NHS 24 COMMUNICATIONS STRATEGY

NHS 24

COMMUNICATIONS STRATEGY

2006 - 2009

1.0 Aim

The aim of the NHS 24 communications strategy is to set out the rationale, approach and actions which will be employed to develop the way in which NHS 24 communicates with key audiences. This strategy has been developed from discussions held by the Board in the second half of 2006, has been influenced by the attached analysis of stakeholders relevant to the communications strategy, and supercedes the earlier communication strategy developed prior to the national roll out of NHS 24, in 2003.

This document presents an integrated approach to communicating with NHS 24’s stakeholders, internally and externally, and details key actions. This approach aims to ensure that staff, external stakeholders and the public understand why and how we propose to communicate, but also how communication can be planned more effectively to support the delivery of the organisation’s strategy for 2006-09.

Communications affects every person in the organisation and communication related activity needs to be aligned to the range of documents, initiatives and plans to ensure that actions are not implemented in isolation. Communications activity is therefore not the sole responsibility of the Corporate Affairs directorate, but must be developed in conjunction with initiatives and service developments to ensure that the public, our staff and key stakeholders are well-informed. To achieve these objectives, the document also sets out a series of principles and standards of communication.

The adoption, and implementation, of NHS 24’s communications strategy will result in a number of tangible benefits, including:

• raising awareness of and explaining NHS 24’s purpose and role among all stakeholder groups to achieve a better understanding of the services we provide, so that comment can be informed rather than uninformed, which will contribute to increased public confidence in the organisation.

• promoting and publicising NHS 24, providing information and highlighting progress on service developments. It is important that public awareness and understanding of the service, and therefore confidence, is increased. This will contribute to increased awareness of developments to the service, such as web-based health information, as well as more appropriate usage of the core service.

• informing and involving staff, to ensure that they have access to high quality information in whatever way they find most appropriate, and can therefore influence decision making. This will help increase morale and understanding, thereby contributing to the culture development programme and providing a shared sense of purpose and direction throughout NHS 24 as services develop. It will also enable the organisation to make better use of staff as advocates for the organisation.

The power of communication should not be underestimated. Good or bad communication can have a subtle but serious impact on public confidence and staff morale.

2.0 Background

The second phase of NHS 24’s transformation programme is now underway and it is appropriate that the organisation consider how it will progress its communications activities over the 2006-2009 period.

This document has been guided by the organisation’s three-year strategy, Working for a

Healthier Scotland, and will be used to support NHS 24’s Local Delivery Plans during that three

year period. As there will be an annual review of NHS 24’s overarching strategy, so the communications strategy will be reviewed, and amended as appropriate, to ensure there is continuing consistency with Working for a Healthier Scotland.

There are also other factors which influence the direction and activities described in this document, and these are explored further in the Forces and Drivers section below. The political environment and electoral cycle, public service reform agenda and associated budgetary issues and internal morale and understanding are other key drivers.

There are three main reasons why it is now appropriate to develop a communications strategy for 2006-09:

• The transformation programme means that significant structural and operational changes will be experienced by internal and external stakeholders. It is important that the organisation is focussed on stakeholders’ communication needs so that the organisation’s aims and objectives can be achieved and the risk of destabilisation mitigated.

• There is continued media interest in the organisation. The proactive and positive approach to building relationships with media contacts must therefore continue to be a priority for the organisation. There is a need to address the media ‘lag’ in reflecting the organisation’s new developments and improved performance. However, this will not prevent negative coverage where events suggest criticism is appropriate.

• Appropriate use of out-of-hours services continues to be an issue for NHS 24, the public,

and NHS partners. At peak periods, there remains a need to support all stakeholders, including NHS staff, in managing the demand for services, particularly over Christmas and New Year public holidays.

3.0 Forces

and

Drivers

There is strong recognition within the organisation of national policy context and that NHSScotland must get better at communicating core values, actions, strategies and achievements. NHS 24’s 2006-09 strategy, Working for a Healthier Scotland, supports the challenges laid out in Delivering for Health (2005) to create services that are more community-focussed and support people in addressing their own individual health and wellbeing.

The three-year strategy sets out major priorities to progress action, redesign and integration of services to meet the needs of the population, to improve health and to further improve the quality and performance of services. It also highlights areas where a shift in how the service is developed is required, by providing a vehicle through which NHS staff, partners and the public can be effectively engaged.

NHS 24’s main aim is to work on the continued improvement of out-of-hours services by deepening integration with partner boards and enabling a more joined-up approach to service delivery in Scotland’s communities. The communications approach must be aligned to the organisation’s strategy. The immediate challenge therefore is to reduce the gap between stakeholder perception and organisational performance and to do this effectively within the context of continuing change. Working for a Healthier Scotland states: “there remains a lack of

clarity amongst many people about the service that we provide, and how that fits in with the out-of-hours services provided by local NHS Boards and the Scottish Ambulance Service. “

Devolved areas of policy, such as health, are likely to be the subject of debate and discussion at particular points during the electoral cycle. The lack of clarity about the service we provide is as much an issue with MSPs as it is with the public more generally.

The NHS Scotland 2006 staff survey results had a high rate of return amongst NHS 24 staff, and an above average staff satisfaction rating. However, it is also the case that morale amongst staff can be improved, and developing a sense of belonging and ownership of the service is key to this. Much of this work is being undertaken through the Engaging People programme, but this area is also a significant factor in developing our approach to internal communications following the review undertaken in June and July 2006.

The current approach towards public service reform espoused by the Scottish Executive, influenced by the UK comprehensive spending review in 2007, is also a significant driver in how NHS 24 communicates. It is important that the efficiency and effectiveness of the service is recognised amongst stakeholders, opinion formers and the public, and the potential for further developments to integrate services with other parts of the NHS is viewed as a positive way to improve public services, rather than as a dilution of services.

4.0 Objectives

and

Actions

This section of the strategy describes the key objectives for each of our principal external stakeholder groups and details the actions and approach we take to communicating to and with each group.

Our overall objective is that external stakeholder knowledge, perception and confidence in NHS 24’s services will improve and we will demonstrate that NHS 24 is a changing, listening and responsive organisation.

Media

Objectives:

Our objective is to improve the balance in the Scottish media’s reporting of NHS 24 so that it better reflects the changed and improved nature of service delivery.

In some instances, an inaccurate and misleading impression of the service has been presented in the media. It is important that the media have a sound understanding of the service we provide, so that it can be reflected accurately. It remains important that we continue the process of engagement with journalists to develop understanding of the service, utilising our senior clinicians as key spokespeople, and striking the right balance to ensure that we are open, honest and robust in our responses.

We will also promote the self-help and health information parts of our service, including those which are accessible via nhs24.com, by seeking out opportunities to tie information into other events and seasonal variations.

Actions:

Stakeholder Group Action

EXTERNAL

Corporate Affairs Pool of spokespeople for interviews and comment, with focus on senior clinicians, to be developed further through media training and exposure. Where practicable and possible, comment, interview or briefing from an individual, rather than providing a stock, remote comment from a “spokesperson”, to be used. Where appropriate, enable interaction with front line staff to help develop understanding of the service we provide.

Corporate Affairs Create a more appropriate voice and tone for dealing with individual cases – ensuring that where the relevant local NHS Board/Scottish Ambulance Service is informed and aware of the case and responses are not contradictory. That responses dealing with individual cases always acknowledge distress and upset, particularly where deaths have occurred, and are contrite where appropriate.

Where we are confident that NHS 24 action is appropriate, then a robust response can be given,

whilst ensuring that patient confidentiality is respected.

Corporate Affairs and Chief Executive

Continue to develop relationships with key journalists and editors of relevant publications. This needs to be a continuous and targeted process given the high turnover of journalists. This includes providing opportunities for health correspondents to see a contact centre in action, either for a feature story or background knowledge.

Corporate Affairs Where coverage is inaccurate, then this will be addressed by NHS 24, through direct contact with the journalist to point out inaccuracies and use that as an opportunity to explain the service, request a correction or clarification be printed in the subsequent edition of the publication or carried in the next broadcast bulletin, although any correction or clarification will not necessarily have the same prominence as the original story. In some circumstances, it may be appropriate to meet with the editor to discuss these issues.

Corporate Affairs Offer positive examples of innovation and new developments (e.g. health information, mental health calls) as exclusives to journalists where relationships are developed.

Corporate Affairs Work with local media to highlight locally based joint-service provision and features, to tap into the local press where more likely be covered.

MSPs and MPs

Objectives:

The 2007 election will bring increased political pressure on the organisation. Our aim is to ensure that MSPs and MPs are informed about the service and have the opportunity to engage with us at all times. This can only be done through regular communication, providing up to date and relevant information to MSPs. At one level this will include regular communication to all MSPs, but more intensive work will be targeted towards those MSPs who have an interest in health matters, regularly comment upon NHS 24 or have a history of contact (constituent casework), to ensure they are aware of developments in the service. NHS 24 can provide information, and establish relationships to enable us to clarify aspects of the service that individual MSPs and MPs may choose to comment upon. Whilst this may be retrospective, it will help to engender awareness and understanding of the service.

Actions:

Corporate Affairs Targeted direct interaction with MSPs focussed on those with an interest in and experience of NHS with meetings and opportunities to visit contact centres. Continue to monitor MSPs interest in NHS 24 through a database of contact covering press comments, PQs, and complaints on behalf of constituents.

and summaries of performance figures. Consider opportunities for further interaction, for example at Board meetings or in public exhibition areas at Holyrood.

Corporate Affairs or

Chief Executive When MSPs make comments about the service in the media or in Parliament that are not accurate or misleading, then follow up with correspondence clarifying position and offer of a meeting to discuss and visit to contact centre.

Corporate Affairs Where issues relating to a particular constituency arise, ensure that the local MSP(s) is/are offered the opportunity of a briefing in advance.

Patients and the Public

Objectives:

Informing and educating patients and the public about NHS 24’s services is a key priority for the organisation. Our objective is to improve the public’s perception leading to a more appropriate use of out-of-hours services and awareness of new service developments.

A second objective is to better align the service to public and patient needs by creating a Patient Focus Public Involvement reference group that will help inform the organisation’s decision-making.

Corporate publications will continue to be available on request to people with diverse needs and in alternative formats e.g. non-English translation, large print, Braille. They will continue to be corporately branded, produced to a high quality standard, but cost effective and accessible online.

Actions: Patients and Public

Corporate Affairs Explain how out-of-hours services work through the media and tap into NHS partners’ existing communications e.g. Boards’ publications and websites, and patient involvement groups.

Corporate Affairs and

board counterparts All communication on out-of-hours services to be presented in partnership with local Boards where at all possible, to explain and illustrate the patient journey.

Corporate Affairs and boards counterparts

Tap into local authority networks of external communication media, e.g. newsletters, to place articles (in conjunction with relevant local boards where possible) to further disseminate information about appropriate use of services and to promote new aspects of the service as, for example, the capacity of the website develops.

Corporate Affairs Focus on local media to promote public involvement in the service and local service delivery. The local media is well read in Scotland, and many weekly titles are more likely to print stories about how to make use of services. This can be tied into planning around peak periods, ie winter, and again should be done in conjunction with local NHS boards.

voluntary sector orgs representative organisations (e.g. CHPs) to place articles, and circulate tailored promotional leaflets/information, in addition to PFPI engagement activity.

4.2 Internal Communication Objectives:

NHS 24 recognises the important role of internal communications in supporting the effective progress and development of the organisation. Looking forward, internal communications will be guided by the vision and values being developed by the organisation’s cultural awareness programme, Engaging People. To achieve an open, honest and effective communications strategy, the key objective of internal communications will be to:

Support the organisation in achieving its strategic aims by providing employees with high quality communication opportunities that engage, involve and also explain the nature, timing and reasons for different activities across the organisation.

To achieve this objective it is important that high-quality communication – at strategic and operational levels – becomes normal practice across NHS 24

Each plan, strategy and service change will therefore include consideration of communication and public involvement issues. All major projects or reviews will contain a communication plan that identifies the methods to be used and the success criteria for the plan. Absence of such consideration will limit the progress of the plan.

Actions:

The actions in this section have been informed and developed following the review of internal communications in NHS 24 which was undertaken in July 2006. The proposed actions have been developed in conjunction with the staff side representatives of the Partnership Forum and endorsed by the Executive Team. Some of these actions are the responsibility of the Corporate Affairs team, although others sit with Operations or Human Resources. All require different parts of the organisation to work together to ensure benefits are achieved. There was a recognition that currently there is too much internal communication, of mixed quality and effectiveness, and all communication is top-down. These actions seek to rationalise the number and frequency of communication activities, increase the quality and relevance of information that is being communicated and enable more bottom-up and face to face communication to occur.

INTERNAL

Operations Team meetings and briefings to be more widely developed in all operational sites. This is being addressed by the Operations team through the introduction of buddy team leaders and lead call handlers, to enable more face to face communication within teams. Currently shift patterns can make it difficult for team leaders to see team members regularly.

sent within the organisation and are cited as a cause of irritation to many staff groups.

Corporate Affairs and Knowledge Team

Combine Staff Bulletin and News Brief into a new publication produced every 4-6 weeks, with a focus on the people working for NHS 24 to give more ownership and identification with the organisation in addition to information. This will form the basis of a staff publication that will be produced in hard copy and also be made available electronically via the intranet. The focus of the publication will be the people who work for NHS 24, with the opportunity for corporate messages to also be disseminated, including staff views and comments back to the organisation. (This will not affect the Knowledge Bulletin which will remain weekly).

Corporate Affairs Issue a bulletin on an ad hoc basis i.e. when major corporate developments occur to ensure that significant messages are disseminated throughout the organisation as rapidly as possible. This will be done using e-mail, message of the day, intranet pop-ups and display boards and plasma screens in contact centres, as appropriate.

Corporate Affairs and Partnership Forum

Partnership newsletter (issue 1 published in July) to be published monthly. This was agreed by the Partnership Forum to help raise the profile of their activity, and is produced immediately after each meeting in conjunction with staff representatives. Corporate Affairs and

IT

Intranet to be redesigned to be more accessible to users. The current staff discussion forums on the intranet, which are monitored and feedback offered, will continue to be available to staff.

Corporate Affairs and

Executive Team Recommence programme of Executive Q&A/awareness sessions in contact centres, to raise the visibility of Directors and enable face to face communication on significant issues. This will begin with roadshow events around preparations for the winter peak period.

In addition to the activities outlined above, there are a number of initiatives in the organisation which will have a significant impact on communications activity depending on the outcome of current discussions. An example of this is the review of the corporate website, nhs24.com, to accommodate the development of the health information service.

4.3 Communication within NHS Scotland Objectives:

NHS 24 works in close conjunction with partner organisations, such as local NHS boards and the Scottish Ambulance Service, in delivering out of hours services across Scotland. However, as an organisation with more than 110,000 direct employees in hospital and community settings as well as GPs, pharmacists and others who provide healthcare services without being directly employed, there are many within NHS Scotland who are not aware of the service NHS 24 provides as part of NHS Scotland. All of those people are in some way potential ambassadors for the NHS within their communities. It is therefore important that those who work for NHS Scotland have an understanding of NHS 24, particularly where they are interacting directly with members of the public who may request information from them about out of hours or health information services. There may be some within NHS Scotland who have a view of NHS 24 which is based upon historic information. To help facilitate more sharing of information and closer working across the health service, NHS 24 should maximise opportunities to engage and communicate with, and within, the health service.

The key objective of NHS 24’s communication activity with those who work within, and for, NHS Scotland is:

To provide the wider NHS community with timely, accurate and useful information about the role NHS 24 currently plays, and will develop, in delivering health care in Scotland. To ensure that knowledge of NHS 24 is shared across NHSScotland so that accurate information is being disseminated to patients, the public and with NHS staff.

To achieve this objective it is important that high quality information is shared widely across the health service, in a range of formats. Whilst engagements and joint working has been primarily with out of hours service providers, ensuring that information about, and the opportunity to provide feedback to, NHS 24 is shared more widely is important in the context of the future development of the service outlined in “Working for a Healthier Scotland”.

This communication needs to happen at a number of levels, from Chairman and Board level meetings, through wider communications and engagement at operational level. As NHS 24 personnel interact with other parts of the NHS, they will need to be able to impart accurate and up to date information about the service. This objective is therefore closely associated with internal communications activity, so the approach outlined in 4.2 above will inform the actions in this section.

NHS Scotland

NHS Board Board meetings, which are held in public, will take place in different health service venues throughout Scotland. Members of the ‘host’ board and their staff will be invited to attend the meeting, or opportunities to network before or after the formal meeting

Chairman To continue programme of regular meetings with counterpart Board Chairman across Scotland, in conjunction with Chief Executive or Chief

Corporate Affairs NHS 24 internal magazine to be circulated to all health boards, via communications leads and Chief Executive office. Bulletins and updates focussing on service developments to be more widely disseminated through out of hours services and leads.

Corporate Affairs Work with other health boards to develop articles on the role and development of NHS 24 to be used within NHS boards various newsletters and publications, which are widely circulated to their employees. Where possible, for this to be tied to local information or developments.

Clinical Directorate Clinical engagement programme to enable interaction with the wider clinical community in a health board area. It is proposed that this is done in conjunction with the local out of hours providers, but the audience is primarily other parts of the clinical community where there will be some impact, such as GPs, surgery staff and Accident and Emergency specialists. This approach will be piloted in Grampian initially.

5.0 Delivering a communications approach

The Corporate Affairs Department has responsibility for co-ordinating all internal and external communication and is the “host” Directorate for Patient Focus and Public Involvement. The Director of Corporate Affairs has overall responsibility for leading the communication activity both at a strategic and operational level and should be responsible for seeking to ensure that the organisation’s communication activity is consistent with this strategy. The Director of Corporate Affairs is also the single Designated Director for Patient Focus Public Involvement (PFPI) for NHS 24 from 1st April 2006 and is therefore accountable to the Chief Executive and the Board for ensuring that NHS 24 delivers on all the PFPI requirements, through this strategy and the various supporting strategies.

The reality is, however, that the effective communication is the responsibility of every member of staff, whatever their role or in whatever part of NHS 24 they work. Responsibility is therefore corporate and deliverability depends on the creation of a culture where communication is valued, and effective communication is seen as a priority – in practice as well as in principle. The effectiveness of this strategy will depend on using all possible techniques to deliver a clear and coherent set of messages about NHS 24.

The communications strategy should not be viewed as a stand-alone document. It sets out the principles and culture against which all communication activities, throughout the organisation, will be delivered. It sets the communication ground rules and will only be effective if a number of supporting strategies and plans are working together across the organisation.

The communications strategy and supporting documents require the NHS 24’s Board to give leadership to the strategy and act as its ambassador. This senior level endorsement together with the capacity and resource to deliver the actions are critical success factors.

APPENDIX A

Principles and Standards

NHS 24’s internal and external communication will be underpinned by the following standards: Open The reasons for decisions are available, decision-makers are

accessible and willing to discuss why and how the decisions were made, for example, to the media or individual members of the public. When information cannot be made available the reasons for this are given. Questions are welcomed and answered promptly.

Corporate Communication style and messages reflect a consistent view within NHS 24 and, when required, across the NHS as a whole. Two-way Systems exist to support communication at all levels of the

organisation as well as across teams, departments, services and directorates. Staff and the public are encouraged to contribute ideas and opinions and give and receive feedback. Timely Information is provided at the time it is needed, is relevant and

is capable of being interpreted in the correct context.

Clear Information is in plain English, without jargon and with minimal use of acronyms, which are always explained. Accessibility guidance is used to analyse our external communications and documents. Leaflets etc are developed with the public. Written messages are clear and concise, use short sentences and avoid management terminology.

Targeted The right messages reach the right audiences, in the right format, at the right time.

Credible Trust is earned by responsible, open, honest and timely communication, promoting a culture of understanding and realism. Recipients of information can trust it and can expect to be advised of any change that might cause the information to be invalidated.

Planned Communication is proactive and planned and communication activity is appropriate and timely.

Consistent Messages are delivered in a co-ordinated fashion, without contradictions. Communication issues are anticipated and planned processes are applied to deal with them.

Efficient The communication and the way it is delivered is “fit for purpose”, cost-effective, to budget and delivered on time.

Integrated Internal and external communication is consistent and mutually supportive.

Evaluated Communication activity will be internally and externally evaluated to ensure that it adheres to the principles and values of this strategy.

APPENDIX B

Stakeholder Map - Communications Strategy

The stakeholder map below sets out an indicative analysis of the key stakeholders which are referenced within the communications strategy. The development of the actions contained within this strategy have been influenced by this analysis. There are different levels of interest and influence amongst each stakeholder group, and the actions within the communications strategy have been developed in a way that is proportionate, targeted and takes into account the level of resources available.

High

Keep

Satisfied

Manage

Closely

Monitor

(Minimum

Effort)

Keep

Informed

• Parliamentary Health Committee

• Health Correspondents/Scottish Press

• Editors of Scottish Press

• MSPs with Health Interests

• MSPs/MPs Generally

• Health Board Chairman/Board Members

• GPs via Local Committees

• Accident & Emergency Specialists

• Out of Hours Partners/Scottish Ambulance

Services _{• Patient}

Representatives (NHS 24/PFPI Ref Group)

• Charities/Voluntary Sector Organisations

• NHS 24 Staff

• Wider NHS Community

• Patient Representatives (Health Boards)

• Local Authorities

• Community Councils

• Community Organisations

• Health Spokespeople Scottish Parliament

Power

• Journalists/Media General