The real NHS: the benefits of a marketing approach
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The real NHS:
the benefits of a
marketing approach
Spring 2008
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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.
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
David Thorp to find organisations that have fully recognised and embraced
Director,
Research and these changes, structuring their activities around patient needs
Information, and improved services. And for many staff within the NHS, the
The Chartered transition to a competitive environment is a disconcerting and
Institute of Marketing
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 []
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Contents The 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
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 provides its services where
Health Service's new marketing they are needed and when
code was issued. This was the they are needed (where this
first explicit sign that the NHS does not conflict with clinical
really was breaking entirely new judgement). A process
ground in engaging with the should be put into place to
practices of the marketplace, capture and exploit customer
and that the long-proposed ideal insights.
of a patient-led service was
• True choice only comes with
underway.
knowledge of all the
possibilities and their
Central to the patient-led
alternatives. Customers of
approach is the need to remain
the National Health Service
true to the founding values of
need a constant and
the Health Service. The future of
meaningful supply of
the NHS is therefore one of
accessible information;
customer-managed relationships
providing this information to
– a world where the service user
each and every customer is
is the person making the key
therefore essential for a
choices about what is
patient-led service.
appropriate for them.
• Neither of the first two steps
This is a significant change in will lead anywhere unless
orientation for the organisation, NHS employees are helped
and one that requires four major to understand what a
steps to be taken if it is to patient-led service will mean
become a reality. in practice and what their
part will be in its delivery.
• The NHS must ensure that it
New customer-focused skills
listens to its customers and
The real NHS: the benefits of a marketing approach [ ]3
the benefits of a marketing approach
and competencies need to communication, both with those
be developed and within the organisation and
embedded. those outside. Perhaps most
importantly of all, it is about
• The development of a
measuring the effectiveness of
commercial orientation will be
the value delivered. Marketing
an essential element of
can help the NHS to re-establish
creating a successful Health
contact with its founding values.
Service for the future. It is
therefore vital that health
trusts begin to recruit staff The future of the
with appropriate commercial NHS is one of
skills who will deliver the customer managed
vision and begin to develop relationships
the next generation of health
service commercial
specialists.
Implicit in the vision of becoming Used effectively, marketing will
a patient-led service is reduce costs by enabling
recognition of the fact that the healthcare providers to segment
initial challenges that must be their customers, breaking them
overcome are marketing down into smaller groups with
challenges. For the NHS to more clearly identifiable needs,
become patient-led it must first in order to allocate spend where
become marketing-led. it is needed whilst cutting out
unnecessary expense. It will give
The benefits of marketing are patients a role to play in the
many for the National Health development of the services
Service. Marketing is not about aimed at them. The patient with
a few advertisements in the local choice is an economically
or regional press: it is about important player who will not be
understanding markets and slow to point out what he or she
identifying where value can be expects of the service provider –
added. Marketing is about and it is the role of the marketer
[ ]
4 The Chartered Institute of Marketing
Introduction
to listen. As a result, the age of Rather, it is a case of
the passive patient is nearly at professional managers
an end. accepting the realities of what
this policy shift would bring –
Contrary to widely-held opinion, the creation of a far more
marketing in the NHS is not competitive operating
simply about advertising or environment than they have ever
selling the service: it is about known – and then sourcing the
developing that service in the skills they will need to maintain
first place, then, by absorbing or improve their competitive
constant feedback from the position in this changed
marketplace, continuing to scenario.
ensure the service is fit for
purpose and is actually what When patients come to
patients want. understand what a marketing-
led approach actually means for
This new world is coming about them, they may come to see it
because of a clear and coherent not only as the time when
government policy, articulated in patients found their true voice,
the NHS Improvement Plan of but, more pertinently, the time
June 2004i. This is not a case of when they discovered someone
grasping marketers forcing within the NHS was actually
themselves onto unwilling trusts. listening to them.
The real NHS: the benefits of a marketing approach [ ]5
Exploring the issues
2. Exploring the issues
Baroness Cumberlege, 2. Set standards or make
Parliamentary Under-Secretary service promises and be
of State at the Department of certain you can deliver them.
Health, stated as long ago as
3. Go hunting for people with
1993:
complaints and reward staff
"We are marketing three things
who uncover them.
in the health business – change,
A satisfied complainant
health and services."
becomes your strongest
(Quoted by Owens and McGillii)
advocate and best long-term
customer.
Owens and McGill went on to
explore why it is that successful 4. Talk about your successes.
organisations concentrate on Show your pride. It does
serving the needs of customers wonders for staff morale.
in a chapter entitled Putting
5. Invest in your staff because
Patients First, which was not
that is the way to win. Your
very far removed from the
staff can undermine any
current initiative for a patient-led
corporate image you may
NHS. Six rules of marketing
generate in a flash.
within the NHS, developed by
Brian Edwards, at that time the 6. Keep checking your
General Manager of Trent customer's perspective. The
Regional Health Authority, were needs of patients change as
proposed: does their image of us.
The wisdom of these rules
1. Make it easy for GPs to
would seem self-evident and
access your services whether
non-contentious to seasoned
they are fundholders or not.
marketers. Yet there is clear
The real NHS: the benefits of a marketing approach [ ]
7the benefits of a marketing approach
resistance to the very idea that or a lack of appreciation,
the NHS offers a suitable amongst some of the elements
environment for marketing of the health services community
practice, as evidenced by of what marketing is and what
General Practitioner Margaret
McCartney in the Financial Are the disciplines
Times article More medicine, of marketing and
less marketingiii medicine really so
polarised that
"Successful marketing sustains, well executed
broadens or deepens its and effectively
markets. Good medical care delivered marketing
does not do this. Good medical cannot deliver
care instead works by value to the
talking, listening, examining, Health Service?
diagnosing, assessing risks and
benefits, and making decisions
on doing something or nothing
or planning a later it's there to do. There are many
reassessment." broadly similar definitions of
'marketing', but in a health
To which the successful
service context the definition set
marketer might well respond –
out below has much to
"And what's so wrong with
commend it:
that?" They might even claim
that "talking, listening, A management process for
examining, diagnosing and understanding markets, for
assessing risks and benefits", far quantifying the value required by
from being the exclusive the different customer groups in
preserve of the medic, are these markets, for
central parts of the marketing communicating this to everyone
planning process too. in the organisation and for
measuring the effectiveness of
Clearly there is either a
the actual value delivered.
fundamental misunderstanding,
[ ]
8 The Chartered Institute of MarketingExploring the issues
Are the two disciplines of • The division between social
marketing and medicine really so and commercial marketing.
polarised that marketing, well • The need for policy-driven
executed and effectively guidance informed by a clear
delivered, cannot deliver value to political agenda.
the Health Service marketplace?
• How marketing success
In the commercial world markets
might be measured in the
need to be sustained, and the
Health Service context.
very existence of market forces
reveals often unpalatable truths The session began with an
and allows them to be exploration of what would
confronted in a way that avoids appear to be the central
stagnation and encourages the problem for marketers within the
adoption of innovative NHS context, the extent to
approaches to problems. Why which 'marketing' is accepted
should this be an anathema to and the perception amongst
the National Health Service? employees of marketing's role.
Margaret McCartney is certainly
In order to understand the not alone in fundamentally
issues more clearly The misunderstanding the role of
Chartered Institute of Marketing marketing and the benefits it can
held a round table forum at its deliver. She speaks of "glib,
Moor Hall headquarters, inviting meaningless statements" and
along senior marketing, paints a picture of an
communications and organisation "shattered into
commercial managers from a pieces and forced to waste its
variety of NHS trusts. resources to compete with
itself"iv. The Unions too are not
The key areas for exploration slow to join in: "The very idea
were: that hospitals should spend
• How marketing cultures taxpayers' money on advertising
come into existence. for patients instead of treating
patients is ridiculous" states
• Building and cultivating
Karen Jennings, Head of Health
awareness of marketing.
The real NHS: the benefits of a marketing approach [ ]
9the benefits of a marketing approach
at the public services union The problem, perhaps, is that
Unison, again seemingly there is no clear comprehension
betraying a lack of by many NHS staff as to what is
understanding of what involved from a marketing point
marketing is actually aboutv. of view, and it is easy to
understand why this might be
Are these the views of neo-
the case. Very few staff
Luddites who need to be shown
members have encountered
the light, or are they vital
marketing before, other than as
stakeholders who need to be
embraced? However the views
Marketing has built
are seen, they represent a broad
up its own
spectrum of the organisation's
formidable
employees and clearly represent
vocabulary over the
a challenge for marketers within years, and many
the National Health Service. terms are either
Perhaps the critics of marketing unfamiliar,
should consider the language misunderstood or
that is already being used to put carry negative
across the challenges facing the
connotations
Health Service. Have they
thought for a moment about
precisely what a 'patient-led'
service entails, about what will passive recipients of consumer
be involved in putting patients at marketing campaigns. Marketing
the core of service delivery as has built up its own formidable
active participants with views vocabulary over the years, and
and needs of their own, rather many terms are either unfamiliar
than as passive patients, (segmentation, service-dominant
accepting what is given to logic etc), are misunderstood or
them? If the 18-week patient carry negative connotations (PR,
journey were so simple, why has advertising etc).
it never been achieved within
previous structures and It seems that the lessons of the
processes? early 1990s, when the first
[ ]
10 The Chartered Institute of MarketingExploring the issues
tentative marketing approaches organisation where clinicians
were being outlined as first-wave and managers work towards a
trusts were being rolled out, common end purpose, rather
have been ignored. Back then, than the current situation where
after a period of time, there was managers and clinicians often
gradual acceptance of what have conflicting agendas. Re-
marketing could deliver, engineering service processes in
alongside an active dislike of this way could have a huge
what was perceived as positive impact on the success
marketing jargon. It may very of the NHS, but previous lack of
well be the case that if a marketing experience amongst
marketing orientation is to be Health Service professionals has
created in the current situation made this an unattainable goal.
we need to investigate the
creation of a new marketing Secondly, marketing strategies
lexicon, drawing on the can be used to improve quality –
experiences and expectations of from the perspective of both the
staff within the health services. patient and the clinician. By
Above all we need to use this implementing commercial
lexicon to demonstrate to all techniques, such as pricing,
stakeholder groups within the market research and
NHS why marketing is needed. segmentation, hospitals,
clinicians and GPs can tailor
Marketing in the National Health their products and services to
Service should focus on two key offer the right solution in the
factors: right place at the right time.
Marketing is also essential to
Firstly, internal marketing is create the kind of push/pull
needed to show clinicians and strategies that will send out
managers the benefits of the messages to GPs and attract
patient-led approach, and to patients towards the trusts.
create a more joined-up
The real NHS: the benefits of a marketing approach [ ]
11A more commercial
approach is not about
being ‘divisively
competitive’...
[ ]
12 The Chartered Institute of MarketingWhy is marketing good for the NHS?
3. Why is marketing
good for the NHS?
Few would argue that the NHS increasingly being met. Whilst
is in need of greater strategic arguments for and against this
direction, but there is little policy are complex, it is an
consensus as to how to indication that principles from
implement that strategic the private sector can be
direction successfully. Pumping employed to bring about positive
in increasing amounts of money change in an organisation that is
does not in itself solve the often perceived as stagnating.
problem, and neither does a
politically-led emphasis on A more commercial approach is
targets because that can lead to not about being 'divisively
massaging of figures and draws competitive', as those who
both clinicians and managers misunderstand the nature of
away from their focus on patient marketing label it. Instead, it is
needs. about adopting a more
commercial approach to the
Firstly, a marketing-led approach budgets that do exist, to extract
can offer a strategy on where maximum value from them. The
the National Health Service is, NHS does not tend, for
and where it needs to get to. example, to consider pricing
The marketing-led approach strategies from a marketing
adopted in England, where a perspective – instead, price is
competitive marketplace has set by cost.
been created, has led to
dramatic falls in waiting times By changing this, for example by
and the '18-week' target is offering the same services at
different prices at different times,
The real NHS: the benefits of a marketing approach [ ]
13the benefits of a marketing approach
resources can be managed Drivers for marketing
more effectively to create more
The main drivers to stimulate the
value from them. For instance,
NHS to see the need for
marketing are Payment by
By offering the Results (PbR), 'patient choice'
right services and competition. With primary
and products,
care the drivers for marketing
at the right time,
will be public health targets – the
at the right price,
benefits of using social
NHS trusts can use
competitive marketing techniques; for
knowledge and example, changes in
marketing commissioning, the potential
communications to need to promote Independent
attract patients Sector Treatment Centres
(ISTCs) and the general desire to
meet patient needs or be
referred to the local County
Council Health Scrutiny
where theatres are rented to
Commission.
private practitioners the cost
could be lower at times when
The value of communication
demand is lower, or patients
could be offered faster treatment The greatest value of marketing
if they are prepared to receive it for the NHS is that it creates a
at unsociable times. Price, in framework for effective
other words, is not a purely communication. By collecting
financial concept; it can be information on patients' wants
applied to any issue of and needs, trusts can more
exchange. It is therefore a valid effectively offer the services and
idea to examine in the public products that are required, and
sector, where many services to tailor them to individual patients.
patients are not financially
'charged for' and the service is With the average customer
'free' at the point of contact. exposed to hundreds of
[ ]
14 The Chartered Institute of MarketingWhy is marketing good for the NHS?
branded messages every day, knowledge about developments
the benefit of a marketing in clinical practice. According to
approach is that the paper Marketing in the new
communications to all NHS by Netcare, patients
stakeholders (patients, referring "expect to participate actively in
GPs, the media, relatives, the their programme of care, and
government and non- not be treated as passive
governmental organisations), recipients"vi. This demand for
become clearer, more consistent information is why organisations
and more readily available. That such as charities commit to
communication generates more marketing spend, and why it is
positive and coherent feedback, now important for the NHS to
which can be used to continue do so too.
the development of the right
products and services, and Patient choice
make them available at the right
The fact that, in England,
place and time.
customers have a certain level of
choice about where they want to
Patients expect to be treated makes the use of
participate actively in marketing techniques inevitable.
their programme of By offering the right services and
care, and not be
products, at the right time, at
treated as passive
the right 'price', NHS trusts can
recipients
use competitive knowledge and
marketing communications to
attract patients. Without this
Thanks to the internet, patients element of commercial thinking,
increasingly have access to trusts will find patient numbers
channels other than their GP to declining and this will have
find out information on their financial consequences. Whilst
condition and the treatment there are many arguments in
options. This means that favour and against patient
patients come armed with more choice (the principal flaw being
that there is a difference
The real NHS: the benefits of a marketing approach [ ]
15the benefits of a marketing approach
between informed consent and introduced into the NHS.
a patient making a choice that Primary Care Trusts (PCTs) have
conflicts with clinical judgement), to pay for the ISTCs regardless
the NHS is in need of change – of whether any patients choose
and having a market helps drive to be treated there.
that change.
PR – explaining rationales,
The media quickly not selling spin
pick up on
With an organisation as large as
discrepancies
the NHS, and one that is so
between regions
that are then squarely in the public eye, all
presented as managers (and to a certain
‘postcode lotteries’ extent clinicians) need to take
personal responsibility for how
the Health Service is perceived
in the wider world.
Any such changes do, however,
One problem with changing the
need to be considered against
Service positively is that making
the fact that increased choice
changes unilaterally proves to be
does not necessarily mean a
almost impossible logistically;
better service – for example the
but when regions or trusts are
benefits of having a centralised
given the power to make
centre of excellence in some
changes to benefit patients, the
specialist fields far outweigh the
media quickly pick up on
benefits of offering increased
discrepancies between regions
patient choice by fragmenting
that are then presented as
services.
'postcode lotteries' or unfair
ISTCs attracted much local discriminations.
opposition when they were
We have seen this recently in the
introduced, and the government
media attention on four devolved
needs to look at whether they
administrations 'pursuing their
are an effective framework for
own agendas' and offering
market principles to be
[ ]
16 The Chartered Institute of MarketingWhy is marketing good for the NHS?
different services, which are then Planning and budgeting
perceived to be unfair if patients
The NHS financial year-end is in
live in a region that doesn't
March, but budgets for the
favour their needs. For example,
following year are not finalised
in England the NHS market has
until the year-end itself. In
resulted in significant falls in
Foundation Trusts these budgets
waiting list times, whereas in
are sometimes not finalised until
Scotland doctors have more
May. This results in planning
input into decision making with
problems where trusts do not
more limited input from the
know what their budgets will be
private sector. In Wales the
until the financial year is
Welsh Assembly has been very
underway. A commercially-run
successful in innovative
organisation needs to have its
approaches, such as abolishing
budgets finalised in advance of
prescription charges, but less
this – typically, next year's plan
successful in reducing waiting
would be finalised three months
times.
before year-end.
Recruiting managers with
Moving towards a more
communications experience,
commercial approach to
and giving existing managers
budgeting would help managers
training in communications, will
allocate resources more
contribute to resolving such
effectively and reduce the risk of
scenarios. Such managers can
deficits. Whilst political changes
communicate why decisions
and elections can prevent the
have been made in certain ways
NHS planning as far ahead as a
and explain the rationale behind
private company would be able
their decision making, whilst also
to do, an improvement in budget
demonstrating that change
planning is a realistic goal.
inevitably leads to teething
problems. They must
communicate the broader
picture and show the long-term
benefits.
The real NHS: the benefits of a marketing approach [ ]
17Why is marketing good for the NHS?
Internal marketing Part of achieving this will be to
ensure that the managers who
The other area where a
are in place have the respect of
marketing-led approach could
clinicians. This can be achieved
make a key difference to
in two ways: firstly, by recruiting
improving the Health Service in
managers who have commercial
the future is internal marketing.
experience; and secondly, by
There is much dissension giving existing managers
between clinicians and marketing training.
managers about the best way to
The final vital element of internal
manage the NHS, and there is a
marketing is to ensure that
certain level of mutual distrust.
senior management both
Internal marketing to encourage
support and facilitate the
clinicians and managers to work
implementation of marketing
in the same direction and create
techniques. The reaction and
a more joined-up organisation
support of senior management
can be achieved by emphasising
within the Health Service is
the focus on the patient.
essential if the momentum
Currently, it is sometimes the
towards a patient-led future is to
case that clinicians want to do
be generated and maintained.
their job and managers want to
do theirs. By showing both
One way to make internal
groups that they are each a vital
marketing more successful is to
half needed to meet patients'
create a more motivating
needs, and that one half cannot
environment for employees. All
do the job successfully without
NHS employees accept that the
the other, steps could be taken
salaries they earn are likely to be
to give a more strategic focus to
lower than they could expect in
the organisation, particularly to
the private sector; employees
those clinicians who see
accept this because they are
managers as little more than an
driven by a desire to have a
obstruction to them doing their
fulfilling job that helps society
job.
and other people. However,
instead of the existing rigorous
The real NHS: the benefits of a marketing approach [ ]
19the benefits of a marketing approach
pay structure that rewards long have always been done is the
service rather than good work, best approach. It would also
two recommendations would be alleviate the problem of talented
to adopt a more commercial and skilled, but frustrated and
approach where effective and de-motivated, practitioners or
efficient work is rewarded with managers leaving the NHS for
bonuses, and to create more the private sector. This results in
flexibility for good employees to the loss of good staff who
be promoted within the system. should have been encouraged
Such an approach goes without One way to make
saying in the private sector, but internal marketing
the National Health Service more successful is to
currently automatically increases create a more
pay scales if an employee stays motivating
for a long period of time, environment for
regardless of the quality of work employees
performed.
By saving money on not
automatically awarding pay
to stay, whilst less effective
increases, part of the budget will
workers remain because the
be freed up to reward good
Health Service's profit and loss
work. This would do several
is not accountable to
things – it would motivate staff,
shareholders or customers.
which leads to better service for,
and more positive feedback Paying more competitive salaries
from, patients. It would go some to prevent talent leaving is not a
way to eroding the long-termist question of asking for more
culture of the NHS that leads to money; it is merely a question of
scenarios where some staff are allocating existing budgets in
change-resistant because they more competitive ways. Whilst
have been working in the same Agenda for Change has started
role for a long time, and believe to tackle this issue with its
that doing things the way they
[ ]
20 The Chartered Institute of MarketingWhy is marketing good for the NHS?
competency gateways, it has service and better treatment.
not changed the situation to the This then creates a virtuous
degree we believe could be circle of profit, improving the
strongly beneficial for the NHS. service to patients. It has knock-
on effects in terms of reducing
Adopting a more competitive costs – for example, in a lower
approach can therefore be seen number of complaints
not as 'divisive' – instead, it procedures and thereby reduced
highlights the need to treat costs of payouts.
public money as a precious
resource that needs to earn its
Other parts of the NHS
keep.
Most of the scenarios outlined in
A business will fail without profit, this paper are, by necessity of
but a sense of urgency of how space, trust-focused and
spend is allocated is largely elective-care oriented. However,
missing from the NHS. the underlying principles of
An increased commercial patient-led marketing can be
awareness would show that applied to other parts of the
there is a need to generate NHS, such as emergency
profit, because that profit can provision, primary care and
then be ploughed back into mental health services, where
research and development, staff they do not conflict with duty of
productivity rewards, more care.
equipment and resources, better
The real NHS: the benefits of a marketing approach [ ]
21The solution
a patient wants
is the right treatment,
at the right time
[ ]
22 The Chartered Institute of MarketingConclusion
4. Conclusion
It is widely accepted that the clinicians struggle with what they
National Health Service is in perceive as 'marketing jargon'.
need of change, but opinions Part of the task in showing
differ widely on how to achieve clinicians the value of marketing
that change in an institution so is to ensure that terminology and
vast and complex. Marketing is concepts are understandable
not the solution to all of its and directly relevant to the NHS.
problems, but it can be a key If marketers are to be accepted
part of the required positive they need to change commonly
change: understood 'marketing' terms to
commonly understood 'NHS'
• Culturally, to help clinicians terms.
and managers work more
Creating a 'marketing
effectively towards the same
department' in health trusts is
goal
not the only answer, because it
• Internally, to extract more does not in itself change the
value for the patient from culture of the organisation or
existing resources generate buy-in from clinicians
and managers, many of whom
• Externally, to show patients have little experience or
the benefits of the new NHS understanding of what
and gain their support by marketing is or does. The
showing them that decisions answer is to bring more
are made for their benefit marketing knowledge to all parts
of the organisation and to
There is much confusion about
communicate the benefits of the
what marketing entails in the
patient-led approach to
Health Service, and many
managers and clinicians.
The real NHS: the benefits of a marketing approach [ ]
23the benefits of a marketing approach
It would also be beneficial to The focus on patient choice
create a senior marketing post in creates a market, but the
the Department of Health and in bottom line is that most people
the NHS itself – interestingly, want their local hospitals to be
neither role currently exists. It is good and to be able to go there
also important for the board, the for treatment. A completely free-
CEO and the non-executive market approach would lead to
directors to be receptive to hospital closures, which is not in
marketing, and this attitude is the interests of the patient.
not consistent across the Health A marketing approach can
Service. balance such conflicting
scenarios and, by understanding
Marketing should be a popular the market and gaining opinions
concept in the organisation and information from all
because it could move it away stakeholders, including patients,
from financial targets and relatives, clinicians and
number crunching towards managers, help make the right
serving, and looking after, the decisions. Allowing market
patient – which is why most forces to work creates
people join the NHS in the first efficiencies and improves
place. A marketing approach performance, with the caveat
could help clinicians and that any extremes of market
managers express themselves in force (eg closure of a bad
more effective ways by using service) has to be countered by
persuasive arguments when a realistic alternative offering for
dealing with what is sometimes the patient. However, no
perceived as political decisions should be taken that
interference. Marketers are contravene clinical judgement.
'change agents', but that
process of change can only be Adopting a marketing-led
strategic if it has broad bottom- approach could help the NHS
up and top-down support. move towards being an
Marketing becomes merely organisation that is better able
tactical and cosmetic without to:
that support.
[ ]
24 The Chartered Institute of MarketingConclusion
• Understand the market – by • Work proactively with the
gaining more information on media to address
patients' needs and wants, misunderstandings about
more effective solutions can strategies and decision
be created and tailored. making, and create a more
positive relationship with all
• Create the service that
stakeholders.
patients want and need –
within the limits of the • Focus on Gordon Brown's
Working Time Directive and recent statement that the
existing budgets. NHS should work more
towards prevention than
• Align managers and clinicians
cure. A wider adoption of
to work more co-operatively.
social marketing techniques
• Save costs by drawing more can help achieve this.
value for both patients and
• Move from a sometimes
the organisation from existing
change-resistant culture to
budgets, allocating spend
one that embraces positive
more effectively where it is
change.
needed.
• Minimise the inevitable
• Fill spare capacity first, then
conflicts between patient
move on to generating new
desires, clinical judgement
income.
and availability of resources.
• Motivate and reward staff,
leading to better efficiency Further practical suggestions
and effectiveness, with
• Introduce a senior marketing
knock-on cost savings.
post into both the NHS and
• Communicate the benefits the Department of Health.
more effectively, reducing
• Bring budgeting in line with
complaints and saving time
the end of the financial year
and money.
across the NHS.
The real NHS: the benefits of a marketing approach [ ]
25the benefits of a marketing approach
For marketers, a customer does right treatment at the right time.
not buy a product or service – For the NHS, being more
he or she buys a solution. The marketing-oriented in its
solution a patient wants is the approach to such issues could
lead to a major shift in
If marketers are to philosophy that places the
be accepted they customer, rather than the
need to change treatment or the provider, at the
commonly centre of its operations. This
understood would lead to better service,
'marketing' terms more positive feedback, and a
to commonly greater willingness amongst
understood 'NHS' patients, doctors and managers
terms. to be more flexible for the
greater benefit to all, and help
return the organisation to some
of its key founding intentions.
[ ]
26 The Chartered Institute of MarketingSources
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, Anne Gibbs, Emma Mooney, Simon Roberts,
Director of Director of Marketing and Head of Business
Communications, Development and Communications Development and
NHS Confederation Marketing, Manager, Royal Marketing, Papworth
Birmingham Women's National Hospital for Hospital's NHS
Sally Bryden, Hospital NHS Trust Rheumatic Diseases Foundation Trust
Head of Strategic
Development, Oxleas Micky Griffith, Tom Neve, Meurig Thomas,
Mental Health NHS Strategy and Assistant Director of Consultant
Foundation Trust Development, Royal Planning and
Berkshire NHS Performance, Peter Tomkins,
Ginette Camps- Foundation Trust Tameside and Non-Executive
Walsh, Chairman of Glossop Hospital Director, Royal United
The Chartered Amit Khutti, NHS Trust Hospital Bath
Institute of Director of Strategy
Marketing's Medical and Service Planning, Shari Payne, Matt Toogood,
Marketing Group, Chelsea and Head of Business Director Marketing
Board member of Westminster NHS Development and and Communications,
2020 Health Foundation Trust Planning, Leeds Teaching
Hertfordshire Hospital NHS Trust
Celia Dossett, Sue Kong, Director, Partnership NHS Trust
Networks Manager, NHS Elect Stephen Winterson,
Foundation Trust James Rimmer, Director of Marketing,
Network John McGill, Director of Strategy, Countess of Chester
Professor of Yeovil District Hospital Hospital NHS
Marketing, Kingston NHS Foundation Trust Foundation Trust
Business School
The real NHS: the benefits of a marketing approach [ ]
27The 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 One day workshop
Level: Foundation Code: 0878
Visit our website for more information and to book: www.cim.co.uk/0878
[ ]
28 The Chartered Institute of MarketingCourses
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 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: 0090
Visit our website for more information and to book: www.cim.co.uk/0090
The real NHS: the benefits of a marketing approach [ ]
29Information 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
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Exclusive Members’ Area Online
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online selection of journals and company reports via the Knowledge Hub:
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‘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
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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 • library@cim.co.ukbooks
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for professional marketers
With over 200 marketing and business
books available, CIM Direct is your
one-stop-shop for marketing knowledge
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