Download The real NHS

The real NHS:
the benefits of a
marketing approach
Spring 2008
learning and development
that keeps you one
step ahead
However the marketing landscape evolves, we’re here
to support you. Our wide range of marketing and sales
courses – from one day workshops through to in-depth
masterclasses – are designed to give you the skills you
need at every stage in your career.
Contact our training advisors today to find out how we
can help you or your team.
Visit www.cim.co.uk/training
Alternatively contact us quoting Agenda/08
Call +44 (0)1628 427200 or email [email protected]
Foreword
Marketing has often been viewed as anathema to the ethos of
the NHS, but as the organisation inches towards becoming a
patient-led service, marketing has a crucial role to play in
making this happen.
David Thorp
Director,
Research and
Information,
The Chartered
Institute of Marketing
With Payment by Results, patient choice and the creation of an
internal market, the patient is increasingly at the heart of the
NHS's operations; empowered by choice and with options over
where they receive their treatment. Yet, within the NHS, it is rare
to find organisations that have fully recognised and embraced
these changes, structuring their activities around patient needs
and improved services. And for many staff within the NHS, the
transition to a competitive environment is a disconcerting and
uneasy experience.
Ironically, marketing has an image problem in the NHS, with
many staff failing to understand what marketing is and what it
can deliver for the NHS. Often perceived as just 'spin' or
advertising, marketing can actually play a far more strategic role
within the NHS and help deliver real benefits for both patients
and staff.
By focusing on patient needs, marketing can help change the
orientation of the NHS away from a process or operations
approach, to one that places patients at the centre of its
activities and delivers appropriate and improved care and
services for patients – something I'm sure all staff within the
NHS want to see. Staff buy-in is crucial to achieving this
change, and again marketing has a significant role to play in
communicating these changes and the benefits a patient focus
will bring.
The Chartered Institute of Marketing consulted with professional
marketers from across the NHS to produce this Paper, which
explores the issues involved in adopting a responsible marketing
approach within the NHS, and what marketing can deliver for
the NHS, its 'customers', and its many stakeholders.
The real NHS: the benefits of a marketing approach
[]
i
COURSES
START
SOON
gain serious competitive
advantage for your company
Boost your marketing team’s performance with
qualifications from The Chartered Institute of Marketing
• Ensure your employees are competent in the latest marketing practice
• Create world-class performance for your business
• Attract and retain the best marketers for your business
Visit www.cim.co.uk/serious
Alternatively contact us quoting serious/08
Call +44 (0)1628 427120 or email qualifi[email protected]
Contents
The real NHS:
the benefits of a marketing approach
3
7
13
23
27
27
28
Introduction
Exploring the issues
Why is marketing good for the NHS?
Conclusion
Sources
NHS advisory group
Courses
For
Forthe
theNHS
NHStoto
become
becomepatient-led
patient-led
ititmust
mustfirst
firstbecome
become
marketing-led
marketing-led
[ ]
2
The Chartered Institute of Marketing
Introduction
1. Introduction
In November 2006 the National
Health Service's new marketing
code was issued. This was the
first explicit sign that the NHS
really was breaking entirely new
ground in engaging with the
practices of the marketplace,
and that the long-proposed ideal
of a patient-led service was
underway.
Central to the patient-led
approach is the need to remain
true to the founding values of
the Health Service. The future of
the NHS is therefore one of
customer-managed relationships
– a world where the service user
is the person making the key
choices about what is
appropriate for them.
This is a significant change in
orientation for the organisation,
and one that requires four major
steps to be taken if it is to
become a reality.
• The NHS must ensure that it
listens to its customers and
provides its services where
they are needed and when
they are needed (where this
does not conflict with clinical
judgement). A process
should be put into place to
capture and exploit customer
insights.
• True choice only comes with
knowledge of all the
possibilities and their
alternatives. Customers of
the National Health Service
need a constant and
meaningful supply of
accessible information;
providing this information to
each and every customer is
therefore essential for a
patient-led service.
• Neither of the first two steps
will lead anywhere unless
NHS employees are helped
to understand what a
patient-led service will mean
in practice and what their
part will be in its delivery.
New customer-focused skills
The real NHS: the benefits of a marketing approach
[ ]
3
the benefits of a marketing approach
and competencies need to
be developed and
embedded.
• The development of a
commercial orientation will be
an essential element of
creating a successful Health
Service for the future. It is
therefore vital that health
trusts begin to recruit staff
with appropriate commercial
skills who will deliver the
vision and begin to develop
the next generation of health
service commercial
specialists.
Implicit in the vision of becoming
a patient-led service is
recognition of the fact that the
initial challenges that must be
overcome are marketing
challenges. For the NHS to
become patient-led it must first
become marketing-led.
The benefits of marketing are
many for the National Health
Service. Marketing is not about
a few advertisements in the local
or regional press: it is about
understanding markets and
identifying where value can be
added. Marketing is about
[ ]
4
The Chartered Institute of Marketing
communication, both with those
within the organisation and
those outside. Perhaps most
importantly of all, it is about
measuring the effectiveness of
the value delivered. Marketing
can help the NHS to re-establish
contact with its founding values.
The future of the
NHS is one of
customer managed
relationships
Used effectively, marketing will
reduce costs by enabling
healthcare providers to segment
their customers, breaking them
down into smaller groups with
more clearly identifiable needs,
in order to allocate spend where
it is needed whilst cutting out
unnecessary expense. It will give
patients a role to play in the
development of the services
aimed at them. The patient with
choice is an economically
important player who will not be
slow to point out what he or she
expects of the service provider –
and it is the role of the marketer
Introduction
to listen. As a result, the age of
the passive patient is nearly at
an end.
Contrary to widely-held opinion,
marketing in the NHS is not
simply about advertising or
selling the service: it is about
developing that service in the
first place, then, by absorbing
constant feedback from the
marketplace, continuing to
ensure the service is fit for
purpose and is actually what
patients want.
This new world is coming about
because of a clear and coherent
government policy, articulated in
the NHS Improvement Plan of
June 2004i. This is not a case of
grasping marketers forcing
themselves onto unwilling trusts.
Rather, it is a case of
professional managers
accepting the realities of what
this policy shift would bring –
the creation of a far more
competitive operating
environment than they have ever
known – and then sourcing the
skills they will need to maintain
or improve their competitive
position in this changed
scenario.
When patients come to
understand what a marketingled approach actually means for
them, they may come to see it
not only as the time when
patients found their true voice,
but, more pertinently, the time
when they discovered someone
within the NHS was actually
listening to them.
The real NHS: the benefits of a marketing approach
[ ]
5
Exploring the issues
2. Exploring the issues
Baroness Cumberlege,
Parliamentary Under-Secretary
of State at the Department of
Health, stated as long ago as
1993:
"We are marketing three things
in the health business – change,
health and services."
(Quoted by Owens and McGillii)
Owens and McGill went on to
explore why it is that successful
organisations concentrate on
serving the needs of customers
in a chapter entitled Putting
Patients First, which was not
very far removed from the
current initiative for a patient-led
NHS. Six rules of marketing
within the NHS, developed by
Brian Edwards, at that time the
General Manager of Trent
Regional Health Authority, were
proposed:
1. Make it easy for GPs to
access your services whether
they are fundholders or not.
2. Set standards or make
service promises and be
certain you can deliver them.
3. Go hunting for people with
complaints and reward staff
who uncover them.
A satisfied complainant
becomes your strongest
advocate and best long-term
customer.
4. Talk about your successes.
Show your pride. It does
wonders for staff morale.
5. Invest in your staff because
that is the way to win. Your
staff can undermine any
corporate image you may
generate in a flash.
6. Keep checking your
customer's perspective. The
needs of patients change as
does their image of us.
The wisdom of these rules
would seem self-evident and
non-contentious to seasoned
marketers. Yet there is clear
The real NHS: the benefits of a marketing approach
[ ]
7
the benefits of a marketing approach
resistance to the very idea that
the NHS offers a suitable
environment for marketing
practice, as evidenced by
General Practitioner Margaret
McCartney in the Financial
Times article More medicine,
less marketingiii
"Successful marketing sustains,
broadens or deepens its
markets. Good medical care
does not do this. Good medical
care instead works by
talking, listening, examining,
diagnosing, assessing risks and
benefits, and making decisions
on doing something or nothing
or planning a later
reassessment."
To which the successful
marketer might well respond –
"And what's so wrong with
that?" They might even claim
that "talking, listening,
examining, diagnosing and
assessing risks and benefits", far
from being the exclusive
preserve of the medic, are
central parts of the marketing
planning process too.
Clearly there is either a
fundamental misunderstanding,
[ ]
8
The Chartered Institute of Marketing
or a lack of appreciation,
amongst some of the elements
of the health services community
of what marketing is and what
Are the disciplines
of marketing and
medicine really so
polarised that
well executed
and effectively
delivered marketing
cannot deliver
value to the
Health Service?
it's there to do. There are many
broadly similar definitions of
'marketing', but in a health
service context the definition set
out below has much to
commend it:
A management process for
understanding markets, for
quantifying the value required by
the different customer groups in
these markets, for
communicating this to everyone
in the organisation and for
measuring the effectiveness of
the actual value delivered.
Exploring the issues
Are the two disciplines of
marketing and medicine really so
polarised that marketing, well
executed and effectively
delivered, cannot deliver value to
the Health Service marketplace?
In the commercial world markets
need to be sustained, and the
very existence of market forces
reveals often unpalatable truths
and allows them to be
confronted in a way that avoids
stagnation and encourages the
adoption of innovative
approaches to problems. Why
should this be an anathema to
the National Health Service?
In order to understand the
issues more clearly The
Chartered Institute of Marketing
held a round table forum at its
Moor Hall headquarters, inviting
along senior marketing,
communications and
commercial managers from a
variety of NHS trusts.
The key areas for exploration
were:
• How marketing cultures
come into existence.
• Building and cultivating
awareness of marketing.
• The division between social
and commercial marketing.
• The need for policy-driven
guidance informed by a clear
political agenda.
• How marketing success
might be measured in the
Health Service context.
The session began with an
exploration of what would
appear to be the central
problem for marketers within the
NHS context, the extent to
which 'marketing' is accepted
and the perception amongst
employees of marketing's role.
Margaret McCartney is certainly
not alone in fundamentally
misunderstanding the role of
marketing and the benefits it can
deliver. She speaks of "glib,
meaningless statements" and
paints a picture of an
organisation "shattered into
pieces and forced to waste its
resources to compete with
itself"iv. The Unions too are not
slow to join in: "The very idea
that hospitals should spend
taxpayers' money on advertising
for patients instead of treating
patients is ridiculous" states
Karen Jennings, Head of Health
The real NHS: the benefits of a marketing approach
[ ]
9
the benefits of a marketing approach
at the public services union
Unison, again seemingly
betraying a lack of
understanding of what
marketing is actually aboutv.
Are these the views of neoLuddites who need to be shown
the light, or are they vital
stakeholders who need to be
embraced? However the views
are seen, they represent a broad
spectrum of the organisation's
employees and clearly represent
a challenge for marketers within
the National Health Service.
Perhaps the critics of marketing
should consider the language
that is already being used to put
across the challenges facing the
Health Service. Have they
thought for a moment about
precisely what a 'patient-led'
service entails, about what will
be involved in putting patients at
the core of service delivery as
active participants with views
and needs of their own, rather
than as passive patients,
accepting what is given to
them? If the 18-week patient
journey were so simple, why has
it never been achieved within
previous structures and
processes?
[ ]
10
The Chartered Institute of Marketing
The problem, perhaps, is that
there is no clear comprehension
by many NHS staff as to what is
involved from a marketing point
of view, and it is easy to
understand why this might be
the case. Very few staff
members have encountered
marketing before, other than as
Marketing has built
up its own
formidable
vocabulary over the
years, and many
terms are either
unfamiliar,
misunderstood or
carry negative
connotations
passive recipients of consumer
marketing campaigns. Marketing
has built up its own formidable
vocabulary over the years, and
many terms are either unfamiliar
(segmentation, service-dominant
logic etc), are misunderstood or
carry negative connotations (PR,
advertising etc).
It seems that the lessons of the
early 1990s, when the first
Exploring the issues
tentative marketing approaches
were being outlined as first-wave
trusts were being rolled out,
have been ignored. Back then,
after a period of time, there was
gradual acceptance of what
marketing could deliver,
alongside an active dislike of
what was perceived as
marketing jargon. It may very
well be the case that if a
marketing orientation is to be
created in the current situation
we need to investigate the
creation of a new marketing
lexicon, drawing on the
experiences and expectations of
staff within the health services.
Above all we need to use this
lexicon to demonstrate to all
stakeholder groups within the
NHS why marketing is needed.
Marketing in the National Health
Service should focus on two key
factors:
Firstly, internal marketing is
needed to show clinicians and
managers the benefits of the
patient-led approach, and to
create a more joined-up
organisation where clinicians
and managers work towards a
common end purpose, rather
than the current situation where
managers and clinicians often
have conflicting agendas. Reengineering service processes in
this way could have a huge
positive impact on the success
of the NHS, but previous lack of
marketing experience amongst
Health Service professionals has
made this an unattainable goal.
Secondly, marketing strategies
can be used to improve quality –
from the perspective of both the
patient and the clinician. By
implementing commercial
techniques, such as pricing,
market research and
segmentation, hospitals,
clinicians and GPs can tailor
their products and services to
offer the right solution in the
right place at the right time.
Marketing is also essential to
create the kind of push/pull
strategies that will send out
messages to GPs and attract
patients towards the trusts.
The real NHS: the benefits of a marketing approach
[ ]
11
A more commercial
approach is not about
being ‘divisively
competitive’...
[ ]
12
The Chartered Institute of Marketing
Why is marketing good for the NHS?
3. Why is marketing
good for the NHS?
Few would argue that the NHS
is in need of greater strategic
direction, but there is little
consensus as to how to
implement that strategic
direction successfully. Pumping
in increasing amounts of money
does not in itself solve the
problem, and neither does a
politically-led emphasis on
targets because that can lead to
massaging of figures and draws
both clinicians and managers
away from their focus on patient
needs.
Firstly, a marketing-led approach
can offer a strategy on where
the National Health Service is,
and where it needs to get to.
The marketing-led approach
adopted in England, where a
competitive marketplace has
been created, has led to
dramatic falls in waiting times
and the '18-week' target is
increasingly being met. Whilst
arguments for and against this
policy are complex, it is an
indication that principles from
the private sector can be
employed to bring about positive
change in an organisation that is
often perceived as stagnating.
A more commercial approach is
not about being 'divisively
competitive', as those who
misunderstand the nature of
marketing label it. Instead, it is
about adopting a more
commercial approach to the
budgets that do exist, to extract
maximum value from them. The
NHS does not tend, for
example, to consider pricing
strategies from a marketing
perspective – instead, price is
set by cost.
By changing this, for example by
offering the same services at
different prices at different times,
The real NHS: the benefits of a marketing approach
[ ]
13
the benefits of a marketing approach
resources can be managed
more effectively to create more
value from them. For instance,
By offering the
right services
and products,
at the right time,
at the right price,
NHS trusts can use
competitive
knowledge and
marketing
communications to
attract patients
where theatres are rented to
private practitioners the cost
could be lower at times when
demand is lower, or patients
could be offered faster treatment
if they are prepared to receive it
at unsociable times. Price, in
other words, is not a purely
financial concept; it can be
applied to any issue of
exchange. It is therefore a valid
idea to examine in the public
sector, where many services to
patients are not financially
'charged for' and the service is
'free' at the point of contact.
[ ]
14
The Chartered Institute of Marketing
Drivers for marketing
The main drivers to stimulate the
NHS to see the need for
marketing are Payment by
Results (PbR), 'patient choice'
and competition. With primary
care the drivers for marketing
will be public health targets – the
benefits of using social
marketing techniques; for
example, changes in
commissioning, the potential
need to promote Independent
Sector Treatment Centres
(ISTCs) and the general desire to
meet patient needs or be
referred to the local County
Council Health Scrutiny
Commission.
The value of communication
The greatest value of marketing
for the NHS is that it creates a
framework for effective
communication. By collecting
information on patients' wants
and needs, trusts can more
effectively offer the services and
products that are required, and
tailor them to individual patients.
With the average customer
exposed to hundreds of
Why is marketing good for the NHS?
branded messages every day,
the benefit of a marketing
approach is that
communications to all
stakeholders (patients, referring
GPs, the media, relatives, the
government and nongovernmental organisations),
become clearer, more consistent
and more readily available. That
communication generates more
positive and coherent feedback,
which can be used to continue
the development of the right
products and services, and
make them available at the right
place and time.
Patients expect to
participate actively in
their programme of
care, and not be
treated as passive
recipients
Thanks to the internet, patients
increasingly have access to
channels other than their GP to
find out information on their
condition and the treatment
options. This means that
patients come armed with more
knowledge about developments
in clinical practice. According to
the paper Marketing in the new
NHS by Netcare, patients
"expect to participate actively in
their programme of care, and
not be treated as passive
recipients"vi. This demand for
information is why organisations
such as charities commit to
marketing spend, and why it is
now important for the NHS to
do so too.
Patient choice
The fact that, in England,
customers have a certain level of
choice about where they want to
be treated makes the use of
marketing techniques inevitable.
By offering the right services and
products, at the right time, at
the right 'price', NHS trusts can
use competitive knowledge and
marketing communications to
attract patients. Without this
element of commercial thinking,
trusts will find patient numbers
declining and this will have
financial consequences. Whilst
there are many arguments in
favour and against patient
choice (the principal flaw being
that there is a difference
The real NHS: the benefits of a marketing approach
[ ]
15
the benefits of a marketing approach
between informed consent and
a patient making a choice that
conflicts with clinical judgement),
the NHS is in need of change –
and having a market helps drive
that change.
The media quickly
pick up on
discrepancies
between regions
that are then
presented as
‘postcode lotteries’
Any such changes do, however,
need to be considered against
the fact that increased choice
does not necessarily mean a
better service – for example the
benefits of having a centralised
centre of excellence in some
specialist fields far outweigh the
benefits of offering increased
patient choice by fragmenting
services.
ISTCs attracted much local
opposition when they were
introduced, and the government
needs to look at whether they
are an effective framework for
market principles to be
[ ]
16
The Chartered Institute of Marketing
introduced into the NHS.
Primary Care Trusts (PCTs) have
to pay for the ISTCs regardless
of whether any patients choose
to be treated there.
PR – explaining rationales,
not selling spin
With an organisation as large as
the NHS, and one that is so
squarely in the public eye, all
managers (and to a certain
extent clinicians) need to take
personal responsibility for how
the Health Service is perceived
in the wider world.
One problem with changing the
Service positively is that making
changes unilaterally proves to be
almost impossible logistically;
but when regions or trusts are
given the power to make
changes to benefit patients, the
media quickly pick up on
discrepancies between regions
that are then presented as
'postcode lotteries' or unfair
discriminations.
We have seen this recently in the
media attention on four devolved
administrations 'pursuing their
own agendas' and offering
Why is marketing good for the NHS?
different services, which are then
perceived to be unfair if patients
live in a region that doesn't
favour their needs. For example,
in England the NHS market has
resulted in significant falls in
waiting list times, whereas in
Scotland doctors have more
input into decision making with
more limited input from the
private sector. In Wales the
Welsh Assembly has been very
successful in innovative
approaches, such as abolishing
prescription charges, but less
successful in reducing waiting
times.
Recruiting managers with
communications experience,
and giving existing managers
training in communications, will
contribute to resolving such
scenarios. Such managers can
communicate why decisions
have been made in certain ways
and explain the rationale behind
their decision making, whilst also
demonstrating that change
inevitably leads to teething
problems. They must
communicate the broader
picture and show the long-term
benefits.
Planning and budgeting
The NHS financial year-end is in
March, but budgets for the
following year are not finalised
until the year-end itself. In
Foundation Trusts these budgets
are sometimes not finalised until
May. This results in planning
problems where trusts do not
know what their budgets will be
until the financial year is
underway. A commercially-run
organisation needs to have its
budgets finalised in advance of
this – typically, next year's plan
would be finalised three months
before year-end.
Moving towards a more
commercial approach to
budgeting would help managers
allocate resources more
effectively and reduce the risk of
deficits. Whilst political changes
and elections can prevent the
NHS planning as far ahead as a
private company would be able
to do, an improvement in budget
planning is a realistic goal.
The real NHS: the benefits of a marketing approach
[ ]
17
Why is marketing good for the NHS?
Internal marketing
The other area where a
marketing-led approach could
make a key difference to
improving the Health Service in
the future is internal marketing.
There is much dissension
between clinicians and
managers about the best way to
manage the NHS, and there is a
certain level of mutual distrust.
Internal marketing to encourage
clinicians and managers to work
in the same direction and create
a more joined-up organisation
can be achieved by emphasising
the focus on the patient.
Currently, it is sometimes the
case that clinicians want to do
their job and managers want to
do theirs. By showing both
groups that they are each a vital
half needed to meet patients'
needs, and that one half cannot
do the job successfully without
the other, steps could be taken
to give a more strategic focus to
the organisation, particularly to
those clinicians who see
managers as little more than an
obstruction to them doing their
job.
Part of achieving this will be to
ensure that the managers who
are in place have the respect of
clinicians. This can be achieved
in two ways: firstly, by recruiting
managers who have commercial
experience; and secondly, by
giving existing managers
marketing training.
The final vital element of internal
marketing is to ensure that
senior management both
support and facilitate the
implementation of marketing
techniques. The reaction and
support of senior management
within the Health Service is
essential if the momentum
towards a patient-led future is to
be generated and maintained.
One way to make internal
marketing more successful is to
create a more motivating
environment for employees. All
NHS employees accept that the
salaries they earn are likely to be
lower than they could expect in
the private sector; employees
accept this because they are
driven by a desire to have a
fulfilling job that helps society
and other people. However,
instead of the existing rigorous
The real NHS: the benefits of a marketing approach
[ ]
19
the benefits of a marketing approach
pay structure that rewards long
service rather than good work,
two recommendations would be
to adopt a more commercial
approach where effective and
efficient work is rewarded with
bonuses, and to create more
flexibility for good employees to
be promoted within the system.
Such an approach goes without
saying in the private sector, but
the National Health Service
currently automatically increases
pay scales if an employee stays
for a long period of time,
regardless of the quality of work
performed.
By saving money on not
automatically awarding pay
increases, part of the budget will
be freed up to reward good
work. This would do several
things – it would motivate staff,
which leads to better service for,
and more positive feedback
from, patients. It would go some
way to eroding the long-termist
culture of the NHS that leads to
scenarios where some staff are
change-resistant because they
have been working in the same
role for a long time, and believe
that doing things the way they
[ ]
20
The Chartered Institute of Marketing
have always been done is the
best approach. It would also
alleviate the problem of talented
and skilled, but frustrated and
de-motivated, practitioners or
managers leaving the NHS for
the private sector. This results in
the loss of good staff who
should have been encouraged
One way to make
internal marketing
more successful is to
create a more
motivating
environment for
employees
to stay, whilst less effective
workers remain because the
Health Service's profit and loss
is not accountable to
shareholders or customers.
Paying more competitive salaries
to prevent talent leaving is not a
question of asking for more
money; it is merely a question of
allocating existing budgets in
more competitive ways. Whilst
Agenda for Change has started
to tackle this issue with its
Why is marketing good for the NHS?
competency gateways, it has
not changed the situation to the
degree we believe could be
strongly beneficial for the NHS.
Adopting a more competitive
approach can therefore be seen
not as 'divisive' – instead, it
highlights the need to treat
public money as a precious
resource that needs to earn its
keep.
A business will fail without profit,
but a sense of urgency of how
spend is allocated is largely
missing from the NHS.
An increased commercial
awareness would show that
there is a need to generate
profit, because that profit can
then be ploughed back into
research and development, staff
productivity rewards, more
equipment and resources, better
service and better treatment.
This then creates a virtuous
circle of profit, improving the
service to patients. It has knockon effects in terms of reducing
costs – for example, in a lower
number of complaints
procedures and thereby reduced
costs of payouts.
Other parts of the NHS
Most of the scenarios outlined in
this paper are, by necessity of
space, trust-focused and
elective-care oriented. However,
the underlying principles of
patient-led marketing can be
applied to other parts of the
NHS, such as emergency
provision, primary care and
mental health services, where
they do not conflict with duty of
care.
The real NHS: the benefits of a marketing approach
[ ]
21
The solution
a patient wants
is the right treatment,
at the right time
[ ]
22
The Chartered Institute of Marketing
Conclusion
4. Conclusion
It is widely accepted that the
National Health Service is in
need of change, but opinions
differ widely on how to achieve
that change in an institution so
vast and complex. Marketing is
not the solution to all of its
problems, but it can be a key
part of the required positive
change:
• Culturally, to help clinicians
and managers work more
effectively towards the same
goal
• Internally, to extract more
value for the patient from
existing resources
• Externally, to show patients
the benefits of the new NHS
and gain their support by
showing them that decisions
are made for their benefit
There is much confusion about
what marketing entails in the
Health Service, and many
clinicians struggle with what they
perceive as 'marketing jargon'.
Part of the task in showing
clinicians the value of marketing
is to ensure that terminology and
concepts are understandable
and directly relevant to the NHS.
If marketers are to be accepted
they need to change commonly
understood 'marketing' terms to
commonly understood 'NHS'
terms.
Creating a 'marketing
department' in health trusts is
not the only answer, because it
does not in itself change the
culture of the organisation or
generate buy-in from clinicians
and managers, many of whom
have little experience or
understanding of what
marketing is or does. The
answer is to bring more
marketing knowledge to all parts
of the organisation and to
communicate the benefits of the
patient-led approach to
managers and clinicians.
The real NHS: the benefits of a marketing approach
[ ]
23
the benefits of a marketing approach
It would also be beneficial to
create a senior marketing post in
the Department of Health and in
the NHS itself – interestingly,
neither role currently exists. It is
also important for the board, the
CEO and the non-executive
directors to be receptive to
marketing, and this attitude is
not consistent across the Health
Service.
Marketing should be a popular
concept in the organisation
because it could move it away
from financial targets and
number crunching towards
serving, and looking after, the
patient – which is why most
people join the NHS in the first
place. A marketing approach
could help clinicians and
managers express themselves in
more effective ways by using
persuasive arguments when
dealing with what is sometimes
perceived as political
interference. Marketers are
'change agents', but that
process of change can only be
strategic if it has broad bottomup and top-down support.
Marketing becomes merely
tactical and cosmetic without
that support.
[ ]
24
The Chartered Institute of Marketing
The focus on patient choice
creates a market, but the
bottom line is that most people
want their local hospitals to be
good and to be able to go there
for treatment. A completely freemarket approach would lead to
hospital closures, which is not in
the interests of the patient.
A marketing approach can
balance such conflicting
scenarios and, by understanding
the market and gaining opinions
and information from all
stakeholders, including patients,
relatives, clinicians and
managers, help make the right
decisions. Allowing market
forces to work creates
efficiencies and improves
performance, with the caveat
that any extremes of market
force (eg closure of a bad
service) has to be countered by
a realistic alternative offering for
the patient. However, no
decisions should be taken that
contravene clinical judgement.
Adopting a marketing-led
approach could help the NHS
move towards being an
organisation that is better able
to:
Conclusion
• Understand the market – by
gaining more information on
patients' needs and wants,
more effective solutions can
be created and tailored.
• Create the service that
patients want and need –
within the limits of the
Working Time Directive and
existing budgets.
• Align managers and clinicians
to work more co-operatively.
• Save costs by drawing more
value for both patients and
the organisation from existing
budgets, allocating spend
more effectively where it is
needed.
• Fill spare capacity first, then
move on to generating new
income.
• Motivate and reward staff,
leading to better efficiency
and effectiveness, with
knock-on cost savings.
• Work proactively with the
media to address
misunderstandings about
strategies and decision
making, and create a more
positive relationship with all
stakeholders.
• Focus on Gordon Brown's
recent statement that the
NHS should work more
towards prevention than
cure. A wider adoption of
social marketing techniques
can help achieve this.
• Move from a sometimes
change-resistant culture to
one that embraces positive
change.
• Minimise the inevitable
conflicts between patient
desires, clinical judgement
and availability of resources.
Further practical suggestions
• Communicate the benefits
more effectively, reducing
complaints and saving time
and money.
• Introduce a senior marketing
post into both the NHS and
the Department of Health.
• Bring budgeting in line with
the end of the financial year
across the NHS.
The real NHS: the benefits of a marketing approach
[ ]
25
the benefits of a marketing approach
For marketers, a customer does
not buy a product or service –
he or she buys a solution. The
solution a patient wants is the
If marketers are to
be accepted they
need to change
commonly
understood
'marketing' terms
to commonly
understood 'NHS'
terms.
[ ]
26
The Chartered Institute of Marketing
right treatment at the right time.
For the NHS, being more
marketing-oriented in its
approach to such issues could
lead to a major shift in
philosophy that places the
customer, rather than the
treatment or the provider, at the
centre of its operations. This
would lead to better service,
more positive feedback, and a
greater willingness amongst
patients, doctors and managers
to be more flexible for the
greater benefit to all, and help
return the organisation to some
of its key founding intentions.
Sources
Sources
i.
Department of Health (2004) NHS Improvement plan. London, TSO
ii.
Owens, J. and McGill, J. (1993) Marketing in the NHS: putting patients first. UK,
The National Association of Health Authorities
iii.
McCartney, M. (2006) More medicine, less marketing. Financial Times, 5 August
iv.
McCartney, M. (2006) More medicine, less marketing. Financial Times, 5 August
v.
Jennings, K. (2006)
vi.
Netcare Healthcare (UK) Ltd (2006) Marketing in the new NHS: a paper based on Netcare’s
presentation to the foundation
NHS Advisory Group
Members from across the NHS have worked with The Chartered Institute of Marketing in
the development of this Paper. We would like to thank the following for their co-operation
and involvement, without whom, this Paper would not have been possible:
Helen Bradburn,
Director of
Communications,
NHS Confederation
Sally Bryden,
Head of Strategic
Development, Oxleas
Mental Health NHS
Foundation Trust
Ginette CampsWalsh, Chairman of
The Chartered
Institute of
Marketing's Medical
Marketing Group,
Board member of
2020 Health
Celia Dossett,
Networks Manager,
Foundation Trust
Network
Anne Gibbs,
Director of
Development and
Marketing,
Birmingham Women's
Hospital NHS Trust
Emma Mooney,
Marketing and
Communications
Manager, Royal
National Hospital for
Rheumatic Diseases
Simon Roberts,
Head of Business
Development and
Marketing, Papworth
Hospital's NHS
Foundation Trust
Micky Griffith,
Strategy and
Development, Royal
Berkshire NHS
Foundation Trust
Tom Neve,
Assistant Director of
Planning and
Performance,
Tameside and
Glossop Hospital
NHS Trust
Meurig Thomas,
Consultant
Shari Payne,
Head of Business
Development and
Planning,
Hertfordshire
Partnership NHS Trust
Matt Toogood,
Director Marketing
and Communications,
Leeds Teaching
Hospital NHS Trust
Amit Khutti,
Director of Strategy
and Service Planning,
Chelsea and
Westminster NHS
Foundation Trust
Sue Kong, Director,
NHS Elect
John McGill,
Professor of
Marketing, Kingston
Business School
James Rimmer,
Director of Strategy,
Yeovil District Hospital
NHS Foundation Trust
Peter Tomkins,
Non-Executive
Director, Royal United
Hospital Bath
Stephen Winterson,
Director of Marketing,
Countess of Chester
Hospital NHS
Foundation Trust
The real NHS: the benefits of a marketing approach
[ ]
27
The Chartered Institute of Marketing: Learning and Development
One day workshop
Marketing to succeed in a competitive NHS
Taking marketing into the NHS – be a winner in a competitive market place
Patient choice, a growing range of service suppliers, and changes to service delivery (closer
to home) are resulting in a less stable market place. Marketing provides a culture, tools and a
process for identifying and meeting these new challenges pro-actively in pursuit of sustaining
profitable patient and income flows.
The purpose of this course:
To provide an insight into the application of marketing principles to healthcare service
provision within the UK secondary care environment. The workshop will examine how
marketing can be used to improve care and the patient experience. It will demonstrate how
marketing can influence service development, resource planning and financial performance,
in a sector where patient choice prevails.
You will learn how to:
•
Interact and work more effectively with PCTs and practice-based commissioners to
improve clinical and financial performance
•
Improve the patient experience by developing new services, modifying care pathways and
existing services using 'Patient Choice' and 'Payment by Results' as a stimulus to change
•
Apply marketing principles to improve resource planning and financial management
•
Develop a marketing plan
•
Communicate and promote services to optimise patient flow
•
Become a patient/customer oriented organisation
•
Deliver customer/patient focused services
•
Use market research and patient referral information to improve service and financial
planning
•
Improve reputation based on favourable patient experience by managing service touch
points
Who this course is for:
This is an introduction programme for those working in NHS organisations seeking to
establish a marketing rather than a service focused organisation. This course is for managers
and healthcare professionals involved in the development of marketing plans, implementation
and/or development of a 'customer centric' culture in NHS organisations.
Course information:
7 CPD hours
Level: Foundation
One day workshop
Code: 0878
Visit our website for more information and to book: www.cim.co.uk/0878
[ ]
28
The Chartered Institute of Marketing
Courses
Two day residential course
Marketing in the NHS – principles and
practice for managers
The market in healthcare has arrived – what should we be doing?
With the drive for a more personalised and responsive system, the mismatch between supply
and demand, and patients turning into consumers, the NHS is rapidly starting to resemble a
market in all but name. To a traditionally centralised, planned public service, the idea of market
forces can be uncomfortable for some. But markets don't respect the public/private divide,
they operate whenever people have choices. The techniques involved in surviving and indeed
thriving in market-driven environments are applicable across any organisation, even the NHS!
The purpose of this course:
The purpose of this course is to learn the key principles that govern how markets work, to
identify how they relate to your organisation, and to apply them to the way that you and your
team operate. You will have time to think, to learn and to apply the ideas in a way that will
work for you. This training uses some of the key principles of marketing as they relate to the
provision of healthcare, and enables managers to apply them to some of the key challenges
they face in the NHS.
You will learn how to:
•
Learn and apply the 7 'golden rules' of marketing in a healthcare context
•
Create a marketing plan for your department/team, based on a structured environmental
analysis and applying the right capabilities to the right strategy in order to achieve
objectives that incorporate the rigours of the market
•
Create a communications plan that utilises the concept of a marketing mix, targeted at
the right 'market', with appropriate objectives and an understanding of potential barriers
to communication
•
Identify the critical success factors that are important to your customers
•
Create an implementation plan that focuses on the most pressing issues, and identifies
the biggest potential risks
Who this course is for:
This course is aimed at managers who realise that the NHS is becoming more marketfocused, and recognise that they need to learn more about how marketing works, in order to
help them survive in a rapidly changing public service.
Course information:
14 CPD hours
Level: Advanced
Two day residential course
Code: 0090
Visit our website for more information and to book: www.cim.co.uk/0090
The real NHS: the benefits of a marketing approach
[ ]
29
Information and Library Service
Vital business intelligence at your fingertips…
Available for all your marketing queries, whether it’s a simple, quick question or a
more in-depth research request. Our stock incorporates marketing books, directories
and market research reports, including Mintel and Key Note. We also carry 120
marketing-related journals.
We have the resources and the professionals to help you with your information
needs…whatever they may be. The Chartered Institute of Marketing – the one-stop
information resource for marketers.
Exclusive Members’ Area Online
In addition to this physical resource, Institute members can access an expanded
online selection of journals and company reports via the Knowledge Hub:
www.cim.co.uk/knowledgehub
‘Cutting Edge gives you the information edge’
Our weekly digest of the latest marketing news comes to Institute members via
Cutting Edge. Access the current edition through the “Knowledge Hub” and sign up
to the alert service. www.cim.co.uk/cuttingedge
For more information, visit www.cim.co.uk/library, www.cim.co.uk/knowledgehub
or call +44 (0)1628 427333
Get your own copy of the
Marketing Trends Survey
The latest Marketing Trends Survey (MTS) from The Chartered
Institute of Marketing reveals a clear split between the up-take of
digital tools that have a networking element and other digital
marketing activities. Over half of the professional marketers taking
part in the survey (55%) say that their organisations use business
networking regularly*, while over a third (37%) claim to be regular
social networkers.
In comparison, just 8% use viral marketing at least ‘a fair amount’, 7% use corporate
blogs and product seeding, while podcasts and mobile marketing have been
adopted by just 6%.
MTS is produced by Ipsos MORI for The Chartered Institute of Marketing on a
bi-annual basis. It is now available to purchase from The Institute’s Information
and Library Service. A summary of the report is available to Institute members at
www.cim.co.uk/mts. Please contact +44 (0)1628 427333 for further details.
Price: Members £125 Non-members £200
+44 (0)1628 427333 • www.cim.co.uk/knowledgehub • [email protected]
books
CIM Direct
for professional marketers
With over 200 marketing and business
books available, CIM Direct is your
one-stop-shop for marketing knowledge
Order online at
www.cim.co.uk/shop
Telephone: +44 (0)1628 427427
Email: [email protected]
Office hours: 9am-5pm, Monday-Friday
Your one-stop-shop: the mail order bookshop
of The Chartered Institute of Marketing
The Chartered Institute of Marketing
Moor Hall
Cookham
Maidenhead
Berkshire SL6 9QH, UK
Tel: +44 (0)1628 427500
Email: [email protected]
www.cim.co.uk/training
© The Chartered Institute of Marketing, 2008. All rights reserved.
Permission to reproduce or extract material from this publication
must be sought from The Chartered Institute of Marketing.
Details correct at time of print.
14196
The FSC Logo identifies
products which contain
wood from well managed
forests certified in
accordance with the rules
of the Forest Stewardship
Council
00-000-0000
© 1996 Forest
Stewardship Council A.C.