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The real NHS:

the benefits of amarketing approach

Spring 2008


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[ i ]The real NHS: the benefits of a marketing approach

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.

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 overwhere 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 theNHS 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 forthe NHS, its 'customers', and its many stakeholders.

David ThorpDirector,

Research and

Information,

The Chartered

Institute of Marketing

Foreword


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ContentsThe real NHS:

the benefits of a marketing approach

3 Introduction

7 Exploring the issues

13 Why is marketing good for the NHS?

23 Conclusion

27 Sources

27 NHS advisory group

28 Courses


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For the NHS to

become patient-ledit must first becomemarketing-led

[ 2 ] The Chartered Institute of Marketing

For the NHS to

become patient-ledit must first becomemarketing-led


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[ 3 ]The real NHS: the benefits of a marketing approach

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 ofthe 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

1. Introduction


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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 commercialskills 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 isrecognition 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 aremany 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

communication, both with those

within the organisation and

those outside. Perhaps most

importantly of all, it is aboutmeasuring the effectiveness of

the value delivered. Marketing

can help the NHS to re-establish

contact with its founding values.

Used effectively, marketing will

reduce costs by enablinghealthcare 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 thedevelopment 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



The future of the

NHS is one ofcustomer managed

relationships


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Introduction

[ 5 ]

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 toensure 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 marketing-

led 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


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2. Exploring the issues

[ 7 ]

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 customersin 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. Theneeds 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


Exploring the issues


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resistance to the very idea that

the NHS offers a suitable

environment for marketing

practice, as evidenced byGeneral Practitioner Margaret

McCartney in the Financial

Times article More medicine,

less marketingiii

"Successful marketing sustains,

broadens or deepens its

markets. Good medical caredoes 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 laterreassessment."

To which the successful

marketer might well respond

"And what's so wrong with

that?" They might even claim

that "talking, listening,

examining, diagnosing andassessing 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,

or a lack of appreciation,

amongst some of the elements

of the health services community

of what marketing is and what

it's there to do. There are manybroadly 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, forquantifying 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.



Are the disciplines

of marketing and

medicine really so

polarised that

well executed

and effectively

delivered marketingcannot deliver

value to the

Health Service?


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[ 9 ]

Are the two disciplines of

marketing and medicine really so

polarised that marketing, well

executed and effectivelydelivered, 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 theissues 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 clearpolitical 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 centralproblem 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 fundamentallymisunderstanding 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 withitself"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




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at the public services union

Unison, again seemingly

betraying a lack of

understanding of whatmarketing is actually aboutv.

Are these the views of neo-

Luddites 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 broadspectrum 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 putacross 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 viewsand 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?

The problem, perhaps, is that

there is no clear comprehension

by many NHS staff as to what is

involved from a marketing pointof view, and it is easy to

understand why this might be

the case. Very few staff

members have encountered

marketing before, other than as

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



Marketing has built

up its ownformidable

vocabulary over the

years, and many

terms are either

unfamiliar,

misunderstood or

carry negative

connotations


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[ 11 ]

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 thislexicon 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 wheremanagers and clinicians often

have conflicting agendas. Re-

engineering 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 commercialtechniques, 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 tocreate the kind of push/pull

strategies that will send out

messages to GPs and attract

patients towards the trusts.




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A more commercial

approach is not aboutbeing divisivelycompetitive...



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3. Why is marketinggood for the NHS?

[ 13 ]

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 tomassaging 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 'divisivelycompetitive', 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,


Why is marketing good for the NHS?


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resources can be managed

more effectively to create more

value from them. For instance,

where theatres are rented toprivate 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.

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 incommissioning, 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



By offering the

right services

and products,

at the right time,

at the right price,

NHS trusts can use

competitive

knowledge andmarketing

communications to

attract patients


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[ 15 ]

branded messages every day,

the benefit of a marketing

approach is that

communications to allstakeholders (patients, referring

GPs, the media, relatives, the

government and non-

governmental 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.

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 thiselement 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



Patients expect toparticipate actively in

their programme of

care, and not be

treated as passive

recipients


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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.

Any such changes do, however,

need to be considered againstthe 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 fragmentingservices.

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

introduced into the NHS.

Primary Care Trusts (PCTs) have

to pay for the ISTCs regardless

of whether any patients chooseto 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, allmanagers (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 regionsthat 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



The media quickly

pick up on

discrepancies

between regions

that are thenpresented as

postcode lotteries


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[ 17 ]

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 withcommunications 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 behindtheir 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 isunderway. 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 morecommercial 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.




22/36


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[ 19 ]

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 thecase 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 achievedin 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 thatsenior 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 momentumtowards 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 thesalaries 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




24/36

pay structure that rewards long

service rather than good work,

two recommendations would be

to adopt a more commercialapproach 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, butthe 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 feedbackfrom, 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

have always been done is the

best approach. It would also

alleviate the problem of talented

and skilled, but frustrated andde-motivated, practitioners or

managers leaving the NHS for

the private sector. This results in

the loss of good staff who

should have been encouraged

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 salariesto 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



One way to make

internal marketingmore successful is to

create a more

motivating

environment for

employees


25/36

[ 21 ]

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 knock-on 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.




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The solutiona patient wants

is the right treatment,at the right time



27/36

4. Conclusion

[ 23 ]

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 samegoal

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 'marketingdepartment' 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.


Conclusion


28/36

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 mostpeople 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 politicalinterference. Marketers are

'change agents', but that

process of change can only be

strategic if it has broad bottom-

up and top-down support.

Marketing becomes merely

tactical and cosmetic without

that support.

The focus on patient choice

creates a market, but the

bottom line is that most people

want their local hospitals to begood and to be able to go there

for treatment. A completely free-

market 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 createsefficiencies 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:




29/36

[ 25 ]

Understand the market by

gaining more information on

patients' needs and wants,

more effective solutions canbe 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 cliniciansto 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.

Communicate the benefits

more effectively, reducing

complaints and saving time

and money.

Work proactively with the

media to address

misunderstandings about

strategies and decisionmaking, and create a more

positive relationship with all

stakeholders.

Focus on Gordon Brown's

recent statement that the

NHS should work more

towards prevention thancure. 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

Introduce a senior marketingpost into both the NHS and

the Department of Health.

Bring budgeting in line with

the end of the financial year

across the NHS.


Conclusion


30/36

For marketers, a customer does

not buy a product or service

he or she buys a solution. The

solution a patient wants is the

right treatment at the right time.

For the NHS, being more

marketing-oriented in its

approach to such issues couldlead 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.



If marketers are to

be accepted they

need to change

commonly

understood

'marketing' terms

to commonly

understood 'NHS'

terms.


31/36


Sources

NHS Advisory GroupMembers 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:

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 Netcares

presentation to the foundation

Sources

Helen Bradburn,

Director of

Communications,

NHS Confederation

Sally Bryden,

Head of Strategic

Development, Oxleas

Mental Health NHS

Foundation Trust

Ginette Camps-Walsh, 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

Micky Griffith,

Strategy and

Development, Royal

Berkshire NHS

Foundation Trust

Amit Khutti,

Director of Strategy

and Service Planning,

Chelsea and

Westminster NHS

Foundation Trust

Sue Kong, Director,

NHS Elect

John McGill,

Professor ofMarketing, Kingston

Business School

Emma Mooney,

Marketing and

Communications

Manager, Royal

National Hospital for

Rheumatic Diseases

Tom Neve,

Assistant Director of

Planning and

Performance,

Tameside andGlossop Hospital

NHS Trust

Shari Payne,

Head of Business

Development and

Planning,

Hertfordshire

Partnership NHS Trust

James Rimmer,

Director of Strategy,

Yeovil District HospitalNHS Foundation Trust

Simon Roberts,

Head of Business

Development and

Marketing, Papworth

Hospital's NHS

Foundation Trust

Meurig Thomas,

Consultant

Peter Tomkins,

Non-ExecutiveDirector, Royal United

Hospital Bath

Matt Toogood,

Director Marketing

and Communications,

Leeds Teaching

Hospital NHS Trust

Stephen Winterson,

Director of Marketing,

Countess of Chester

Hospital NHSFoundation Trust


32/36

One day workshop

Marketing to succeed in a competitive NHSTaking 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

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The purpose of this course:

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Who this course is for:

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Course information:

7 CPD hours One day workshop

Level: Foundation Code: 0878Visit our website for more information and to book: www.cim.co.uk/0878

The Chartered Institute of Marketing: Learning and Development



33/36

Two day residential course

Marketing in the NHS principles and

practice for managersThe 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

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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 identifiesthe biggest potential risks

Who this course is for:

This course is aimed at managers who realise that the NHS is becoming more market-

focused, 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 Two day residential course

Level: Advanced Code: 0090Visit our website for more information and to book: www.cim.co.uk/0090


Courses


34/36

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MTS is produced by Ipsos MORI for The Chartered Institute of Marketing on a

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