NHS lessons on internal comms

It’s clear that the current workforce challenges facing the NHS are prompting deeper and more urgent thinking by comms teams, if the number of sessions devoted to internal comms in the past six months is anything to go by.

A focus on internal communications has been a feature of almost every seminar or presentation that I’ve been to in the last six months as organisations seek to tighten their relationships with employees.

The previous NHS Providers session looked solely at internal comms (you can read my blog here) while the latest NHSi development day in London provided some excellent case studies on what good employee comms should look like in the health service.

With the NHS struggling to recruit the volume of staff needed and hospitals facing large increases in demand (around 5% in our organisation this year alone) proactive and responsive internal comms are becoming more important than ever before.

I posted previously that the traditional boundaries between internal and external comms are breaking down, with staff becoming more used to getting information from elsewhere and using networks that are primarily designed for communicating with the public.

Having a different ‘face’ for the public and the people you employ is not really viable in modern times, especially when you want to create trust and consistency in your brand.

The NHSi development series is a fantastic initiative and I’d urge anyone working in health to take a look at what’s on offer here: https://improvement.nhs.uk/resources/communications-development-programme/

These were my key takeaways from the day:

Nobody is perfect

Although we all glance enviously at bigger or better funded communications teams it’s clear that there’s no perfect world. No comms team (no matter how big or high profile) knows everything that’s going on. We all face the same challenges and frustrations right across the country (can I have a poster? Can you send an all staff email because I’ve lost my keys? Where’s the QR code? etc)

Networks and influencers

Just as we’ve learned to target external audiences by using influencers and networks within networks it’s important to think how that relates to internal channels too.

Many of the older, more established channels will no longer reach the intended audiences, with many people simply too busy to read your messages. You can’t really communicate with everyone directly in such a busy and fragmented world.

Relying on influencers and leaders within your organisation who can spread the word among their own networks was an interesting point raised by a few of the speakers.

In our own organisation we also spend a lot of time thinking about who each audience will listen to and respect – who is the best person to influence nurses or who will support staff listen to? In practice it’s rarely the same person, even if the message is the same.

Internal comms touches every part of an organisation so it’s a vital part of any successful group.

Understanding the frontline

For any successful comms programme leadership visibility, especially during times of change, is fundamental. You will never understand the business unless you know how the frontline works so as a comms person you need to get out there and spend time with them.

This is not just so you know the best way of communicating with that audience but also so you can really understand their issues. In fact, I was inspired to do another clinical day with one of our nurses the week after this session (see here)

Crisis comms

Internal comms also has a big role in crisis management although it can often be forgotten because of the pressure to manage competing demands. Cumbria talked about the challenges of Storm Desmond and the Beast from the East last year and explained how good staff comms were essential in managing the crisis.

Thinking about how you reach staff (who are often widely dispersed) out of office hours and during times of crisis is a real challenge worth considering. Crafting messages and techniques that can cut through at times of so much noise is also increasingly difficult.

Collaboration beyond organisational boundaries was another recurring theme, especially in terms of resilience, and is something that’s really important when we mostly have such small teams in the NHS.


Making sure frontline staff get public thanks and recognition for the extra efforts they are putting in during times of key pressure is not only really useful in terms of internal comms, but can also be a key source of stories to share with the public and media.

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