Getting local people to understand the role of primary care trusts has proved difficult, so has the NHS rebranding helped? HSJ polled the public to find out

It is just over a year since primary care trusts got permission from then health secretary Alan Johnson to rename themselves as NHS organisations, following concerted lobbying.

Now, the majority of PCTs’ public facing brands use the NHS prefix and PCT is a much less commonly used term in conversations with local populations.

PCTs had argued that the change was necessary to enable them to communicate with the public - the term “primary care trust” was misleading as the commissioning role encompassed much more than simply overseeing GP services.

World class commissioning demanded that PCTs became “local leaders of the NHS”, so using the term NHS more prominently in their titles would help the public understand their role in funding NHS care for their areas, the argument went.

Has it worked? HSJ took to the streets to find out. Our conversations revealed that of the 20 members of the public we spoke to, nearly twice as many recognised the old PCT names than the new NHS versions - 13 compared with seven - although this could be simply because they were around for longer.

That said, Tara Cannell, senior account manager at Ogilvy Health PR, believes PCTs have much to gain from adopting the NHS prefix, pointing out it would be difficult to find a single person in the UK who is not familiar with the NHS brand.

She says: “Some PCTs have done really well at communicating under the PCT brand, others not so well.

“In areas where PCTs have done well, that’s fantastic, but in using the overarching NHS brand, the others will get that recognition.”

The rebranding also makes the NHS seem more cohesive and could help to counter notions of postcode lotteries in the public mind, she says.

Precedent Communications health strategist Michael Guida agrees: “The value of the PCT brand for the public is difficult to assess.

“The NHS as a brand is clearly fantastically powerful.”

But simple brand recognition is only one part of the story. Once the population knows that the PCT exists, the next challenge is to explain what it does.

When asked what they thought PCTs did, most of the people interviewed by HSJ were unable to give a full answer.

Responses ranged from blank looks to confusion over the difference between PCTs and NHS Direct, to the misconception that primary care trusts were private healthcare providers.

The most common response was that the PCT could help them find a GP.

In an attempt to help PCTs better communicate complex messages, the NHS Confederation has hired pollster Ipsos Mori to research how the public reacts to different messages about commissioning and prioritisation, using focus groups.

PCT network director David Stout says that it is helpful if residents have a detailed understanding of what a PCT is. But he thinks the role of commissioners as local leaders of the NHS can be fulfilled as long as people understand they should contact the PCT if they have concerns about the local health service.

He says: “The PCT’s job is to explain what they are doing and involve people in what they are doing. The specifics will vary enormously along the commissioning cycle.”

Complex messages

PCTs need feedback on how good services are and must inform and engage the public to get this.

Mr Stout says this requires “a multiplicity of approaches”.

Tower Hamlets PCT in London has been working hard to boost GP access, which was the worst in England two years ago, and is now the most improved.

Faced with the challenge of communicating a complex message to a diverse population, the PCT chose to personalise its approach, using chief executive Alwen Williams as a figurehead for its communications with the public on GP access.

This means that all of the communication materials sent to patients feature Ms Williams’ signature, a message from her or her picture.

Head of urgent care and GP access David Groom says the messages worked as Ms Williams has a good local profile as “health chief” in the London borough. He says: “It’s very important people know what the PCT is - people need to understand we’re responsible for the range and quality of services they experience.

“It is difficult because as soon as you use the word ‘commissioning’, you are into territory that is not easily understood by a mass audience.”

The Tower Hamlets approach helps the public understand its work on quality by using a figurehead as a shorthand for the role of the commissioner.

But PCTs still face a challenge in increasing understanding among their populations about what they actually do, particularly if more sophisticated debates about service redesign are to take place.

Karen Beardsell, who works in human resources at Diabetes UK, says even though she has a better understanding than most about the NHS, she still isn’t clear about the work of her local PCT.

She thinks PCTs should make more use of patient organisations like her own in order to get around the problem that many service users don’t know who they are.

Ms Beardsell says: “They want these patients to sit at the table and if the patients

are engaging with these [patient] organisations rather than the NHS directly, that would seem to me to be a good way to do it.”

That said, the fact that a majority of people interviewed by HSJ recognised the existence of PCTs should be encouraging for commissioners.

NHS Yorkshire and the Humber director of communications Karl Milner says the acid test was always whether an MP would approach his or her local PCT for updates on the health service or simply go straight to the acute trust.

He says: “Now MPs go to both and the chief executive of the PCT is a powerful player on the patch.

“PCTs have only been around for three years [in their current configurations]. The recognition they are getting as commissioners is quite good - I thought it would take about five years for that to sink in.”

Brand designs

  • PCTs were given the option of renaming themselves NHS in June 2008
  • The Department of Health says the change enables PCTs to “position themselves as frontline commissioners of patient care and be identifiable to their populations as such”
  • So far, 100 PCTs are using the NHS prefix
  • Care trusts are not affected by the change

Straw Poll: What the public said about their PCT

HSJ took to the streets to find out what the public know about their PCT

“It helps you register at the doctor”

“It gives you advice if you’re in trouble”

“I’ve heard of the PCT but I just go to the surgery”

“I dealt with the PCT when I was going to hospital for an operation”

“I know it’s in charge of Epsom and St Helier Hospital”

“It provides people’s health service needs”

“I don’t know what it does - are they the ones that make money?”

“You go on their site to find out where all the doctors are”

“It provides health services for residents but I’ve never been in touch”

“What’s that? Is it private?”

“I’ve seen it on leaflets but I wouldn’t be able to describe what they do”

“I presume they are the authority responsible for administrating and managing the health service”

“I’ve no idea what they do - I’ve just heard of them”

“Is that what my daughter phones up when the kids are ill?”

“Is it my local GP?”