Communications Strategy

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					Communications Strategy and Action

                     January 2010

Jackie Stephen, Head of Learning and Corporate Affairs

1.       Background

The Royal National Orthopaedic Hospital NHS Trust (RNOH) is the largest
orthopaedic hospital in the UK and regarded as a leader in the field of
orthopaedics both in the UK and world-wide. We provide a comprehensive range
of neuro-musculoskeletal healthcare, ranging from acute spinal injuries to
orthopaedic medicine and specialist rehabilitation for chronic back sufferers. This
broad range of neuro-musculoskeletal services is unique within the NHS. The
Trust‟s aim is “to be the specialist orthopaedic hospital of choice by providing
outstanding patient care, research and education" and this is underpinned by our
values, which were developed by staff: Patients first, Equality, Respect,
Excellence, Trust, Honesty.

The Communications department works with Executive Directors, clinicians and
managers across the Trust, providing advice and support on all communications
issues and handles media enquiries as well as Freedom of Information requests.

This strategy paper sets out our aims for enhancing communications across the
Trust and with our stakeholders, patients and the public outside the Trust.
Specifically, we aim to:

        Raise the profile of the Trust in the local community by increasing
         coverage in local press
        Raise the profile of the Trust within the national community by increasing
         coverage in national and specialist press
        Promote the Trust‟s services through online and other media
        To improve the content of the Trust‟s website to enhance its effectiveness
        To encourage greater use of the Trust‟s intranet by staff across the Trust
        To ensure that key messages from the Trust are clear, easy to
         understand, timely and relevant and that we are responsive to feedback
        To enable clear, open and accessible communication between staff, our
         patients and the public, including difficult to reach groups
        To ensure consistency of content and visual style of communications
        To enhance existing communication channels with staff to ensure their
         involvement and understanding of Trust issues and priorities
        To raise awareness of, and explain RNOH‟s decisions and policies,
         justifying our actions and responding to criticism

The strategy necessarily includes both internal communications (with our staff)
and external communications with a wide range of stakeholders and opinion
formers. NHS Trusts experience high levels of media and political interest that
brings pressure on organisational communication needs, consequently open,
effective communications are essential with all stakeholders to help drive
improvements and changes in the Trust.

This communications strategy aims to make communicating with our
stakeholders (both internal and external) integral to the work of the Trust. It sets
out the role of communications and reputation management in contributing to the
achievement of the Trust‟s aim and corporate goals, and to complement our
Trust values. It also specifies the work of the communications team and their
collaboration with key staff across the Trust both on an ongoing basis and
through specific Trust projects. Through enhancing our communications, we aim
to raise the visibility of the Trust as well as develop its credibility in terms of the
work it does.

Effective communication is an important element of any successful Trust but
particularly at this time for RNOH when we are aiming to become an NHS
Foundation Trust and we are establishing strategic partnerships beyond the Trust
itself. Open, timely and responsive communication will play an essential role in
determining the public perception of the Trust and fostering increasingly effective
relationships between the Trust and other bodies, groups and individuals.

This strategy paper will be supported by an action plan, underpinned by a set of
core principles. These need to be continually responsive to policy changes, new
developments and, most importantly, to ensure that patients, carers, staff and
key stakeholders remain at the heart of the strategy.

The communications strategy is underpinned by a range of local and national
initiatives including the Data Protection Act, the Freedom of Information Act, NHS
plans, the Trust‟s business plan as well as a range of Trust policies and

Communication is part of everyone‟s role and therefore we acknowledge that
effective implementation of this strategy will be dependant on:

      Ownership by all staff
      Support of senior management and the Trust Board
      The capacity of the communications team

2.       Roles and Responsibilities

Members of the Trust Board should:

        Ensure that key messages are cascaded to staff and/or patients/the public
         in a timely, clear and relevant manner
        Support the communications team at both strategic and operational levels
         in the implementation of this strategy
        Act as media spokespeople as and when necessary
        Listen to feedback from both internal and external sources and respond
        Take opportunities to build on the Trust‟s reputation and profile with key

All managers should:

        Be communications champions for their team/ward/department ensuring
         an effective cascade and feedback process for internal communications
        Follow corporate guidelines for communicating both internally and
        Ensure that communications guidelines are followed when managing
         projects or undertaking organisational change initiatives

All staff should:

        Ensure that they communicate responsibly and sensitively with patients
         and their carers
        Take opportunities to engage with the wider organisation to ensure that
         they are well-informed about Trust developments and priorities
        Identify positive news stories for distribution either internally or externally,
         as appropriate
        Refer all media issues and enquiries to the communications department

The communications team should:

        Lead and drive the Trust‟s communications strategy, measure and report
         on its effectiveness
        Ensure that systems are in place to foster effective two-way
        Develop and circulate corporate messages and publications e.g. Team
         Brief and Articulate
        Provide an effective media service
        Contribute to all Trust projects to enhance communications through those

        Drive improvements in web-based communications both internally and
        Provide support and advice on strategic and practical communications

3.       Principles/Standards

Communication at the Trust will be underpinned by the following principles:

        Open – the reasons for decisions are available, questions are encouraged
         and answered promptly
        Corporate – our communication style reflects a consistent view in line with
         Trust guidelines
        Two way – processes are in place to support two way communication at
         all levels within the Trust, with staff and patients encouraged to give and
         receive feedback
        Timely – communication takes place when it is needed
        Clear – all communications are concise and provided in plan English with
         minimal jargon
        Targeted – the right message reaches the right audience, in the right
         format, at the right time
        Credible – Trust communications are recognised as being open, honest
         and timely and changes are communicated when they happen
        Consistent – both internal and external communications are consistent
         and mutually supportive

4.       Stakeholders

The Trust has a broad range of individuals and groups who we consider to be
key stakeholders. These include:

Internal to the Trust:

Union representatives
Staff working for our contractors
Volunteers e.g. the Friends, Radio Brockley

External to the Trust:

Patients and their carers
The public
GPs and PCTs
Voluntary groups/charities/special interest groups
NHS London Strategic Health Authority
Other NHS Trusts and health service organisations

Department of Health
Health Protection Agency
Healthcare Commission
NHS Employers
Local authorities (e.g. social services)
Local services e.g. fire, police
Local groups e.g. Harrow LINk
MPs and councillors
Educational organisations including our academic partners, local schools and

Foundation Trust:

Existing and potential FT members
Council of Governors
Foundation Trust Network
Other Foundation Trusts


Local press
Specialist and national press/broadcast media
News agencies

5.       Communication Channels

The Trust has identified a range of communication channels through which we
wish to communicate key messages and wishes to build on and improve on the
effectiveness of these channels. Progress has already begun e.g. the style and
process of team briefing has become less formal and more inclusive.

The communication channels include:

Face to face communication
Articulate (the staff newsletter)
Team Brief
Directors‟ Open Forums and ad hoc staff briefings
Corporate induction and staff training programmes
Letters from Executive Directors
RNOH Web – the Trust‟s Intranet
RNOH website
Publications e.g. annual report
Annual General Meeting and other public meetings

Information produced and distributed by other NHS Trusts, health organisations
and the Department of Health
Displays e.g. in the Outpatients‟ department
Press releases/statements
Tours and visits
Say So Scheme – a process for providing comments, compliments, suggestions,
PALS service
FOI publication scheme

The use of these channels will be determined by specific objectives e.g. to
inform, persuade, clarify, change behaviour and will be selected to enhance the
Trust‟s credibility with its target audiences.

6.       Internal Communications

It is recognised that well-informed, engaged staff are more likely to be motivated
and willing to act as ambassadors for the Trust. The Trust already has a range of
communication channels through which it communicates with staff and this
strategy aims to support improvement/enhancement of the channels that exist as
well as determining new ones.

Current methods include:

Articulate (the staff newsletter)
Directors‟ Open Forums
Team Brief
Team-based discussions with senior managers/directors
Poster campaigns
Noticeboards with details of forthcoming events and training courses

The annual staff survey asks staff for their views on communications across the
Trust. The results of the 2008 survey reinforce the need for an effective strategy
to effect change and improvement. Key results included:

        29% of staff felt that communication between senior management and
         staff is effective

        64% of staff felt they were able to contribute towards improvements at

        53% of staff agreed that they understand their role and where it fits in

     In 2007, only 24% of staff felt that, on the whole, the different parts of the
     organisation communicate effectively with each other. This question was not
     addressed in the 2008 survey.

The Trust will aim to:

        Facilitate a culture of effective communication within the Trust, leading to
         involved and motivated staff

        Ensure that all staff are well informed and understand key issues relating
         to Trust business

        Develop effective two-way communication at all levels across the Trust

        Create a workforce that understands and is committed to the key goals of
         the Trust

7.       External Communications

The Trust aims to enhance the effectiveness of its communications with
stakeholders outside the organisation. There are a large number of audiences
who need different information and different approaches.

Currently the Trust uses the following communication methods but recognises
that more can be done to achieve our dual aims of raising visibility and
developing credibility:

        Meetings with key stakeholders e.g. representatives from PCTs
        Annual General Meeting and other open meetings
        Visits to other organisations by key Trust personnel
        Press releases
        Mailshots e.g. to FT members
        Patient Forums
        RNOH website
        Presence on „NHS Choices‟

The Trust needs to build on its relationships with opinion formers such as MPs,
local groups and patient forums, particularly as it is seeking approval for the
Stanmore redevelopment and is working towards becoming an NHS Foundation
Trust. Currently the Trust enjoys good relations with local MPs but it is
acknowledged that more could be done to involve the local community and to
maintain the Trust‟s profile.

Traditionally, the Trust has adopted a responsive approach to the media, rather
than a proactive one. It is recognised that the media‟s handling of issues can
have an immediate and direct impact on staff morale and Trust reputation.
Consequently, it is essential that the Trust pursues a policy of active engagement
with the media in order to raise awareness and further their understanding of the
work undertaken by the Trust.

The Trust will aim to:

        Increase public understanding and awareness         of the work      and
         achievements of the Trust

        Advise patients and the public of major developments and changes which
         will affect them directly, and involve them wherever possible

        Use a range of appropriate and effective methods of communicating with
         our audiences to raise awareness

        Foster links with key opinion formers

        Learn from complaints relating to communication

        Develop guidance and a set of standards for publications to ensure
         consistency, clarity and good practice

        Encourage public confidence in the quality of care we provide as well as
         ensure openness and accountability

8.       RNOH Website

The World Wide Web continues to grow in importance as a communications
channel, an accessible source of information and resources, and a delivery
mechanism for a range of services. The Trust has taken advantage of the
opportunities that have arisen as a result of web technologies and needs to
consider now which tools to use, as well as effective ways in which to deploy

The Trust‟s website ( is managed by the communications
department, supported by an external web design and maintenance service. The
site has been developed incrementally, with a major redesign in early 2009
(which has elicited very positive feedback from a range of sources). The current
site provides information for patients, the public and health professionals and
also fulfils statutory/Department of Health requirements by providing access to
Board information, Care Quality Commission standards, action plans etc.

In October 2009, the RNOH website had 16,054 visitors, from 101 countries. This
indicates that our web presence is clearly a channel that we can continue to use
to reach a very wide and disparate audience.

We recognise the website‟s potential for delivering on many of our
communications objectives and so have identified a series of web-specific
actions to pursue, outlined in Appendix 1.

9.        Marketing, Brand and Reputation Management

The Trust may wish to adopt a marketing approach to developing its services as
this approach is gaining support within the NHS. We have stated elsewhere that
our service development vision is to:

      •   Accept patients that other hospitals cannot treat
      •   Expand our range of specialist orthopaedic services
      •   Undertake research to find better ways to treat patients
      •   Export our expertise to other hospitals

Using the above as a starting point, we should begin by gathering intelligence
about our market to develop a better understanding of the needs and wants of
our patients, GPs and other stakeholders in order to make our services more
responsive and to help us understand the factors which influence their choices.

The Trust has a world-wide reputation for good clinical outcomes and for the
delivery of highly specialist services. We wish to maintain public confidence in
the RNOH and so need to protect the reputation of the Trust, for example ensure
that we understand public perception of issues such as infection rates, waiting
times and other issues which affect choice and public opinion. Opinions are often
based not just on formal communications but also perceptions of quality and
comments from friends, family and staff. An initial step to developing our
reputation is to truly understand what our current reputation is, how the Trust is
perceived and so set a baseline on which to shape and develop our services,
aligning them with the reputation we have and/or aspire to.

Branding can be difficult for NHS organisations because so much of the brand is
determined nationally through the image of the NHS. We may, however, develop
the brand by being clear about how we present ourselves e.g. through our
buildings and written communication, as well as how we relate to our
stakeholders and respond to their feedback.

10.       Crisis Management

Given the size of the Trust and its communication resources, it has been
recognised that we need to complement our internal resources with external PR
support (currently Jonathan Street PR) for use out of hours and in crisis

management. The relationship between the Trust and its external PR provider
may be enhanced by more regular contact.

11.       Action Plan

An action plan has been produced (Appendix 1) to enable the Trust to deliver this
strategy and so that we may monitor our work against set timescales.

Key communications objectives for the next 12 months may include:

         Maximising opportunities to raise awareness of the Trust‟s work both
          locally and nationally

         Creating a staff body which is well informed and feels valued

         Seeking to achieve positive publicity for the Trust and minimising the
          impact of negative coverage

         Keeping existing and potential Foundation Trust members well informed
          and motivated to contribute to the Trust‟s journey towards becoming a
          Foundation Trust

         Facilitating partnership working and meaningful engagement with our staff
          and external stakeholders

         Protecting and enhancing the reputation of the Trust as an excellent
          employer and service provider

         Developing a reputation for excellent care, responsiveness to feedback, a
          Trust that staff are proud to work for, an organisation that others seek to
          emulate and learn from

12.       Evaluation and Monitoring

Measuring effective communications is not a precise or easy task; it is essential,
nevertheless, that we strive to review how well our communication methods ar e
working, to identify areas of success as well as to prioritise areas for
development or improvement. The Trust‟s communications strategy will be
evaluated in a year‟s time using a range of methods to measure outcomes e.g.
changes in people‟s perceptions as well as outputs (e.g. the number of press
releases issued). Methods may include 1 to 1 discussions, focus groups, patient
and staff satisfaction surveys, exit questionnaires and media analysis.

Appendix 1

Action Plan

Stakeholders        Key messages       Medium              Timing/       How     can     Outcome          Led by          Deadline     Already    Priority
                                                           Frequency     success   be                                                   being       1=
                                                                         measured?                                                      done?    Essential
Employees           Centre of          Email               Dependant     Staff survey    Improved         Comms team      Within one                1
                    excellence         Articulate          on e.g. CQC   responses       morale           Executive       month of
                                       Open Forums         returns                       Reduction in     Directors       results
                                       Feedback                                          errors                           being
                                       sessions on                                       Reduction in                     available
                                       staff survey                                      disciplinaries
                                       results                                           Improved
                                                                                         results from
                                                                                         staff survey
Employees           Developing         Learning at         Annually      Take-up of      Increased        Training team   Ongoing                     1
                    staff, providing   Work day                          development     participation
                    opportunities                                        opportunities
                    for                Joint Investment    Ongoing                       Positive
                    development        Framework                                         feedback
                                       Email, Articulate
Staff working for   You‟re             Email               Ongoing       Attendance at   Increased        Comms team      Ongoing                      2
our contractors     appreciated, an    Articulate                        events          involvement
                    important part     Team Brief                                        from staff and
                    of what we‟re      Open Forums                                       contracted
                    doing                                                                staff
Volunteers          You‟re             FT members‟         Quarterly     Attendance      Positive         Chief                                        2
                    appreciated, an    events                            Feedback        working          Executive +
                    important part     Meetings with                                     relationship     Director of

Stakeholders      Key messages       Medium           Timing/     How     can      Outcome          Led by         Deadline   Already    Priority
                                                      Frequency   success   be                                                 being       1=
                                                                  measured?                                                    done?    Essential
                  of what we‟re      volunteer                                     Development      HR &
                  doing              organisers                                    of volunteer     Corporate
                                                                                   role             Affairs,
                                                                                                    supported by
                                                                                                    Comms team
Patients and      High quality       Admission        Ongoing     Say So           Feedback         Clinical                                 1
their carers      treatment, low     booklet                      responses        leads to         Governance
                  infection rates                                 Patient survey   improved         team
                                                                  – areas of       quality of       supported by
                                                                  improvement      care             Comms team
GPs, PCTs,        High quality       Written          Ongoing     Referral rate    Feedback         Commissioni    Ongoing                   1
specialist        treatment, low     communication                Feedback         leads to         ng
commissioning     infection rates,   – consider                   process          improved
groups,           VFM, quality,      clarity of                                    relationship
commissioners     innovation,        information                                   with
of our services   specialist         presented                                     referrers/com
                  nature vs.                                                       missioners
GPs, PCTs,        What we are        Meetings with    Quarterly   Feedback from    Higher profile   Commissioni    Ongoing                   1
specialist        doing at the       clinicians                   stakeholders     of innovative    ng
commissioning     moment – more                                                    work
groups,           of/different?                                                    undertaken at
commissioners                                                                      the Trust,
of our services                                                                    increase in
                                                                                   referrals for
Department of     Importance of      Direct links,    Ongoing     Go-ahead for     Redeveloped      Chief          Ongoing                   1
Health/NHS        specialist         “knowing the                 redevelopment    Stanmore         Executive +
London            hospital,          right people”,               of Stanmore      site to meet     Executive
                  redevelopment      lobbying                     site             needs of our     Team
                  needed                                                           patients

Stakeholders      Key messages      Medium             Timing/         How     can      Outcome          Led by         Deadline      Already    Priority
                                                       Frequency       success   be                                                    being       1=
                                                                       measured?                                                       done?    Essential
Education &       Mutual benefits   Meetings           Quarterly       Raised profile   More             Chief          Ongoing                    1
Research          of partnership    Joint Academic                     of education     publicity        Executive +
Partners e.g.                       Plan                               and research     around           Executive
Institute of                                                           at RNOH          education        Team
Orthopaedics,                                                          Grater success   and research
UCLH                                                                   in gaining       undertaken at
                                                                       grants for       the Trust
Regulators e.g.   Confidence in     Returns            As per          Improved         Improved         Executive      As                           1
CQC, HPA          services we                          regulators‟     results          quality of       Team           appropriate
                  provide                              timetables      Positive press   care
                                                                       coverage         Improved
                                                                                        and retention
                                                                                        of staff
MPs and           Viable future     Meetings, visits   Ongoing         Higher profile   Investment       Executive      Ongoing                      2
Councillors       for specialist                                       for RNOH         made in          team,
                  services                                                              Stanmore         supported by
                                                                                        site/future of   Comms team
                                                                                        RNOH as a
Specialist        Key player        Links with         Ongoing         RNOH             Increased        Chief          Ongoing                      1
Orthopaedic                         manager of                         proposals        ability to       Executive +
Alliance                            SOA                                accepted by      influence        Medical
                                                                       SOA on           SOA              Director
                                                                       regular basis    members
Media             Promote           Via national and   Invitation to   Coverage in      Improved         Executive      Ongoing                       1
                  developments,     local              events e.g.     newspapers,      relationship     team
                  changes,          newspapers,        AGM,            journals         with the         supported by
                  achievements      specialist         members‟                         press            Comms team
                  to highlight      publications       events                           Greater press

Stakeholders   Key messages       Medium           Timing/     How     can     Outcome          Led by       Deadline   Already    Priority
                                                   Frequency   success   be                                              being       1=
                                                               measured?                                                 done?    Essential
               innovation and                                                  exposure
               specialism of
FT Members     Involving them     Events,          Ongoing     Increased       Strong           Comms team   Ongoing                    1
               – important role   newsletters,                 membership      membership
               in the future of   letter from CE               Of FT and       base in
               the Trust                                       Patient Forum   support of the
                                                                               hospital and
                                                                               its plans

Web-specific          Choose and Book – enhance our presence on NHS Led by Communications team
actions               websites as well as provide a link from our own
                      website                                         Ongoing
                      Future inpatients - improve the quality and volume of Priority = 1
                      information for patients preparing for a hospital visit
                      e.g. FAQs, virtual tour, patient admission booklet
                      Other websites e.g. NHS Choices, Map of Medicine –
                      update RNOH information held, include photographs
                      wherever possible; respond quickly to comments on
                      these websites, ensure all our services are mentioned
                      Consultants – develop our current list of consultants
                      by enhancing individual entries, include photographs
                      Forums – we have used forums in the past – this can
                      be utilised in the future for e.g. FT members,

consultations etc.
Foundation Trust members – investigate use of a
forum for FT members, initiate a members‟ area on
the website (as currently offered for Estates and
Facilities contractors)
IOMS – liaise with IOMS to enhance the quality of
research information on the website
General – develop web standards, metrics and
associated KPIs to enable us to measure the results
of investment and activity

Appendix 2            Current methods of Communication

Stakeholders                How we communicate now                How we could communicate

Regulators                  Returns as required                   As currently

Patients and carers         Range of leaflets, website, through   Direct communication e.g. in outpatients
                            Patient Group
                                                                  Regular input to Improving Patient
                                                                  Experience Committee

                                                                  Through FT membership – focus groups,
                                                                  newsletters etc.

Staff                       Articulate, Team Brief, Open          Continue current communication methods
                            Forums, Back to the Floor, staff
                            survey feedback sessions              Increased use of RNOH Web

                                                                  Ad hoc visits of senior managers to

Media                       Respond to enquiries                  Proactive press liaison, offering regular
                                                                  news items

                                                                  Encouraging use of site for TV

Stakeholders               How we communicate now            How we could communicate

Foundation Trust members   Newsletter, FT members‟ events,   Via website forum, focus groups

GPs, PCTs, specialist