Published: 23 November 2012

Changing the health game

The changes to NHS service market reforms present significant opportunities for charities willing to engage – but only if they know how.

The new structure of the NHS in England is now pretty clear with old structures having been replaced by suspiciously similar organisations with different names (clinical commissioning groups, commissioning support units, health and wellbeing boards and the NHS commissioning board). But more fundamental is the opening of the NHS ‘market’ to non-NHS players.

The ‘any qualified provider’ reforms now make some 25 areas of the NHS open to outside organisations. Some of these are not new (think wheelchairs and Whizz-Kidz and end of life care and the hospice movement). What is different is the scale of the opportunities available to non-NHS organisations. These opportunities will be taken: the question is whether it will be charities benefiting or other players, including the private sector.

Challenging private companies

There are many who want to see private companies running core NHS services. Indeed William Wells, former chairman of the NHS Appointments Commission, in his recent Guardian blog he suggests to ban the ‘privatisation’ word in his desire to smooth the way for more ‘partnership’ between the NHS and private companies.

Although private companies can genuinely partner the National Health Service in some capacity, the voluntary sector is much better placed to do so in so many ways.

Charities have a core advantage over the private sector and social enterprises in that they are the champions of the ‘patient voice’, a key commodity much talked about by NHS managers but poorly understood and in very short supply.

Problems and solutions

The problems facing the NHS and charities benefiting from cross-sector partnership are manifold. The following are four problems identified by both charity and NHS managers. What they indicate is that the solution for charities is to get their communications and marketing teams at the forefront of their effort to engage with the NHS.

1. Musical chairs have destroyed relationships
Almost no one in the NHS – whether in a local commissioning organisation, provider, or central commissioning board – is doing the same job as they were 18 months ago. This makes an already opaque structure even less transparent, making it harder for charities wishing to better understand and form a relationship with a potential commissioner.

2. New organisations and new priorities
All the commissioning organisations – and many of the providers – have been swept away (or, in the case of providers, have often merged and are facing a competitive market themselves) and have new strategic objectives and ways of working. This means that arguments and pitches that may have worked six months ago are often irrelevant.

3. Money
The single focus in the NHS is how to save 20% or more. While quality, engagement and patient experience are still important; all of these are secondary to an NHS organisation’s need to achieve cost savings. It means that the language and skills that charities bring to the fore need to reflect this cost saving imperative.

4. Neither party really understands each other
NHS managers are often ignorant of the strengths and skills a charity can bring to bear. And the voluntary sector generally doesn’t understand the pressures or decision-making processes of NHS managers.

The answer to all these questions can be provided by thoughtful communications and marketing leads. Because, at the heart of these problems is the need to gain insight into the ‘customer’ – not the market – and then to communicate clearly the offer and wider charitable proposition.


John Isitt, director (founder), Resonant Media

John is a specialist in health and wellbeing marketing with more than 20 years experience. His particular interests include information, behaviour change and the NHS.