Posts tagged "nhs"

A report today by the BBC confirms what many of us have been expecting. The NHS has a big problem looming. Now I’m not an economist and my understanding of the financial levers required to prop up the economy in a downturn are pretty non existent, but I do understand what has happened before. Recessions hit tax revenues (less people working) and so the Government has less to spend. Even if we ignore all the other stuff like quantitative easing and budget deficits the simple fact remains, money is tight, and its going to get tighter. Add to this an ageing population, the threat of pandemic viruses and a grossly over-administered system the impact on the health service has no choice that to be considerable. Inevitably the spectre of large scale cost cutting, drug tariff pressure and even new drug prescription caps become the norm. There is no doubt in my mind that our industry and our clients business are in for difficult years as soon as the election is called. The policy maker the BBC interviewed called it 7 years of pain from 2011 . In my humble opinion the industry future requires us to be more innovate in the way we plan and launch new treatments, more cognisant of who needs to have meaningful relationships with medicines and more accommodating of the multiple layers of influence that will become normal. It’s true that innovation normally is more prevalent in crisis and whilst no one welcomes what is going on, I am confident that through adversity will come opportunity. We need to mirror the radical reform that our principal customer will undergo, recognise that doing what we have always done will not change anything and embrace the need for new thinking. Thankfully, that’s sort of why we set up…

It’s been interesting watching the unfolding pandemic and the approach taken by the DoH.

We have just won a HIV portfolio pitch and I am getting up to speed with patient comms, and its hard not to contrast this with how HIV/AIDs were dealt with in the early days.  Although a different kettle of fish the approach to communications has evolved thank God and much has been written on the development of the campaign and its subsequent panic and confusion.  

As our pandemic appears not to be living up to our initial fears its been a fascinating time to review the communications issued and the civilized approach that has been taken. Even our press, not known for their calm nature with a health story, seems to have calmed down and now tow the line when it comes to panic reduction.  With the exception of Sky News who still go live to every suspected cold in Guatemala.

I like the TV ad , I think its cooked well and does information provision in a simple way to-the-point way. Although I do find the ‘your all going down’  line a little unhelpful. The mailer that popped through the door a few days ago, alongside the leaflet given out at Angel Tube this morning and much of what I have seen on TV spokesman is integrated. The channels are pretty aligned around one strategy – we need to keep the population focused on their role. It’s given me something to do rather than worry. Although the rep in me does cry out for campaign branded tissue giveaways.

Is this is the equivalent of a nice cup of tea post bombshell? A task for us to concentrate on instead of getting all chicken liken. When I view the early iceberg/don’t die of ignorance/AIDS campaign they just confuse and scare me. They smack of a group of people who didn’t  know what to do, so they packed away their leadership and shared their panic with the nation.

Of course sneezing into tissues is a big part of reducing down the transmission of flu but given the loads of other methods  of transference could this be a finger in an ever gushing dyke. Does this mean that panic control has been prioritized over disease control? Regardless –  its been successful and bloody interesting.

It’s not often within our blog that we end with an offer of something. We have tended to use the blog as a way of shouting, chatting, ranting, or whispering a view held by someone within. But…

…we are coming to the end of a sizable project for the NHS to help understand and develop communications strategy, and having spent a month wandering the countryside running group sessions with practice managers, GPs, cluster heads, management and directors.

Getting close up and personal has been nothing but a learning experience. Not only in terms of the levels of influence geography, personality and demography have on strategy and implementation, but also in terms of the consistent views that these groups have on the pharma world. We have been using pharma activity as a baseline comparison for communications approach and tactical execution. But also constantly drawing comparisons with the challenges that pharma have faced and solved and the challenges that exist for the NHS. Centrally dictated strategy, regional focus, localised resistance, the role of local representatives, consistency of tone, internal buy in, and the sliding scale between command and latitude all are massive issues for everyone. The industry has consistently been reported by the groups as good communicators, great at training, and generally good to have around. With the ever present caveat as always trying to sell something.

As an agency we are increasingly invited to join in meetings with NHS liaison departments, working alongside them in a consultancy role to help build strategic partnership and hunt down joint working projects. In contrast to the ground troops, the NHS directors we speak to are all uncertain about the risks of engaging with pharma. Mistrust and uncertainty being justified with tales of burnt fingers during various ‘nurse audits’ and other provided services where they have felt at least “tainted” or at most “turned over”.

I cannot help but feel on the tale end of this project that a good place to start would be to offer an olive branch, in areas that are often alien; internal communications, remote command and control, inspiration and engagement. All what we consider bread and butter to the pharma world. The lessons we learn rolling out a campaign across 20 markets in Europe for Alli recently are directly relevant to a regional role out of World Class Commissioning.  

The very present need for short term ROI doesn’t help this, you need to be in a relationship to benefit with it, and at some point a risk has to be taken by one of the parties. To put their faith in the medium/longer term potential of developing this relationship.

I feel that our current world with reps being the main NHS interface is not far from being extinct, and those companies that make a first move will be best placed in the brave new world. I would love to speak further to anyone who would listen on this – we have an idea that might help with this first step.

Sitting down this week with a group of nurses led me to give some thought to the types of work they do and the role they have.

Nurses have long been considered the ‘touchy feely ones’, with GPs dealing with the pragmatics of  prescription and referral. As the UK system evolves it increasingly requires a different, more-doctor-like-nurse, with changes in responsibility, remit and patient influence. Resulting in less time to do what is often considered a foundation of nursing – care. Alongside this evolution, sits a fundamental patient requirement to still have ‘caring’ held high. I believe we still need to place value on someone who is willing to sit and explain what we have missed, didn’t understand or are just worried about. It strikes me that these two requirements can be often at odds.

Our role as communications guys needs to evolve to help bridge this divide between the demands of the structure and that of the patient. In the old days it was enough to target this group as an advertising audience, whereby we would fight for share of voice in the b2b journals. We spent time defining key messages, and shouting them, thinly veiled ad ideas, carrying key messages, kept front of mind, alongside a hope that they would somehow be spewed up during the all important consultation.

In this new world, we need to leap forward and try to understand them not as consumers of journals, and message parrots, but as partners and conduits to driving a better patient experience. This requires a very different approach, and a need to evolve from top down parasitic paternalism to sharing values of partnership, respect, and mutual understanding. I think we  need to ask ourselves - how might our brands catalyse their talent? Rather than how best might we use them to our advantage.

Patient choice is a hot topic in healthcare, so it was interesting to review the latest clinical guideline from NICE: Medicines Adherence and Patient Choice 

Hive’s focus is patient-centric communication, but we don’t claim to have all the answers on the perplexity of patient choice. It’s a tough one for NICE too, who admit that there are gaps in evidence-based learnings. I picked up on a more basic disconnect – NICE’s policy is one of optimal Adherence, but it is Choice that underpins any behaviour. So, more patient choice infers that adherence is optional rather than optimal.

Patient choice embraces much more than adherence. How the two fit together might go like this: more honesty and understanding between doctors and patients leads to shared decisions about treatment. This increased choice translates into a prescription that is handed over with the mutual assurance that every item will be taken as prescribed. Less wasted medicines and consultation time, arguably better health outcomes for individuals.  

Can this happen when medicine and humans are an unpredictable mix? Not only do people respond differently to treatments, but our choices change from moment to moment. We try things, get a result, forget what it was that gave us that result, and start from the beginning. We’ve only our own bodies to give us feedback, and sometimes that feedback isn’t clear enough to justify repeated behaviour.  

Still, people like the sound of choice, at least in theory, and NICE outlines the many ways that doctors can improve at delivering that right. The guidelines are a step in the right direction, albeit a giant leap from current practice. Eyes will be rolling in surgeries at the thought of fitting more whys and hows into a standard consultation.

Of course, the real mental shift lies not with providers but with users. NICE has not yet issued patient guidelines on choice, and whether or not they do, every patient must find out for themselves what choice really means and how to play it out. I often politely accept a prescription knowing I’ll never fill it. I think I would be braver in talking to the doctor about this if I had proof that there is value in doing so.

 We need a bit of genius to get this right. Let’s teach kids about choice: how to visualise the results of actions, verbalise the decision and analyse the outcome. What else – any ideas?

The NHS constitution was today unveiled, two years after it was first suggested. The document sets out the rights and responsibilities of the patient. Critics have been quick to speak out against the constitution, claiming that it tells us nothing new.

The content itself may not be new – but the message it sends certainly is. Information on patients’ rights is of little value if it is hard to find and hard to read. This constitution aims to provide a ‘one stop shop’, where patients and NHS staff can easily access and understand the rights and responsibilities of the patient. It provides a foundation for true patient empowerment, by increasing the transparency of the system, and thus its accountability. It is an exciting step away from the traditional paternalistic doctor-patient relationship, towards a more sustainable and mutually satisfying partnership model.

But as Mike Sobanja of the NHS alliance points out “If it remains a piece of paper, it won’t help – action not words will bring it alive.”

Hear for yourself -  The R4 Today Programme with Alan Johnson.

Last Friday saw me showing my mum and girlfriend around my nearly completed extension. Excitement and stupidity led me to fall (off what will be the retaining wall,) landing and cracking my ankle. Result – me, prostrate on the concrete floor and what has become a huge blue foot/ankle/leg, a pimp style limp and walking stick that has cheered my colleagues up no end.

Having left it a number of days, I finally hobbled down to St Charles Hospital’s Minor Injuries Unit for a check up and X-ray expecting the usual secondary care inner London cliché. What greeted me was an organisation that sang with efficiency and care. Each person I hobbled passed asked, ‘did I need a hand?’, and ‘whether I knew where I was going?’ Furthermore, each initiated interaction contributed hugely to my view of the NHS as a service. I couldn’t help but ask the source of this feeling. The receptionist, porter, doctor, and nurse all were consistent in their answers. They put the amazing vibe of the hospital down to it feeling autonomous, working within a clear process whilst having the freedom to use their initiative,  team and individual visibility,  defined roles, and putting the patient right at the centre. I raised this last night at a meeting with a strategy head of a large PCT, and he aired the view that Polyclinics are aiming for exactly this – smaller, autonomous, organisations, staffed with empowered carers all driving towards a better patient experience. I only hope this can be realised.