Working with an NHS in crisis: health tech in 2023

In January, Highland Marketing co-founders Mark and Susan Venables looked at the trends that would shape digital health in 2023. Half-way through the year, they revisit their predictions, and consider what they mean for marketing, PR and communications this autumn and winter.

In January, we said: It can be difficult to make predictions for the year ahead – but not this year. It’s easy to pick out the trends that will impact on health tech and communications over the next 12 months, because we are already living them.

For example, it is hardly a prediction to say the NHS will be under enormous pressure in 2023. Ambulance and hospital trusts were at the highest level of alert in the run-up to Christmas, even before nurses and ambulance workers struck, and there’s no reason to think demand will let up anytime soon.

At the same time, waiting lists have been growing by 100,000 per month since the end of the Covid-19 pandemic, while NHS finances have deteriorated as inflation has risen. Unless there’s another change of government, or a big switch in policy, there’s no reason to think these trends will be reversed. 

Six months in, we say: These trends continue to shape the focus of the health and care system. The NHS has had some success in tackling very long-waits and ambulance hand-over delays, but strike action has continued and intensified, impacting the overall waiting list, which has continued to grow.

Integrated care boards and trusts are already off-course on their budget plans, councils are warning they could be bankrupted by the crisis in social care, and think-tanks are demanding urgent action to address a “public health emergency” that is not only driving demand for care but holding back economic growth.

Against this background, and concern that a bad flu season in Australia is headed for Europe, NHS England issued its winter planning guidance earlier than usual. Although the Royal College of Emergency Medicine has argued it won’t be enough to stop the service “sleep walking into disaster.”

Communicating in a crisis

In January, we said: This backdrop of unprecedented stress has implications for tech companies that want to work with health and social care. Suppliers need to recognise that the NHS is facing a crisis and engage with that in their marketing and communications activity.

We see a lot of digital innovators pitching their products and services on the basis that they will “transform” health and care, or “delight” clinicians, or “empower” patients. When the feedback we get from NHS IT leaders is that they want honest and straightforward communication that shows suppliers understand what they are up against and lasers in on a problem or problems that they can resolve – right now.

So, in 2023, we would re-emphasise the advice that we’ve always given, which is that to succeed in digital health, you need to be clear about the specific issue or issues that your solution can, and how you address them, and how your approach stands-out from the rest.

Plus, you need to be able to back-up what you are saying, by getting your customers to endorse you, or running good data collection projects that prove the business case delivered. And then you need to get that information to the right people, in the right format, to secure their attention.

Six months in we say: This advice has only become more apt. The looming financial crisis and a lack of funding for capital investment, means integrated care boards and trusts are less focused on big strategies than on tactical projects that can be delivered from defined pots of funding.

Often, these are tied to NHS England priorities: as an example, the winter planning guidance doubles down on ‘care traffic control’ and virtual wards. So, companies should think about how their solutions align with these priorities and how they can demonstrate success to organisations wondering if they can really deliver for them.

Responding to a changing NHS  

In January, we said: Another easy prediction for the year ahead is that there will be further changes to the structure of the NHS and its IT leadership. NHS England will complete its merger with NHS Digital in January, ushering in a new team at the transformation directorate to push ahead with the Frontline Digitisation programme.

Trusts are being encouraged to form provider groups with neighbouring organisations, which could have significant implications for infrastructure and electronic patient record decisions. And integrated care boards, which have only just started work, are being encouraged to rationalise and share services, including IT strategies and assets, to save costs.

This level of churn impacts health tech companies, because it makes it harder to work out who to talk to, where they sit in the decision tree, and whether they have the budget authority to progress an idea. Also, at a very practical level, it means that NHS IT leaders are just incredibly busy.

We see health tech companies putting together traditional event and PR campaigns, in the hope that IT professionals will take time out from their day jobs to engage with them. When what we hear is that professionals want content that is targeted at a few, key shows and must-read publications.

In 2023, we expect to be supporting fewer companies at conferences and expos that require one, two, or more days away from the office – and to be running a lot more webinars that people can attend from their desks or watch in their own time.

This summer, we say: The reorganisation hasn’t gone quite as predicted. The Department of Health and Social Care and NHS England are setting up an NHSX-lite body to handle aspects of IT policy, and NHS England is setting up an improvement board – called NHS Impact – to focus on the change piece.

Meanwhile, Tim Ferris is going back to the US, the funding available for Frontline Digitisation has been cut, and the programme has been extended by a year – putting the target date for completing the digitisation of trusts back to March 2026.

The rest of our advice stands. It can be hard for innovators to work out who to engage with in the NHS, what they want to hear, and how they want to hear it. Which is why you need to work with an agency that really understands the market and can help you to cut through.

Reacting to a changing media

In January, we said: A third trend that we have seen in 2022 and we expect to continue into 2023 is change in the media landscape that is available to digital innovators. The number of health and IT publications that still work to print runs has been declining for years, but now websites are under pressure.

Traditional advertising budgets shrank during Covid-19 and have never recovered. Sales and editorial teams have shrunk in line, leaving sites looking for new ways to fund themselves. Increasingly, we are advising clients to put aside a budget for paid content, and to think creatively about how that can be used to create opinion pieces and case studies that are credible for sites and compelling for readers.

At the same time, we see clients taking control of their own communications, and asking us for advice on how to create blogs (in written, audio or video format) that can be promoted on social media and linked back to a well-crafted website or campaign micro-site. Today, we say: These trends are still playing out, but since January we have seen well-known health tech websites shift whole categories of content from free to run to pay to run. Although that puts an additional cost onto content generators, it also means there are new opportunities to talk about hot topics and how your ideas, services and products align with them.

2023 checklist:

What does that all mean for health tech and communications for the rest of 2023? Well, our top tips would be:

• Keep on top of the latest changes to the finance, policy and structure of the NHS – and make sure you are ready to respond to any new IT programmes, pain points or opportunities that arise.

• Recognise that the NHS has never been under more pressure – and adjust your marketing and communications to respond to the crisis.

• Be clear about the problems your technology can address, how it addresses them, and how you stand out from the competition – and find the customers and data to prove it.

• Don’t let up on marketing, PR and communications. Just think creatively about how to get your message out – and include paid and self-published content, backed up by social media.

• Find the right help and support – look for an agency that really understands health tech, and can help you say the right things, to the right people, at the right time, first time.