Engagement and communications in integrated care systems

Systems that have achieved notable success in partnership working have embedded strong engagement and communications at the heart of decision-making and system transformation work. They recognise that it is a key enabler of change and in building common ambition across partner organisations, professions and areas. Both are fundamental to ensuring the voices of patients, service users, communities and staff are involved and that their insights are used to inform planning and decision-making.

Systems that have had success in building strong relationships do so on a planned, systematic and continuous basis. Strong engagement and communications are part of the glue that hold ICSs and STPs (sustainability and transformation partnerships) together. Part of the answer here is getting governance and co-production processes right so that everyone can see how decisions are made – transparency breeds trust. This also requires leaders to invest time in building relationships systematically and to make the space for others to do so, reaching out across institutional, professional and hierarchical boundaries to find common purpose.

A compelling narrative that all system partners buy into and which is well understood and supported by the public and staff, is crucial. Getting all partners to agree on their shared ambition takes time and planned effort. Ultimately, clarity of vision and purpose at system level, with coordination of engagement and communications activity across a system, will support the delivery of effective communication at local place and neighbourhood level. The endeavour must be shared ‘with’ people, not done for or to them. Just as important is making the narrative ‘stick,’ demonstrating through action that it is real. Stories of hope matter, and staff in particular want to know they are doing the things that will make a difference. Articulating stories that demonstrate steady improvements in the lives of patients, communities and staff is among the most important roles that engagement and communications leaders play within the partnership. 

Many local systems have developed effective approaches to engaging with patients, staff and the public. A broad and strategic engagement approach is important to build confidence and trust. This should encompass a focus on transparency and the provision of clear public information about vision, plans and progress. Innovative approaches, such as citizens panels, should be used to ensure services are designed in partnership with patients, carers, staff and other partners.

As integrated care systems have developed, different areas have developed different approaches to how they structure, resource and network their engagement and communications functions across organisations. It is important to develop these functions and networks, ensuring roles are clear and that they have the right leadership, capacity and expertise. As we found, this should include strategic thinkers, strong relationship builders and expert storytellers that understand the nuances and commitments required to contribute to and sustain effective partnership working. Effective pooling and coordination of resources and expertise across organisational boundaries is key and stands out as a critical enabler in systems that are furthest ahead in their integration journey. Senior health and care leaders should ensure the communications and engagement teams of all organisations in the system understand and contribute to effective partnership working, alongside their institutional responsibilities, so as to collectively support improvement in population health.

In 2021, the NHS Confederation will be supporting engagement and communications leaders in integrated care systems, and the partners that comprise them, to take forward the findings from our report. We are grateful to the advisory group for leading the development of this work: 

• Daniel Reynolds, Chair of the Advisory Group; and Director of Communications, NHS Confederation
• Alex Ball, Director of Communications and Engagement, Nottingham and Nottinghamshire Integrated Care System
• Cara McDonagh, Head of Content and Engagement, NHS England and NHS Improvement
• Carrie-Ann Wade, Director of Communications and Engagement, North East London NHS Foundation Trust
• Charlotte Gawne, Director of Communications and Engagement, South West London Health and Care Partnership
• Claire Norman, Director of Communications and Engagement, Greater Manchester Combined Authority and Greater Manchester Health and Social Care Partnership
• Frances Aviss, Senior Public Engagement Lead, Dorset Integrated Care System
• Georgina Stanton, Assistant Director of Service Development, Central Bedfordshire Council
• Helen Stevens-Jones, Director of Communications and Engagement, South Yorkshire and Bassetlaw Integrated Care System
• John Underwood, Director, Centre for Health Communications Research
• Joy Okunnu, Head of Content, NHS Confederation
• Kim Parfitt, Head of Communications, Buckinghamshire County Council
• Mehreen Hussain, Senior Programme Manager (Content Management), NHS England and NHS Improvement
• Michelle Dixon, Director of Communications, Imperial Healthcare NHS Trust
• Roger Davidson, Director of System Partnerships, NHS England and NHS Improvement
• Sharon Ward, Director of Communications and Engagement, Frimley Health and Care
• Sue Harris, Director of Strategy and Partnerships, Worcestershire Health and Care NHS Trust and Herefordshire and Worcestershire STP Communications and Engagement Lead.