Using marketing terminology in relation to the health service is more acceptable now than it has ever been. Many use the term “marketing” synonymously with selling, advertising or promotion and public relations.

Apply this view of marketing to the NHS and a picture appears of providers engaging in any range of activities to communicate more clearly about their service – what’s delivered, to whom and why people should use it. They may just be highlighting the availability of their service or, indeed, they may want to sustain or improve their service’s image.

Conscious of the less attractive competitive behaviors and marketing practices sometimes found within the private sector, many NHS organisations are rightly keen not to have resources squandered on needless or improper promotion. The Code of Practice for Promotion of NHS Services provides a guide to public services in their promotional activities.

The concept of marketing has evolved over past decades. It has moved from one of “selling” to one in which the needs and wishes of the customer are captured and reflected in the service. And services also seek to have a distinctive marketing strategy, to differentiate them from other providers and support the development of their provision.

This is reflected in the Chartered Institute of Marketing (CIM) definition of marketing as “a management process responsible for identifying, anticipating and satisfying customer requirements profitably.” Public and voluntary sector managers prefer to substitute “efficiently” or “within the resources available” for the word “profitably” in agreeing their vision of effective marketing.

Those who adhere to this broader definition recognise that marketing has more in common with public and patient engagement than “selling”. They see it as an ongoing process of assessing and responding to your position within a dynamic marketing environment. For the NHS, this includes flexing provision to meet the needs and views of public and patients. It means being mindful of the existing or potential provision by “competitors” or alternative providers.

In this model, promotion is viewed as just one possible activity out of a range of optional “marketing mix” adjustments that might be used to keep your service viable or, to use another term, “contestable”.

Take the former view of marketing – that equates to selling, if not promotion – and the benefits are limited. They largely hinge around maintaining or improving your service’s image, and excelling over any competition.

Use the CIM’s broader definition of marketing, review marketing theory and apply the principles and practice to the NHS, and commissioners and providers alike will find there is a range of tools with which to assess and shape provision.

Some marketing techniques may be new, others may already be familiar. For instance, you can use environmental scanning frameworks, such as SWOT (strengths, weaknesses, opportunities and threats) analysis to assess the future viability of a service.

Market analysis enables you to generate reliable information that can underpin and prioritise marketing efforts and the use of resources.

Mapping different types of customer is a good starting point. These might include commissioners, stakeholders and staff as well as patients, their families and carers, both within the local area and further afield.

In a tendering context, marketing positioning models can help to assess your service’s attractiveness to commissioners compared with those of competitors. Look at what percentage of the market competing providers have, and whether they focus on a niche group within the overall market.

Whatever tools you use, it helps to follow a clear market planning process. Start with marketing objectives, align these to market opportunities and resources, formulate a strategy, then develop and implement a detailed plan of specific marketing activities.

Originally published in the Health Management Journal Sept / Oct 2008

An article in Health Management earlier this year assessed some of the implications of becoming an independent consultant. But what does it mean in practice? What are some of the pitfalls you should be aware of? Here we outline some tips for those contemplating the move based on our own experiences.

No more the financial security of a regular monthly pay cheque. Overnight, income becomes contract-based and variable. Before starting out, review your personal lifestyle and budget. Focus on essentials, reduce personal overheads, pay off loans and decrease the mortgage. Any NHS ‘package’ should be put to good use. Consider part-time employment (without compromising your availability for contracts) while business builds. Keep six months’ living costs reserve as a buffer.

How easy it was to taker infrastructure for granted. Now you must develop and maintain your own business and office base. Organise travel routes to incorporate banking, buying stationery and equipment (resisting the seductive, glossy brochures) and visits to your accountant. Build in time for book-keeping, getting quotes for professional indemnity and office insurance and seeking out and writing proposals for new work. Techno-nightmares (your system corrupts tomorrow’s Powerpoint presentation, a fault cuts off the phone, email and fax) will cause you to revoke your criticism of the IM&T Help Desk.

Once an organisation animal, now you must tackle the isolation of independence and the challenge of being ‘home alone’, perhaps for several days. With whom do you bandy ideas, obtain sanity checks or find creativity for your proposals and projects? Where is the social chat that lifts your mood, provides interest or brings fresh perspective? Office interruptions give way to domestic distractions if based at home. A good network of business and NHS colleagues, a supportive partner and family, a well-planned and varied diary will help, but strong self-discipline and determination must underpin all.

No longer part of the NHS, your former colleagues’ perceptions of you will shift. Some will use the resource you offer, a few may be envious or suspicious – inevitably, all will become more distant. You find yourself on the outside, looking in. While disturbing at first, the time and self-assurance, you will adapt. Use your new objectivity and maintain your networks by doing most of the running. Exchange your external view-point learning and experience for new information and knowledge of the Service.

Your move to independence may reflect a wish for more control of work and increased quality of life. Yet, just as work never arrives in a steady stream, so customers and contracts ‘ebb and flow’. A single, large project offers security but limits flexibility in attracting new work. Smaller contracts provide less security, but a great deal of variety. Achieving a ‘mixed portfolio’ of work is ideal – but requires you to balance the demands of various clients’ deadlines. Planning for and allowing time to acquire new business is essential. Building in vacation and training time is a risk. Turn down a contract in haste – repent at leisure.

Going solo, how will you obtain sufficient work on a regular basis? The NHS changes. Former colleagues move on. Contracts become hard to maintain. Over time, you will not be able to trade on your original reputation. Larger projects must be tendered for. Tendering, a skill in its own right, is time consuming and de-motivating if unsuccessful. Continually build your reputation through assignments and proactive networking. Explore options to become an associate with an established consultancy, they are experienced in tendering and more resilient. Create a network with other independent consultants with complimentary skills, in complementary sectors – or those in similar fields. Bouncing ideas off one another can lead to sub-contracting or joint-tendering. While the network can be as formal as you like, trust and some ground-rules will be needed. However, the reputation of established consultancies may still prove overwhelming.

Plan ahead. Allow extra time and resources for each job. Network to supplement your resources. Cope with the challenges and generate the work. As an independent, nothing is quite as high as the highs you will experience. Good luck!

Originally published in Health Management Journal Nov 2001