Communication as a vehicle for change
 

How has your background shaped your work?
I always had a love of writing and had a passion for journalism. I went to journalism college after school, worked on local newspapers, and then studied media studies at what was then the Polytechnic of Central London.

When I graduated, one of the old Regional Health Authorities in the NHS (about five restructures ago!) was looking for a PR officer. They approached the course leaders, and I got the job.

Why did you make the switch to healthcare communicator?
It was completely by accident that my first job was in health. But I quickly caught the bug for health communications. I’ve been in the field pretty much ever since, mostly in mental health, with stints in ambulance services, an acute trust and, briefly, as a special advisor at the Department of Health.

I’ve always loved the power of a good story and the ability to use words to create meaning, convey complex ideas and help make sense of things. What really drew me in was the variety – media relations, digital comms, strategic planning – there’s so much to get involved in.

What is the most important principle for you when developing healthcare content?
Social justice. During one of my earlier jobs, at the Maudsley Hospital and the Institute of Psychiatry in 1997, I became really passionate about the role comms can play in public education: tackling stigma and busting myths around mental health. It’s a role that genuinely adds value to what clinicians do.

About 10 years ago when I was at the South London and Maudsley NHS Foundation Trust, we did a four-part documentary series with Channel 4 called Bedlam, following the journeys of people with serious mental health problems. It was a real privilege to be involved in that piece of work and it had a huge impact – we won a BAFTA. We did it to try and help demystify mental health conditions and services, and to convey that recovery is possible with the right support.

There’s still stigma and discrimination around mental health and learning disabilities, but public attitudes have shifted considerably, and health communications and public relations have played their part in that.

What’s the biggest misconception you see in your work?
That communication is a one-way process – that it’s all about reputation management. I think of it as more about relationships – with all your stakeholders, whether the public, patients, families or staff.

And at our best, communications also add value in supporting change and improvement – whether helping explain strategy, tough decisions or change in a way that’s clear, honest and authentic.

It’s also about encouraging clarity in everything you do. For example, at our Trust, we realised our complaint responses were often too corporate, too long and didn’t get to the heart of the issue, so I’m leading on complaints improvement, including response times, clarity of content, and tone of voice.

There’s still a view in parts of the NHS that saying sorry equals admitting liability. But it’s powerful to acknowledge mistakes. Sometimes, you just have to say, ‘We got this wrong. Thank you for raising it. Here’s what we’ll do to try and prevent it happening again.’ That not only respects the voices of patients and carers – it also improves your service.

What trends are you seeing in the sector?
I’m excited about the growing professionalism of communications. In some quarters there’s still a view of it as a slightly superficial, cosmetic function that’s all about spin, but it’s beginning to shift.

Alongside my day job I’m deputy director of the Centre for Health Communications Research, which is in part about bringing an academic grounding to our practice. A couple of months ago we launched the postgraduate programme for NHS Communications and engagement professionals and we have about 20 practitioners in the current cohort.

That’s important as you don’t often see academics who are practising in the field of communications. I wonder whether people think the abstract theoretical stuff doesn’t have much to do with the day-to-day job of being a comms or PR practitioner. Whereas I would argue that it that it absolutely does, because it means your practice by credible evidence, not guesswork.

And if we’re serious about communications being a strategic function, with the same weight around the board table as Finance and HR, then having that evidence base enables us to talk with credibility and authority.

As part of this, the NHS Taskforce on Diversity, led by Edna Boampong (see the interview with her here), is shortly publishing its report on addressing the lack of diversity in NHS comms – a welcome opportunity to tackle this issue.

What’s on the horizon for you?
I’ve just about completed my PhD thesis in organisational change, leadership and communications in the NHS, which I’m hoping to publish in a peer-reviewed journal.

Change is often conceptualised as a technical, rational process. I contend that to do it successfully, you have to increase awareness of the emotional impact. I’ve developed a conceptual framework called Grounded Optimism. This is essentially about having a hopeful, realistic and plausible organisational vision where you’re open about the challenges associated with change.

It feels like a pertinent topic for our times. The NHS is facing high levels of need, with finite resources. Despite the great work being done every day, public satisfaction is low and people are frustrated with access and waiting times.

So we need to be up front about these problems, while holding up the hope that improvement is possible. And clear, timely, two-way communication and engagement will play a critical role in making that happen.

1. Stay curious. Keep learning. Especially as you get more experienced, it’s easy to think you’ve got it figured out. But there’s always more to explore.

2. Be open to change. There are always new practices, new ways of doing things. That’s what keeps me excited – seeing what others are doing across the NHS, other public services and the private sector.

3. Don’t be afraid to experiment. Our job isn’t about having one fixed answer – it’s about knowing there are different ways to approach challenges.