Communications may be on brink of fracture, DoH warns

A hard-hitting Department of Health document has warned that 'vulnerable' NHS communications systems could 'fracture' in the upheaval of the Shifting the Balance shake-up.

Shifting the Balance of Power: communications, published last week, says existing variations in communications roles and responsibilities, and in competence and capacity across the NHS are 'unacceptable'.

The impact of Shifting the Balance will require primary care trusts in particular to boost their communications capacity, the document says, warning that many NHS organisations 'are not giving it adequate priority in terms of planning or resource allocation'.

'Often during periods of major change there is a danger that established communications systems will fracture. It is essential this is not allowed to happen in a situation where the current arrangements are already vulnerable, ' it says.

Strategic health authorities 'must have senior communications staff on their boards even if not in an executive role'. But as SHAs have a performance-management role, 'it will not be possible for them to provide communications services to trusts and PCTs'.

'As the media begins to appreciate the role of the PCT, they will increasingly fall under the spotlight, ' the document warns. 'At present, the majority of PCTs are not fully equipped to handle this responsibility.'

It urges PCTs to follow a 'strong recommendation' from the national primary care development programme that they have a communications lead at director level.

The report is explicit in urging NHS organisations to ensure that rifts between themselves should be hidden from the public.

It warns: 'Encouraging organisations to build up their communications function should not be seen as an excuse to go back to the worst excesses of the purchaserprovider split when NHS organisations were often seen maligning each other in public.

'A key role for the SHA will be to ensure that this does not happen and that the public is not exposed to internal squabbles.'

North West regional communications director Hugh Lamont said his region had brought together PCT and primary care group chief executives some months ago to discuss the need for communications staff. 'I had a letter from one chief executive who said, 'I do not know why you're doing this because we can't afford a communications executive.' But you can't afford not to do it.'

Mr Lamont cited the three Manchester PCTs - all with their own communication leads, but working jointly on city-wide campaigns - as a positive example of the way forward. 'They have put people in post to make sure That is happening.'

But one NHS communications manager warned that specialists unsettled by the restructuring could be lost to the health service.

'There is clearly considerable anxiety at the centre that effective communications could fall apart following Shifting the Balance of Power, ' he said.

'As well as many PCTs being very slow to see the importance of setting up good communications, Shifting the Balance has caused a lot of uncertainty among existing NHS communications staff.

'The danger is that there will not be enough good-quality communications managers to go round as they are tempted out of the NHS' - into what he described as 'a very buoyant media jobs market'.