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Challenges and advantages of integrated working with the NHS

Hayley Cook, Marketing and Communications Manager for Portsmouth City Council and NHS Hampshire and Isle of Wight Integrated Care Board (ICB), shares her reflections on working in an integrated communications team across local government and the NHS.

Joined-up working, collaboration and integration might sound like comms buzz words of the month, but successfully done can be an effective way of working. So how do you work well across complex organisations like local authorities and the NHS?

Most of my day is spent in meetings. The good kind. Talking to comms, marketing and engagement officers in my immediate team, other comms teams at NHS hospitals or community providers, partners in the voluntary sector, senior leaders, councillors or MPs. To be honest, it’s hard not to be talking to people when the team around you spans across six organisations who have all made a commitment for their communications teams to work collectively.

My job is to bring people together; encourage organisations to work collaboratively to achieve greater results; engage residents and co-produce services; develop relevant campaigns; and encourage collaboration to save money, time, and resources.

The meetings are generally positive with enthusiasm, creativity, and innovation, and we all have a sense that joined-up working is the right thing to do. And it makes sense, doesn’t it? We all want what’s best for our residents – at all points of their healthcare journey. Whether it’s preventative work to encourage healthy lifestyles through stopping smoking, losing weight or drinking less; supporting patients to access NHS services like GP practices, pharmacies, urgent treatment centres or emergency departments; promoting mental wellness; helping families to give children the best start in life; or looking after our older population in their own homes or care homes. To residents, it doesn’t matter whether these services are local authority-led or NHS-led so our ethos is to be people-led. And if the healthcare system is at its best when it’s working together, it makes sense that our communications teams work together too.

We’re lucky in Portsmouth that our senior leaders are absolutely committed to integrated working. Health and Care Portsmouth was established in 2015 and is made up of six organisations across the city – Portsmouth City Council, NHS Hampshire and Isle of Wight ICB (formerly Portsmouth Clinical Commissioning Group), Portsmouth Primary Care Alliance, Portsmouth Hospitals University NHS Trust, Solent NHS Trust and HIVE Portsmouth.

We have a virtual team of comms, marketing and engagement officers from the six organisations, which I joined in 2021. It was the middle of the pandemic and collaborative working across organisations had never been stronger, but there was still some confusion around when else we should work together, who did what across the teams, and why joined-up comms is better than going it alone.

With the support and encouragement of our senior leaders, we’ve worked more closely in the last few years than ever before. We have a clear communications and engagement strategy, shared branding, reporting mechanisms, and regular meetings to come together, update each other on our projects, and find opportunities to work collaboratively. We work together because it’s better for the people we serve in Portsmouth. But, if we didn’t have the backing of our senior leaders, and we didn’t show them what we are achieving by working together, I don’t think we would have the fantastic team we do today.

Challenges of integrated working

Of course, there are challenges; working together isn’t straightforward. You won’t generally have one leader for an integrated team but multiple leaders, with different personalities, ideas, and ways of working. They’re also likely to have very different job titles. I worked in local authority before integrating with the NHS and early on, I think people found it difficult to understand where my role sat in the NHS hierarchy, why my title didn’t appear to hold much seniority and yet I was being invited to meetings with the Chief Executive of the council. Job titles really shouldn’t matter, but sometimes they do!

Organisations will also have their own objectives, and while some will be similar, there will be competing priorities and encouraging people to focus their efforts can be challenging. More partners generally also means a lengthier, more frustrating approval process.

And then you’ve got conversations around branding – do you create a new brand for an integrated system? One that represents you all coming together under one umbrella, and something that everyone can share on their channels? Or do you use existing brands that people might already know, but risk needing 25 different logos, fonts and colours on each design asset? And when do you decide to compromise? Not every campaign will be suitable for a shared brand and having that conversation openly and transparently will help, but it can be difficult if you haven’t established a good relationship with your colleagues and can have a frank discussion about who’s logos need to be included and who’s don’t.

Working together isn’t easy, but it is beneficial – and when was anything worth doing easy?

Benefits of working together

The time and effort that is saved by representing multiple organisations at once is one of the greatest advantages to collaborative working. In Health and Care Portsmouth, our comms officers understand the internal processes for their own organisations, including who to speak to when things need moving forward, what budgets might be available, and what else is happening that might impact our work. Where one partner might have budget for something and another might have resource or capacity, we lean on each other accordingly.

Having access to more communications channels is also a huge benefit of collaborative working. Local authorities and hospitals tend to have greater reach than ICBs through printed magazines, e-newsletters, social media channels, events, schools, and spaces such as community centres, libraries, care homes, leisure centres and hospitals, while ICBs work closely with GP practices, pharmacies, and urgent treatment centres. Tapping into each other’s channels means you’re likely to reach different audiences, and you’re likely to save money if your partner organisations are making requests on your behalf. You might also benefit from additional resources within the organisations you work with. Portsmouth City Council for example has in-house graphic design, digital and market research teams that the ICB don’t – so we access this through Health and Care Portsmouth and have more joined-up marketing and communications campaigns as a result.

Working together also means you’re likely to avoid duplication. Why develop a campaign for mental health that’s like one another Trust is developing? Or send five e-newsletters to the same audience when you can combine efforts and send one? Why not develop case study videos and avoid putting a logo on, so anyone can use them and help to spread the word. Sometimes, working collaboratively can be about putting your organisational pride to one side and focusing on other people first.

Top tips for integrated communications

So, if you’re part of an integrated communications function or want to be, here are my top tips for effective collaboration:

  1. Have the want to work together – start from the point of knowing that you’re going to work together and then work out how, instead of debating whether it’s a good idea. It is! If you are truly integrated, you will want to work together as much as possible, and you’ll reap the rewards of being in a wider team.
  2. Have a shared vision – see which objectives you have in common across your organisations and agree what you’ll work together on. Come together often to feedback on your objectives and discover more opportunities to further your own priorities with support from colleagues.
  3. Put residents first – break down barriers between organisations and think about what’s best for your residents. If you can make health and care easier and more accessible for them by working together, make it happen.
  4. Work as a team – think of your comms colleagues in other organisations as your day-to-day colleagues in your immediate team. Make the effort to get to know each other and build relationships – it will help no end when you’re working together on a campaign or need support with something.
  5. Split the work (and the bill!) – share your comms plans and divvy out tasks between everyone. It will make the team feel more like a team, and the transparency will show that everyone’s pulling their weight. And if you don’t have a pooled budget, consider offering to pay for part of the work – you’ll get it back another time, perhaps when you most need it.

Working in an integrated communications team will have its challenges – we’ve faced them, and continue to face them, but there are also so many advantages. We’re so proud of how we work in Portsmouth and what we’ve achieved through Health and Care Portsmouth, and we wouldn’t have it any other way!

Hayley is one of the panel members for the upcoming webinar ‘Health and care – working together. A conversation about system working and how communications can oil the wheels’. Register for free here and join us online at 9.30am on Thursday 13 July.

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