Why Marketing is at the core of co-production in the Big Society

The coalition government's flagship Big Society agenda aims to decentralize decision making within the public sector and give power back to the people. Local authorities and the Public are to work together to provide services more tailored to their needs, than national governance could offer.

The recent Government White Paper, Equity and excellence: Liberating the NHS, lays out how the Big Society relates to the NHS. Co-production of services will be the joint responsibility of newly formed GP consortia, social enterprises and the local population.

The White Paper explains the intention of raising public involvement in shaping their local health services to unprecedented levels. The various points of contact between the Public and their local suppliers needed in achieving this will revolve around effective communication and engagement. This is intrinsic to the Big Society initiative and it cannot possibly work without it.

The knowledge and expertise within the Marketing sector has to be utilized in providing and supporting this.

Transparency of information is inherent in the Big Society concept. Ineffective delivery of information is essentially the same as keeping it behind closed doors. Not only does it need to be delivered well, but also presented in such a manner as to be easily digestible by the Public at large. Making data available is one thing, but to truly involve the Public and to have that transparency mean something, it needs to engage the public, being presented in an appealing manner.

Local HealthWatch organisations will have the role of ensuring listening to the Public is central. Will this be a matter of simply checking that the local authority is going through the motions, sending out the odd survey, or will it go deeper, assessing and guiding the efficiency and effectiveness of Public engagement?

This engagement will not only be feedback, but also taking an active part in commissioning. This, as part of the overall 'Big Society' policy of deepening the Public's role in providing their own services, makes it all the more essential that that communication channels are as effective as possible. Marketing agencies from the Private sector will need to be central in making this a reality, as it is they who hold the required knowledge and tools in communication and engagement.

The new NHS Commissioning Board will provide leadership and guidance for GP consortia in commissioning, championing greater public involvement, and supporting the development of GP Consortia. If they're to do that, one would hope that will include support in commissioning marketing agencies with the required expertise, as the services they provide in public engagement are absolutely essential to the core aims of the Big Society.

Though the government claim their agenda is not the privatisation of the NHS, their proposals do seem to represent a restructuring from what is essentially a national corporation into a loose association of, for all intents and purposes, small businesses. Small business, with limited budgets, often have marketing as a low priority, perhaps conducting it themselves, rather than employing a marketing department or employing agencies. This cannot be the case for the GP consortia and social enterprises if the reforms are going to succeed, as public engagement is the corner stone of the policy and marketing agencies are THE experts in that field.

This Big Society is about listening to and involving the Public. Marketing provides the tools to make that happen.

The Incentive Dilemma

“Can cash incentives encourage better health choices?” That is the question being bounded around by the media today.

The answer, it seems is ‘yes’. With the mainstream media reporting this morning that a report by the independent Citizens Council, run by the National Institute for Health and Clinical Excellence (Nice), backs schemes that offer incentives to people to quit smoking or eat healthier food, i.e. leading to positive changes.

This was always going to be a thorny issue and with the BBC using the catchy “Swap ash for cash” and “Gain pounds for losing pounds” in a report this morning, it’s something that will bring out strong opinion.

Britain is the most overweight country in Europe and fifth in the developed world; hardly a great endorsement ahead of the 2012 Olympics celebration of physical achievement. However, when we look at this, perhaps the fact that we have such a developed NHS helps create an environment in which its OK to become obese, because there are plenty of safety nets and support services available for free (at least as it would seem).

So, we hear that these incentives are “an effective way of encouraging people to change their unhealthy ways”. With pressures to cut costs in the NHS, the business case for programmes like this suggests that it could be a worthy investment.

However, it’s the question of morality that is going to rage on this one. A question that will be addressed in further posts and as this story develops.

In the meantime, I have some fears about the message this story sends. In particular, to smokers considering stopping smoking or overweight people preparing to improve their lifestyle.

Are “Swap ash for cash” and “Gain pounds for losing pounds” schemes on their way? Is this an incentive to smoke for a while longer to wait for the pay-off? This might sound like an infantile comment to make, but when faced with the pain of breaking an addiction, we often look for reasons to maintain our behaviour and this could be yet another excuse to put it off for another day.

Its pretty clear that we haven’t heard the last of this one.

 

You can view the press release from NICE here:

http://www.nice.org.uk/newsroom/pressreleases/CitizensCouncilIncentives.jsp

Read the BBC article at;

http://www.bbc.co.uk/news/health-11421046

 

Case Study: Sandwell PCT Social Marketing Hub

Sandwell is located in the West Midlands and the PCT covers a population of approximately 320,000 people. The PCT has recently begun to develop it's social marketing and launched a website (http://www.overthegardenfence.org) to support their efforts. We're going to take a look at this website and discuss how it achieves it's goals, but first below's a link to a great video produced by Sandwell PCT, explaining exactly what Social Marketing is.

http://vimeo.com/9468125

The first impression I get from the website is that it's a lovely design, being bright and cheerful, with the colour scheme and illustration in the banner. The name, "Over the garden fence" implies a neighbourly community conversing. This matches the stated aim in the tag line, this being "Providing people a place to share their insight on health and wellbeing across Sandwell".

The welcome message goes into further detail, describing the site as a hub for sharing Social Marketing insight within Sandwell. The page does this by allowing people to register, then upload insight documents. These are displayed in chronological order underneath the welcome message.  Filter options appear to the right, with a search box and pinboard displaying popular search times, allowing a user to find posts on specific topics. Above this is a big red button, linking to an area where users can register, then leave posts.

And that's it. Very simple, with nothing extraneous and doing nothing more than what it says on the tin. This is probably the biggest positive of the site. A user knows straight away what the site does and what it does is right there on the same page, so they can find what they want as quickly as possible. This is perfect from the users point of view. Websites often get bogged down in bells and whistles, to the point where they lose sight of their core reasons for being, which may keep it out of sight for the user too. Over the garden fence doesn't make this mistake.

It's a great little website, but what else could they do going forward? Here's our suggestions.

Without being an administrator for the site, it's difficult to say how much traffic it's received, but it may be an idea to make this a little more visible. If it's not obvious that a page is active, it can actually discourage people from using it further. A few tweaks here and there, to show how many people have downloaded a document and visited a post, as well as some pointers to encourage further comments and debate would go a long way to achieving this.

The PCT will have conducted their research and determined that there would be uptake enough for this site to justify commissioning it. Promoting the site, both internally and externally, as an ongoing process would help increase this uptake, with things such as regular email campaigns highlighting points of interest within the site.

The website looks great, but maybe encouraging contributors to include relevant images or videos with each post would make it even more visually appealing. Social Marketing, even within a professional context such as this, is about people and it would be good to get a feel for this on the page. The copy in each post is useful and informative, but if this is the only place where the people of Stanwell can see all the initiatives their PCT are conducting as a whole and they're essentially the customers, perhaps “selling” them a little more would be a good idea.

As mentioned before, the simplicity of the site is fantastic, but maybe splitting the posts into categories and displaying them in the spare space usually used to navigate between pages in the banner, would improve the user experience further.

At this stage in the internet's development, Social Media functionality could also be built in to the website. This would include allowing users to share a post to Social Networks, such as facebook. This may not seem immediately relevant, as the documents are more internal than public facing, but you can presume that those that do share have similarly employed people within their online social networks. Besides, the welcome message on the site does state that it's also aimed at the public, so helping spread items to non-employees within the Sandwell area through Social Media, wouldn't be a bad thing.

Just one tiny little negative to finish (sorry Sandwell!). The logo to the top right links back to the home page, whereas I expected it to go to the PCT website and certainly think it should. There should also be a link in the welcome message. In fact, I couldn't find a link through anywhere on the website. I found the PCT website through Google and again, couldn't find any links back to Over the garden fence. It's a website to be proud of, so should be well displayed and easily reachable through wherever Sandwell has a web presence.

But that's a small niggle really and the site is a great example of a PCT beginning to embrace and see the importance of Social Marketing. Well done Sandwell!

An Example of a Social Marketing Strategy: Dudley PCT

A well defined strategy is vital in a PCT's Social Marketing efforts. Not only does it demonstrate to the Public that their local NHS has a considered approach, but also ensures that staff and any other stakeholders are consistent in their practice, all singing from the same hymn sheet.

Dudley PCT's Strategy is a great example of a PCT embracing and fully understanding the concept of Social Marketing. The document was published in 2007, but still remains entirely relevant. It can be downloaded from here.

A concise explanation of Social Marketing leads into an introduction where it states key problem areas within Dudley that could benefit. As with commercial marketing, identifying goals and aims is massively important. A general 'increase the public's health' objective is far too broad. Breaking it down into specific targets makes attaining them more achievable, as well measuring progress more practical. It also increases efficiency by only focusing on those areas of the populace that need attention, rather than approaching the whole.

The strategy then goes on to discuss segmentation further, making a very valid point;

"Many people see marketing as a form of communications, but the area is much more complex that this, marketing allows organisations to understand their audience in detail and to segment this audience into similar groups, for example, by demographics such as age, sex, geographical location, by behavioural traits and by needs and wants."

This understanding is great to see. For Social Marketing to be truly effective, a thorough knowledge of the audience is paramount. Not only does this help identify those target, problem areas, but also defines which campaigns to run and how to go about them. Every so often I'll see a marketing campaign aimed at teenagers using the sort of 'teen speak', such as 'fab' or 'groovy', that hasn't actually been spoken by youngsters for decades. It's fairly obvious it's been written from an assumed, stereotypical point of view, with little understanding of the modern audience. It has no chance of engaging and may even insult the audience. Without that in depth understanding, any campaign could do the same.

The PCT's insight is demonstrated further, as the Strategy goes on to discuss why Social Marketing is needed. Within this section is a great diagram showing that behavioural change is achieved through a staged process, rather than a single intervention. Educating the Public on health risks is only the first stage, with the desire to change, having the necessary skills, etc, all needing to be supported as well. Social Marketing offers the tools and methodology to help address all these stages, ensuring change is effective and long term.

The Strategy then outlines the key objectives, followed by responsibilities of the Board, Managers and Communications Heads. These highlight important points, such as considering Social Marketing as a viable alternative for preventative campaigns and allotting reasonable time to fully understanding audiences further.

Have a look at the strategy for yourself at the link above. Does it cover all the bases?

Further documentation regarding Dudley PCT's attitude towards Social Marketing are available below;

Communications and Social Marketing Action Plan 2008.

Communications and Community Engagement Strategy - October 2008 (Large file 6MB).