news focus: Would you rather an annual report read like an informative historical document or an unputdownable blockbuster? Jennifer Trueland gets hooked

Published: 04/04/2002, Volume II2, No. 5799 Page 18

Public health director Peter Donnelly still has several boxes containing copies of his 2000 annual report. Not the one with the controversial cover, featuring condoms and the word 'sex' in big bold letters, but the alternative, sanitised version which pictured, in his words, a nice pregnant lady sitting doing yoga.

Dr Donnelly, director of public health with Lothian board, produced two versions of the report, much like a Harry Potter paperback with their 'child' and 'adult' covers to save embarrassment on the train.

While being aware of the shock value of having a condom on the cover, he had anticipated that this might not go down too well with some clients. But he couldn't have been more wrong. 'Nearly everyone requested the one with the picture of a condom on the cover.'

It wasn't gratuitous, he adds. 'It was there because there was a story in the report about HIV and AIDS. But It is true to say, it encouraged debate and interest.'

Annual reports are a headache or a joy for the NHS, depending on your approach. Every trust and health authority or board has to produce one and there are varying ideas on how this should be done.

For some, the annual report should be a factual and informative document, which sets out the activity of the organisation over the previous year. For others, particularly directors of public health, it is a report they want the public to read, as a medium for getting positive health messages across.

Newcastle University Hospitals trust chief executive Len Fenwick leans towards the former view, believing that annual reports should be a thorough review of the previous year. He complains that other trusts' reports are more like 'comics' containing little 'real information'.

'I see annual reports as historical documents, ' he says, adding, however, that he stopped sending his to HSJ some time ago. 'HSJ only reported on how heavy the reports were in the diary column, ' he says.

A glance at the 2000-01 report backs his view. Its 180 pages are packed with tables and statistics and provide a full picture of the trust's activities.

Dr Donnelly, on the other hand, tries to keep annual reports to less than 100 pages. His organisation uses its website and CD-ROMs to publish an exhaustive list of its tables and statistics, while the annual report is intended more for public consumption.

'Part of the idea is to introduce novelty, ' he says. 'Though you wouldn't want to do it every year as it wouldn't stand out as much.'

Few annual reports can have achieved as much interest as Bethan's Story, published when Dr Donnelly was director of public health with Iechyd Morgannwg Health in Swansea. The annual report, in the form of a paperback novel, essentially followed the life of 15-year-old Bethan, a fictional character whose brushes with local health services were used as lead-ins for factual information.

'Bethan got pregnant by her drug-abusing boyfriend - yes, very Trainspotting, ' grins Dr Donnelly.

'Then her father is involved in a tanker accident. I suppose it was like a bad episode of Brookside, but it had a major impact. People actually wanted to read it. The secretaries at work took it home to read and we know parents and kids were reading it together.'

Dr Keith Baker, director of public health with Barnet, Enfield and Haringey health authority, decided to take a more visual approach with his 2000 report. He put it on video. The product, which cost£28,000, is still being used in local schools' citizenship classes and Dr Baker describes the response to it as largely favourable.

'We wanted to do something different and innovative and get people involved by interviewing them about their experiences. For example, what it was like to live in a tower block in Edmonton.

'We felt a video would reach a wider audience. Local councils were able to look at it, and as it was only 15 minutes long people would watch it to the end.'

The video format had other advantages too, Dr Baker believes.

'It could start debates. In book format, they are generally looked at and put on a shelf. A video brings it to life and makes people think.'

A booklet with statistics was produced to go with the video, which was made by a professional company.

Dr Donnelly is not aiming to shock with this year's report, which he says will be on a partnership theme. But it will still use magazine techniques, such as slick graphics, to make it as attractive as possible. 'We want people to be drawn in and read the interesting stories in the report, ' he says. 'Part of the job in public health is to tell and sell stuff, like positive health messages. Quality reports can help.'