longer holds. The Board needs to occupy some of the ground (actively championing the interests of patients) that the Health and Social Care Act has forced ministers to vacate.
Of course (I hope) the Board would argue this is indeed its purpose. However, believing it yourself is not enough. Others need to believe that is what you are ‘for’. Managing a transition (with lots of necessary focus on people moves, organisational change and reassurance) inevitably creates a communications imbalance – there is lots of noise about the NHS, but comparatively little about how change will help patients. The Board cannot allow this to continue. Otherwise it will never develop sufficient political support or capital to sustain itself.