Celebrating the NHS at 70

Shortly before 15-year-old Freya Lewis, a survivor of the Manchester Arena bombing, rose to address the 2,500 strong audience at Westminster Abbey gathered to celebrate the NHS’s 70th anniversary on 5 July, she logged onto her Snapchat account to take a selfie only to find a special NHS geo-filter.

‘She was totally surprised,’ says Antony Tiernan, director of engagement and communications NHS70 at NH England. ‘You wouldn’t expect the NHS to do that.’

Lewis certainly didn’t, and nor did many Facebook users who logged on to find two special NH frames that they could temporarily add to their profile pictures. Coupled with the announcement that 87-year-old Ethel Armstrong, who started as a cadet nurse on 5 July 1948 and continues to volunteer today, was taking over @NHS, which has more than 34,000 followers, for the day, this was part of the organisation’s multi-layered social media strategy to engage with the public about the anniversary and to connect with the nurses, doctors, paramedics of the future.

It was also Armstrong, speaking in an NHS England film featuring former staff, who succinctly summed up what the launch of the world’s first free health service meant to the nation back in 1948. ‘They could not believe that they did not have to pay any money. A home delivery, if it was the 4th of July, was one and sixpence, but if it was born on the 5th of July, it wasn’t anything,’ she explains. ‘One and sixpence after the war brought a loaf of bread to feed the rest of the family and a tub of margarine; that’s the reality of what we take for granted now.’

It is hard to believe that when Aneurin Bevan posed for photographs at Park Hospital in Manchester (now Trafford Hospital) surrounded by nurses forming a guard of honour, to mark the launch of the National Health Service, the concept was not universally supported. Just one in ten doctors were in favour and the British Medical Association, now a key partner, campaigned against its launch. Today, the National Health Service is regarded as crucial to British society and around 90 per cent still support its guiding principles, according to a recent poll by the King’s Fund.

But it is not without its challenges, and so back in June 2017, when Tiernan first sat down with his two-person team and a blank piece of paper to map out how celebrations for its 70th birthday should look, he was adamant that these should have three clearly defined objectives. The celebrations should ensure that the NHS’s 1.5 million employees felt valued, thereby encouraging recruitment and retention; they had to demonstrate to both Parliament and the Government that investing in the NHS remains worthwhile; and, finally, they needed to engage the public.

If the public recommits to our core values, it effectively gives us permission to continue

He explains: ‘We had to engage the public with our celebrations. If the public recommits to our core values, it effectively gives us permission to continue. So we asked them to get the NHS a birthday present. We said Please do celebrate with us, and here are seven ways that we suggest.’ Unsurprisingly, the ‘gifts’ did not include socks or alcohol, but rather meaningful ways in which people could ‘contribute’ to the NHS, such as giving blood or signing up for the Organ Donation Scheme or by using its services wisely, ringing 111 rather than 999.

All three objectives, or audiences, were weighted equally, although Tiernan’s team was aware when they determined that the celebrations should involve all the NHS’ stakeholders, including its 700 NHS trusts, GP surgeries, private companies and 250 charities, that contribute to its success daily, there was a risk that too much attention might be given to the staff festivities.

‘We decided early on that the NHS70 celebration was not just about what NHS England wanted to do,’ he explains. ‘It was important to engage as many of our organisations as possible. We had a year to build this up.’

One of the first actions Tiernan took was to hold a Dragon’s Den style competition for NHS staff, organised by NHS England and NHS Improvement, inviting them to suggest ways to celebrate the big occasion. While ‘the vast majority’ of these were used, in some form, the standout suggestion was the NHS Big 7Tea, where members of the public could get friends together for tea and cake to raise funds for the 250 or so dedication NHS charities.

Indeed, the NHS Big7Tea became the focus of fundraising during the celebrations, engaging local communities, raising both funds for the charities and awareness of the work they do, which in turn prompted people to volunteer.

Tiernan then put together a national steering committee, comprising 30organisations, such as the Care Quality Commission, health commissions, Public Health England, unions, including Unison and Unite, and patient associations, to discuss potential ideas and the practicalities and pitfalls of each one – which led to a draft blueprint of a plan being drawn up.

‘We also went and met 70 organisations that weren’t on the steering committee, such as the Royal College of Surgeons and the Royal College of Physicians, to say Please get involved,’ he adds. ‘People definitely wanted to get involved with our birthday, but there were obviously concerns about capacity, and some organisations and hospitals also had other anniversaries or events they were celebrating. The Royal College of Physicians, for example, is 500 years old this year.’ The team also broadened its connections, for example, creating a partnership with supermarket group ASDA, which offered space for local NHS facilities to host tea parties or mount exhibitions in the week of the birthday.

Focus groups were held across various bodies and at every hospital and clinical commissioning group, who were each asked to discuss ways in which they could celebrate around five main themes.

‘We asked them to hold Open Days, where we could show local communities the work that we do; to get out and hold exhibitions explaining the work that we do; to host staff awards, themed around our 70th birthday; to host Big 7Tea parties; and to organise competitions for children and young people, who are the future workforce of the NHS, opening up about how they could look after their health and wellbeing and use our services wisely,’ explains Tiernan.

‘We had tested plans that we developed from a national perspective, but we gave them permission to take these away and adapt and amplify them – to do something similar, that looks like the national campaign but at a local level.

‘We also made clear that we wanted the celebrations to start from 1 January, and not just on 5 July.’ He adds: ‘The hardest thing was to avoid having everything on 5 July. We had to try to convince people that it was not about us trying to steal their thunder, but to avoid everything landing at the same time. We had a massive grid on the wall, which gave us an eight-week run in so that we knew what was happening and planned to happen at any one time.’

We had developed plans from a national perspective, but we gave permission to take these away and adapt and amplify them at a local level.

NHS England shared materials, such as branding, posters, templates, films and videos, graphics and social media advice, that other organisations could adapt and use. NHS Communicators created a toolkit, containing a guide to hosting a successful staff awards event.

‘There were only three of us initially working on this, so we took a partnership approach – internally and externally – to help us. I used resources of NHS England to help deliver the project, who did this as well as their day jobs, while other organisations did massive chunks of work for us,’ says Tiernan.

A timeline film, which took people through the key milestones of the NHS, was created for use at local events. Organisations gained access to a photo library and archives, although many had their own archives.

‘We created a partnership with the British Film Institute, looking at how healthcare has been portrayed in film over the past 70 years,’ says Tiernan. ‘There were many privileges being involved in an event like this, but one of them was talking to the retirees who worked with the NHS at the start. We did lots of Q&A sessions. It was fascinating.’

Working with the University of Manchester, which secured National Lottery grant, they trained volunteers to go out and record oral histories to form part of a big catalogue The NHS at 70: the story of our lives. This work will form part of the legacy of the anniversary.

From the outset, it was felt that key to the celebration’s success would be holding at least one major event a month, which would be promoted via a mix of digital and traditional media, in the runup to the main celebrations in July and beyond.

On 1 January, the timeline film 70 years of achievement was released and promoted on social media. And that month marked the launch of#NHS1000Miles, an idea put forward by children’s nurse Kath Evans, where supporters were encouraged to walk, run, cycle or swim 1,000 miles over the year as a birthday present to the NHS. More than 4,000 people pledged to participate, and are currently tracking their progress on a special Strava site, where leader boards are updated weekly, and Facebook.

In February, NHS England launched a competition in conjunction with the Royal Horticultural Society, which donated the Feel Good Garden that it had displayed at the Chelsea Flower Show as the prize. ‘We asked all our mental health trusts in England Do you want to win this garden? [which would be adapted and installed by designer Matt Keighley]. They had to explain why they deserved to win it.’ Just five mental health trusts were expected to bid, but 39 out of 54 submitted the reasons they felt they would benefit from the garden.

(The winner was Camden and Islington NHS Foundation Trust, and the garden has since been installed in Highgate Mental Health Centre, one of its two in-patient psychiatric facilities.) The competition is also part of a bigger effort between the RHS and NHS to highlight how gardens, gardening and green spaces are good for our mental health and wellbeing.

‘When we realised so many trusts wanted a garden, we invited those who didn’t win to attend a session at the Chelsea Flower Show where they heard from leading gardeners,’ says Tiernan. ‘The RHS has also agreed to give us a garden for the next two years.’

In March, the Royal Mint marked the occasion with the launch of an NHS 10p coin. The coin also forms part of the Royal Mint’s first A to Z coin hunt, with26 coins representing each letter of the alphabet featuring a Great British icon, such as D for a double decker bus and N for NHS.

‘We started work on this in May [2017]. The Royal Mint did the design and we signed off,’ says Tiernan. ‘But the challenge with a coin the size of a ten pence is how do you represent the NHS in just one image. The NHS is not just about hospitals and GPs, it is so much more. But you need an image that is instantly recognisable.’ The solution was a stethoscope, entwining the letter N, with its tubing forming a heart.

‘We also asked sporting bodies if they would like to support the NHS, by donating tickets to major events that we could hold draws for,’ he adds. ‘We received 800 tickets, including 70 for Wimbledon with a pair of tickets for the Royal Box. There were also some once-in-a-lifetime tickets, such as one for the Rugby Super League Grand Final at Old Trafford, Manchester where a family of four could meet the teams.’

April marked the launch of the NHS’s educational work. ‘A big part of our work is to try to leave a legacy of our anniversary by targeting audiences that we wouldn’t necessarily normally target,’ explains Tiernan. The organisation partnered with charities Speakers for Schools, which brings influential leaders into state secondary schools to inspire students and broaden their horizons through talks, and Inspiring the Future, which brings careers to life by connecting young people with those on the frontline.

He adds: ‘101 senior members of NHS staff [including NHS England chief executive Simon Stevens and Jane Cummings, chief nursing officer for England, are participating in Speakers for School] while we have invited more junior members to connect with local schools [as part of Inspiring the Future]. More than 1,000 staff have logged into the website and joined up.’

Resources were also created for schools wishing to deliver lessons and activities to coincide with the NHS70 celebrations, while other organisations within the NHS, including Health Education England and Public Health England, created services and action packs for those wishing to pursue a career in healthcare or looking for advice on health and well-being. And in May, the NHS teamed up with parkrun UK to promote a special themed parkrun for the NHS on 9 June, with the support of Dame Kelly Holmes, who was a nursing assistant before she joined the British Army. Around 150,000 people participated in more than 360parkruns.

There are 350 different professions within the NHS

‘They all did something different to celebrate,’ says Tiernan. ‘In Wimbledon, for example, they made The NHS staff stand at the front and they all sang Happy Birthday. People dressed up. It was an amazing experience’

While not as explicit as the others, Tiernan’s team also had a fourth objective for the celebrations – promoting the diversity of the NHS service, not just the different nationalities that work there but also highlighting that there are 350 different professions within it. ‘We have the play specialists, the cleaners, the scientists… if you don’t have the scientist doing the tests, the NHS stops. If you don’t have porters moving patients and products around the hospitals, the NHS stops,’ he explains.

‘We also have so many volunteers. The broadcaster Jeremy Vine was once a hospital DJ.’

It is no coincidence that the 70th anniversary of the arrival of the cruise liner Empire Windrush, carrying 492 passengers from the West Indies, is just one fortnight before the 70th anniversary of the NHS. Many passengers were among the first to join the NHS, which launched just two weeks later. ‘They are intrinsically linked. If it hadn’t been for Windrush, the NHS would have suffered in its early days.’

Today, the NHS is represented by staff from more than 200 nationalities, and remains the largest employer for black and ethnic minority staff – who make up one fifth of the workforce. ‘We wanted to celebrate that too, so we worked with a number of organisations to create the Windrush 70Awards celebrating the contributions of BME staff, past and present,’ he says. More than 11,000 nominations were received, and 12 awards were presented at a gala dinner in Manchester, including a special recognition trophy to 92-year-old Alford Gardner, one of the few surviving passengers.

Today, the NHS is represented by staff from more than 200 nationalities

However, it was really only May – two months before the anniversary date – that the national media, particularly broadcast, started to pay attention. For example, ITV announced an NHS Heroes Awards, in association with The Daily Mirror, and invited people to nominate worthy recipients. It was here that Tiernan met Freya Lewis, who was three metres from the bomb at Manchester Arena, and has since undergone more than 60 hours of surgery as she learned to walk again. Lewis has raised more than £40,000 for the Royal Manchester Children’s Hospital.

‘She was so inspirational –her best friend died in the attack – that I invited her to speak at Westminster Abbey.’ The BBC devoted two weeks to the celebrations, with a mix of radio and television programmes, including a 20 part history radio series and five programmes about NHS milestones. On the actual anniversary ‘it ran all through the news, there was NHS Songs of Praise, NHS Holby City, Today splashed on it, with a Prayer for the Day and a Quiz of the Day dedicated to the NHS’, says Tiernan. There were also the unexpected celebrations.

‘There was so much landing that my hair started to go grey,’ he jokes. ‘We promised partners doing stuff that they could have their day. We worked together and a lot of the celebrations were promoted on digital.’ PR agency Freuds, who were providing pro bono support, informed NHS England one week from the anniversary that its client Aardman, creators of Shaun the Sheep, wanted to produce a celebratory animation.

‘We had also talked about lighting up buildings but we weren’t getting anywhere, so we launched a competition between the four regions, and within a week more than 200 famous buildings announced they would Light up blue on the night of our birthday,’ he says. ‘Lots of celebrities started doing things on our birthday. The choir at Lewisham and Greenwich NHS Trust, known as the NHS Choir, released a single, that was recorded at Abbey Road, and many celebrities [such as Myleene Klass, Nile Rodgers and Ric Astley] got involved. Andy Murray backed two initiatives – a Public Health England campaign for healthy living and the Daily Mile, encouraging young people to run or jog for 15 minutes a day.’

While an evaluation of the celebrations is ongoing, Tiernan believes that anecdotal evidence – such as attendance figures at Open Days and 5,000 NHS Big 7Tea parties, which raised ú150,000 – suggests trust in The NHS at a local level has risen. He plans to add an additional question into the organisation’s annual MORI survey of staff to assess the celebration’s impact on engagement levels.

‘A year ago, I don’t think we expected the level of involvement or coverage, including media you wouldn’t expect. The Voice had an African Caribbean special supplement, with a member of the NHS as guest editor. We were in the Jewish Chronicle, Women’s Weekly and had afront cover in First News, the newspaper for young people,’ concludes Tiernan. ‘Even from my perspective, it exceeded all expectations.’