NHS 111 Marketing Communications Strategy v2.0

8/2/2019 NHS 111 Marketing Communications Strategy v2.0

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NHS 111 Marketing

Communications Strategy

NHS 111 Programme

Version 2.0

July 2011


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NHS 111 Marketing Communications Strategy v2.0.doc Page 1 of 41

Audience NHS 111 Programme Team, NHS 111 Communications Working Groupand external specialist agencies.

Document title NHS 111 Marketing Communications Strategy

Document status Version 2 - updated of the version approved by the NHS 111 ProgrammeBoard.

Document Version 2.0

Issue date July 2011

Prepared by NHS 111 Marketing and Communications Manager

Version Date Name Comment

0.1 15.3.10 Phil Bastable First draft circulated for comment0.2 24.3.10 Phil Bastable Amended to take into account comments from the 111

programme team and the 111 SHA teams.

0.3 10.5.10 Phil Bastable Amended to take into account comments from the DHComms Directorate and 111 SHA teams. and to reflectdevelopments in the Programme.

04 17.5.10 Phil Bastable Updated to reflect programme and policy developments.0.5 24.5.2010 Phil Bastable Updated to take in comments from 111 SHA teams.0.6 1.7.2010 Phil Bastable Updated to take in comments from the 111 Programme

Board.1.0 23.7.10 Phil Bastable Approved by 111 Programme Board.2.0 Phil Bastable Updated to include lessons learnt from the evaluation of

the marketing campaign run within the initial four NHS111 pilots.

Document control


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Document control 1Contents 21 Summary Error! Bookmark not defined.2 Introduction 62.1 Purpose 62.2 Document audience 62.3 Status 62.4 Related documents 62.5 Structure 63 Overview of the NHS 111 service 83.1 Introduction 83.2 Vision 83.3 How will 111 work? 83.4 Core principles 83.5 Benefits 94 Research Insights 104.1 Introduction 104.2 Insights driving peoples behaviour in accessing urgent care services 104.3 Insights to inform NHS 111 communications 125 Strategic Aim and Approach 145.1 Introduction 145.2 Strategic aim for marketing communications 145.3 Behaviour change model 145.4 Barriers to behaviour change 155.5 Role of marketing 155.6 Campaign principles 165.7 Strategic approach 165.8 Campaign phases diagram 176 Marketing Campaign Objectives 186.1 Introduction 186.2 Marketing communications objectives 18

Contents


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7 Target Audience 197.1 Introduction 197.2 Target audience 197.3 Target audience segments 197.4 Internal audiences 218 Messaging 228.1 Introduction 228.2 Launch phase campaign messages 228.3 Phase 2 campaign messages 228.4 Detailed messages 229 Media Channels 249.1 Introduction 249.2 Media selection 249.3 Media recommendations 2410 Evaluation 2510.1 Introduction 2510.2 Evaluation plan 2510.3 Research approach 2511 Branding 2711.1 Introduction 2711.2 NHS Brand 2711.3 NHS 111 identity 2712 Roles and Responsibilities 2812.1 Introduction 2812.2 NHS 111 Marketing and Communications Manager 2812.3 NHS 111 SHA Teams Communications Leads 2812.4 NHS 111 Communications Working Group 2912.5 NHS 111 Communications Governance structure 2913 Risks 3013.1 Introduction 3013.2 Marketing risks 3014 Timing 3114.1 Introduction 3114.2 Timing plan 31


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15 Budgets 3215.1 Introduction 3215.2 Financial Years 32Annex A 33

Annex B 36

Annex C 39


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The NHS 111 service is being introduced to improve the publics access to urgent

healthcare services. For the implementation of NHS 111 to be successful, it is essential to

change the publics behaviour in the way that they access urgent health care when theyhave an unexpected, unplanned healthcare need. This will only be achieved through amarketing campaign to raise public awareness and understanding of the new service. Thisdocument sets out the marketing strategy for NHS 111.

The NHS 111 marketing campaign is required to launch the service in new areas as theroll-out of NHS 111 continues to national coverage, and to continue to support the servicein the existing live areas. The NHS 111 identity and campaign creative was developedwith the wider national roll- out in mind.

The marketing campaign in 2010/12 for the initial NHS 111 pilot areas provided theopportunity to test campaign creative and media plans to find the optimum balance

between raising awareness and understanding of the new service and generating demandin a manageable way. The evaluation of this campaign activity has been used to refine theNHS 111 marketing strategy.

The public launches of the service in the new NHS 111 areas in 2011/12 will bestaggered, with the first scheduled for September 2011. These will take place a number ofweeks after the soft launch date in each area to allow time to test the service. The launchmarketing campaign will be run simultaneously in a number of areas following the publiclaunches.

Direct mail and outdoor media will continue to form the core campaign activity in eacharea, supported by other media to build awareness and understanding of the service. Themedia plans will be bespoke for each area, where the service is being launched.

This version of the NHS 111 marketing strategy is an update of the strategy that wasagreed by the NHS 111 Programme Board. It is to be implemented by the NHS 111Programme Marketing and Communications Manager working with the Department ofHealths Marketing Team, the NHS 111 Communications Working Group and the SHAsNHS 111 teams Communications Leads.

All communications activity requires the approval of the Department of HealthsCommunications Control Panel and the Cabinet Office and HM Treasurys EfficiencyReform Group (ERG).

1 Summary


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2.1 Purpose

This document sets out the marketing strategy for the NHS 111 service for 2011/12.

It has been produced by Phil Bastable, NHS 111 Programme Marketing andCommunication Manager and Kate Frankum, Department of Health Marketing Departmentwith input from the COIs strategic communications team and the NHS 111

Communications Working Group.

The strategy will be revised as further evaluation data becomes available.

2.2 Document audience

The primary audience for this document is the NHS 111 Programme Team, the StrategicHealth Authority (SHA) NHS 111 programme teams who are delivering the NHS 111service and the external specialist agencies (advertising agency, media planning agency,and marketing research agency) that have been appointed to deliver the marketingcampaigns in each of the NHS 111 areas.

2.3 Status

This is the version 2.0 of the document, which is an updated version of the one that wasapproved by the NHS 111 Communications Working Group and the NHS 111 ProgrammeBoard for the marketing campaign in 2010/11.

2.4 Related documents

This document should be read in conjunction with the following:

NHS 111 Identity Guidelines

2.5 Structure

The remainder of this document is structured as follows:

Section 3 Overview of the NHS 111 service

This section provides an overview of the NHS 111 service including a description ofthe benefits that the programme is expected to deliver for the public and the NHS.

Section 4 Research InsightsThis section summarises the research insights that have informed the development ofthis marketing strategy.

Section 5 Strategic aim and approachThis section details the overall strategic aim of the marketing strategy and approachto be taken to achieve this.

Section 6 Marketing campaign objectivesThis section sets out the quantified objectives that the effectiveness of the campaign

will be measured against.

2 Introduction


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Section 7 Target audienceThis sets out the audiences that the marketing campaign is to target.

Section 8 MessagingThis section describes the messages that the marketing campaign will aim tocommunicate to the target audiences.

Section 9 Media channelsThis section describes the areas that the media plan is to take into consideration todeliver the overall strategic approach.

Section 10 EvaluationThis section describes the evaluation approach that is to be taken to measure theeffectiveness of the campaign.

Section 11 BrandingThis section describes the branding guidelines that the marketing campaign mustfollow.

Section 12 Roles and responsibilitiesThis section describes the roles and responsibilities of the NHS 111 Marketing andCommunications Manager and the Communications Leads within the SHA NHS 111programme teams. A governance chart is included.

Section 13 RisksThis section sets out the key risks for the marketing strategy.

Section 14 TimingThis section describes the timings for the marketing campaign.

Section 15 BudgetsThis section details the allocated central budget for the NHS 111 marketing

campaign.

Annex A Launch campaign materialThis annex contains samples of the campaign creative of the 2010/11 campaign.

Annex B Evaluation reportThis annex contains the executive summary from the evaluation research report forthe 2010/11 marketing campaign.

Annex C Timing planThis annex sets out the timing plan for the 2011/12 campaign activity.


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3.1 Introduction

This section provides an overview of the NHS 111 programme, setting out; the vision,describing how it will work, the core principles of the service, and the expected benefits ofthe NHS 111 service.

3.2 Vision

NHS 111 TRANSFORMING ACCESS TO URGENT HEALTHCARE

The NHS 111 service will make it easier for the public to access urgent healthcare and willdrive improvements in the way in which the NHS delivers that care.

3.3 How will 111 work?

NHS 111 is being introduced to make it easier for public to access urgent healthcareservices.

The free to call 111 number is available 24 hours a day, 7 days a week, 365 days a yearto respond to peoples healthcare needs when:

you need medical help fast, but its not a 999 emergency

you dont know who to call for medical help oryou don't have a GP to call

you think you need to go to A&E or another NHS urgent care service

you require health information or reassurance about what to do next

Callers to 111 are put through to a team of highly trained call advisers, who are supportedby experienced nurses. They use a clinical assessment system and ask questions toassess callers needs and determine the most appropriate course of action, including:

callers facing an emergency will have an ambulance despatched without delay;

callers who can care for themselves will have information, advice and reassuranceprovided;

callers requiring further care or advice will be referred to a service that has theappropriate skills and resources to meet their needs; or

callers requiring services outside the scope of NHS 111 will be provided withdetails of an alternative service.

The NHS 111 service also provides management information to commissioners regardingthe demand for and usage of services in order to enable the commissioning of moreeffective and productive services that are designed to meet peoples needs.

3.4 Core principles

NHS 111 operates according to the following core principles:

Completion of a clinical assessment on the first call without the need for a call back

3 Overview of the NHS 111 service


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Ability to refer callers to other providers without the caller being re-triaged

Ability to transfer clinical assessment data to other providers and bookappointments where appropriate

Ability to dispatch an ambulance without delay

These are the fundamental requirements that underpin the NHS 111 service.

3.5 Benefits

The introduction of the new NHS 111 service is expected to provide key benefits to thepublic and the NHS, by:

Improving the publics access to urgent healthcare services: Providing a simple, free to call, easy to remember three-digit number, that is

available 24 hours a day, 365 days a year; and Directing people to the service that is best able to meet their needs, taking into

account their location, the time of day of their call and the capacity of localservices.

Increasing the efficiency of the NHS: Providing consistent clinical assessment that ensures people access the right

service, first time; Directing people to the service that is best able to meet their needs; and Rationalisation of call handling.

Increasing public satisfaction and confidence in the NHS: Improving the publics access to urgent healthcare services: Providing an entry point to the NHS that is focused on peoples needs; Enabling people to access the right service, first time; and

Increasing efficiency of the NHS by directing people to the service that is best

able to meet their needs.

Enabling the commissioning of more effective and productive healthcare servicesthat are tuned to meet peoples needs: Identifying the services, which are currently over or under used; Providing information on peoples needs and the services they are directed to;

and Increasing understanding of the shape of demand for each service.

Increasing the efficiency of the 999 emergency ambulance service: Reducing the number of non-emergency calls received by 999; and Reducing the number of avoidable ambulances journeys.


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4.1 Introduction

This section provides a summary of the research insights, drawn from relevant researchby COI, which have been used to inform the development of the NHS 111 marketingcommunications strategy.

The research sources that COI used included: NHS Norfolk Appropriate use of services,Ipsos MORI July 2009; Three Digit Number For Urgent Care Concept Research,Diagnostics November 2008; Three digit number for urgent care, CRD April 2009; 3DNTariff Research, Jigsaw April 2009; McKinsey for NHS South Central.

4.2 Insights driving peoples behaviour in accessing urgent care services

People believe they are using services sensibly and responsibly

Overall, most people think of themselves as sensible users of NHS services: 89% of the population claim to use A&E only when seriously ill; and 80% of the population claim that they tend to think carefully about which is the

most appropriate NHS service to use if needing to seek medical advice.

People are unaware that they are misusing services

The majority of the general public (and specific groups within it) are unlikely to realisethat they are using services inappropriately. They often recognise that misuse is aproblem, but not that they are causing it. This can be related to ignorance ofalternatives to A&E and an unwillingness to recognise that their use is inappropriate.

People are clear about defining emergency situations

Consumers are reasonably clear about identifying emergency situations, defining

them as potentially life threatening (e.g. anaphylactic shock, heart attack, meningitisor unconsciousness and with conditions that could not be treated at home e.g. badfractures). These emergency situations are recognised as requiring a 999 call forimmediate face to face medical attention.

Despite this clarity about the definition of emergency situations, 12% of people admitto having used A&E in the past even when they knew there was nothing seriouslywrong with them or a family member and 60% of people living in households withchildren under 16 would prefer to go to A&E rather than take a risk with their health.

However, people are much less clear about defining urgent situations

Consumers have a less clear action profile for Urgent, defining it as not life

threatening, but requiring immediate medical attention.

There is confusion for two main reasons. First, defining urgent requires making ajudgment, which is often difficult when experiencing the stress and trauma (or evenpanic) of unexpected illness and accidents. In these circumstances judgements aboutwhich service to use can be clouded. Second, there is confusion generally about whatservices are available locally and in which circumstances they should be used. Forexample, only 59% of the population has a clear understanding of the alternatives to

A&E in their area.

4 Research Insights


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Parents with children have a lower threshold for urgency

Parents are even more likely than the general population to feel a strongresponsibility to define borderline or uncertain medical situations as urgent. Parentsare more likely to fear the consequences of inaction and therefore their defaultposition is often to define theirchilds illness or injury as urgent.

Older people define urgency in real rather than abstract terms

Many older people understand the concept of urgency differently from younger andmiddle-aged groups. Young and middle-aged groups often speak of urgency inabstract and dramatic terms, because they have less experience of these situations.Many older people have more recent experience of pain, fear and anxiety associatedwith their own conditions and can express them in concrete terms rather than theabstract.

Perceptions of A&E

A&E is perceived by a significant number of people as a reliable urgent needs option.

Many feel that a long wait is a small price to pay for the perceived security andreassurance of guaranteed treatment accessible at all hours. A&E is viewed as asafety-net - an environment in which to bring someone suffering a potentially seriouscondition, in which if something went wrong, the patient will be looked after.

People dont think about services until they need them

The majority of the population do not take an interest in the provision of healthservices until they actually need them.

Lack of understanding is a key barrier to appropriate use

A lack of understanding is the most powerful barrier to appropriate use of emergencyservices, with people not knowing what else is available, not knowing how to findalternative services and not understanding the healthcare system. If people areunaware of the alternatives, such as out-of-hours GPs or walk-in-centres, they areless likely to name them spontaneously and much less likely to say they would usethem in different scenarios. If people do not know what else is available, they areunlikely to be aware that they are using services inappropriately.

Only 52% of people claim to have a good understanding of A&E services in theirarea. 54% know where their nearest Minor Injuries Unit is (and 52% are confident onhow to use the service). 45% know where their nearest Walk in Centre is (and 46%are confident on how to use the service).

Research shows that there is much confusion about when and how to use urgent

care services, particularly outside normal working hours.

In the event of a non-life threatening health issue where help or advice is neededfrom the NHS, most people (59%) would call their GP if they were at home during theday. If they were at home and it was outside NHS hours (so their GP surgery wasclosed), people would be most likely to call NHS Direct (36%). However there is littleconsensus about what to do if the need for NHS advice arises when a person is outand about, or away from home. In this situation, 14% of people are likely not to knowwhat to do with far fewer calling their GP or NHS Direct (22% and 24% respectively).Instead, more people would turn to the emergency services: 9% would dial 999 in thissituation compared to 5% if they were at home out of hours and 4% if they were athome during the day.


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Inability to judge risk and unwillingness to take a chance is a major driver ofinappropriate A&E use

When people are ill themselves out of hours they might wait until a GP becomesavailable again during working hours or use a less urgent service. However thedynamic is very different when people are responsible for caring for someone else.

When faced with this added responsibility people prefer to err on the side of cautionwith a better safe than sorry attitude, especially for vulnerable groups.

Convenience is a substantial driver of misuse

Some pre and post research completed for the evaluation of the Choose Wellcampaign indicates that perceived convenience is the second most common reasonstated for inappropriate choice. A number of reasons are given for the perceivedconvenience of A&E including shorter travelling distances, that people can be seenmore quickly, that no alternative exists and a sense that if they go to the GP theyll

be sent to A&E anyway.

Some have the perception that its my right to misuse services

Although people rarely say explicitly that they use services such as A&E becausethey feel that it is their right, this can be inferred to be the case for many from the

matter-of-fact way people access healthcare services and the spontaneous mentionof A&E when talking about urgent care. There seems to be low awareness of justhow much treatment in A&E costs.

Service misuse is partly driven by concerns about quality of alternatives

Some patients are concerned about the quality of alternatives to A&E, claiming thatthey would choose A&E because they believe that staff and equipment are betterthere. Some also say that they would not use other services such as NHS Direct dueto concerns about the expertise of staff. Also, there is some preference for face-to-face treatment particularly where when people explain why they wouldnt use web-based services. In addition, some people describe the personal relationship they havewith their GP who has knowledge of the personal history of the patient.

4.3 Insights to inform NHS 111 communications

Service well received

Overall, there is a lot of evidence that the new NHS 111 service will be perceived asan excellent idea both in terms of easy access via an easy number and in terms ofthe one-stop triage service it offers to the general public.

Using the phone as a medium to discuss health matters is becoming increasinglyaccepted, with even those less comfortable in doing so accepting it in urgent oremergency situations, especially if speaking to someone medically qualified.

Research indicates that the NHS 111 service will be used widely and appropriately.Most people seem clear that they would use the service if they wanted simpleinformation and advice, and did not want to bother or wait for their GP.

Positioning alongside 999 quickly enables comprehension

Research shows that overtly describing the relationship between the NHS 111 serviceand the 999 emergency service helps enable people to quickly understand the newservice. People have a very good understanding of what an emergency situation isand when to call 999.


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Ability to despatch an ambulance builds confidence

Most respondents are loath to call 999 when they are unsure whether there is agenuine emergency. The idea that in this situation they can call the NHS 111 serviceand be diverted to 999 if necessary is very well received and generates confidence inthe service. Most feel confident that they could tell when emergency care was

needed.

Scenarios increase understanding

The 111 service does need to be defined within itself and be positioned versus othermedical service options. Using scenario exercises makes a significant difference tohow people understand and appreciate the service.

Effective communications should rely on creating a conversation about what to do

when you dont know where to go and youre not sure how bad things are, ratherthan focusing on what to do when something is urgent. As a term, urgency does not

resonate and connect with real situations for many people.

Non-clinical staff a barrierThe communications needs to communicate that call advisers are fully trained andsupported by clinically trained staff as the most significant barrier to using the NHS111 service is peoples desire to speak with a health professional in the first instance.This is an issue for 39% of people.


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5.1 Introduction

This section details the overall strategic aim for NHS 111 marketing and the strategicapproach to be taken for the campaign to achieve this.

The strategic approach is based upon the campaign principles that have been developedfrom the research insights and behaviour change model outlined in section 5.3. Thisapproach has been refined based on the evaluation and lessons learned from themarketing communications activity conducted in 2010/11 in the initial pilot areas. Thestrategic approach will be further refined as the campaign is evaluated.

5.2 Strategic aim for marketing communications

The overall strategic aim of the NHS 111 marketing communications is to change thepublics behaviour in the way that they access healthcare when they have an urgent need.

To ensure that the NHS 111 service is successful and that the expected benefits aredelivered for the public and the NHS, the marketing campaign needs to stop peopleaccessing urgent healthcare services incorrectly (such as, calling 999 when it is not anemergency issue or admitting themselves to A&E when it isnt a serious injury or illnessthat requires immediate treatment) and start them calling NHS 111, so that they can bedirected to the right service that is best able to meet their medical needs.

5.3 Behaviour change model

As the overall aim is to introduce the NHS 111 service to the whole population, thestrategic approach for the marketing communications is based upon the generic behaviourchange model.

5 Strategic Aim and Approach

Social normUse of NHS 111 service

becomes normalbehaviour

BehaviourPeople use the NHS 111service appropriately

IntentionPeople retain knowledgeand understanding about

the NHS 111 serviceand are confidentlycommitted to using

when the need arises

AdvocacyPeople actively endorse

and recommend theNHS 111 service

AwarenessPeople are aware of theNHS 111 service

UnderstandingPeople have an understanding

of the NHS 111 service andknow when they should use it.People understand how the

can service benefit them


























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In terms of behavioural theory, this represents a diffusion of innovation model, with theexpectation that there will be; early adopters who quickly gain a full understanding of theNHS 111 service and become advocates of it; laggards who are resistant to its offer; andthen the majority of the population occupying a position between these two extremes, whogradually over time come to appreciate the service.

For example:

Early adopters are likely to include those that are acutely aware of the need forpeople to use services appropriately and are concerned about burdening the NHS willbe attracted to the NHS 111 service and will understand the benefits of the serviceand embed in their mind the number for possible future use; and

Laggards would include those that are the most intransigent urgent healthcare servicemisusers who would be resistant to using NHS 111, because of entrenched attitudesand habits relating to how they access NHS services when they have an unexpectedneed.

For both these extremes and the majority in between, the first step is to make them aware

of the NHS 111 service, and build their understanding of the service and the benefits tothem. So that gradually the marketing campaign takes all groups through the journeyabove to becoming responsible users of urgent healthcare services.

5.4 Barriers to behaviour change

Research indicates that the vast majority of users dont want to misuse NHS services andthat the NHS 111 service has very significant latent appeal. This suggests that thediffusion of innovation model, described in the previous section is relevant to launchingthe NHS 111 service.

However as has been described in the Research Insights section there are barriers toachieving this behavioural change that the NHS 111 marketing campaign must address.

Broadly, there are four generic barriers to appropriate use of services:

Convenience (using services that are the easiest option);

Service unaware (not knowing what else is available and not understanding thesystem);

Worried user (anxious and risk averse about the health of another (e.g child, oldperson); and

Emotionally attached (a strong attachment to A&E, because its the best and most

reliable option, whatevers wrong).

5.5 Role of marketing

Unlike many public sector marketing campaigns, the role of the NHS 111 marketing is notto use a call to action to generate an immediate response.

Instead, the priority is to embed an intended behaviour - for people to be aware of what todo if and when urgent medical circumstances arise to such an extent that they willautomatically remember the 111 number and be motivated to use it even when in a stateof panic. This requires people to retain a number in their minds for latent recall when theyhave an unexpected, unplanned urgent healthcare need.

To achieve this, the marketing campaign has two main tasks:


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Increase awareness the campaign must build public awareness of the NHS 111service so that the total population are as aware of 111 as they are of 999. Themarketing needs to establish 111 as a heuristic or short-cut to urgent care in thesame way that 999 is synonymous with emergency care.

Increase understanding the campaign must also build public understanding of the

NHS 111 service so that people know when to call 111. This means that the vastmajority of people need to know that 111 is the number to call when they needmedical help fast, but its not a 999 emergency. The service will not be able to cope ifpeople call the service when they want to make a routine appointment with their GP.

NHS 111 needs to become the accepted way, the social norm, for accessing urgenthealthcare services when people have an unplanned, unexpected medical need.

5.6 Campaign principles

The following marketing communications principles have been developed from theinsights we have into the target audience, the NHS 111 service itself and the context inwhich it will be operating. These have been used to guide the strategic approach for thecampaign:

ACCESSIBILITY we need to make use of the full range of communicationsopportunities to ensure that information on NHS 111 is available to everyone withinlaunch regions. We should consider contexts where calling 111 may be of immediateuse as well as those in which knowledge of NHS 111 may be seeded for usesubsequently at the right time.

LONGEVITY because of the potential time lag between people learning about theNHS 111 service and needing to use it, communications need to have a long shelflife and where possible a continuous presence, to keep people reminded of the

service and how it works.

GIVE TIME FOR EXPLANATION we need to use a combination of long and short-copy opportunities, as well as those with long and short-dwell time to ensure that thecommunications increase our audiences understanding of the service as well asincreasing awareness.

TRANSMITTABLE word-of-mouth and advocacy of NHS 111 will be crucial innormalising its use and therefore we should use communications channels in a waythat makes this as easy as possible for people, such as using formats they can keepor pass on.

CONTROLLABLE AND RESPONSIVE we need incorporate some channels which

are flexible and will allow us to respond to operational pressures on the service toensure that the quality of the service is not compromised.

5.7 Strategic approach

The strategic approach for the NHS 111 marketing campaign is to make use of ownedcommunications opportunities, earned communications, and purchased marketing activity.This has been developed from the approach taken for marketing campaign in the initialNHS 111 pilot areas in 2010/11.

In a new NHS 111 area the NHS 111 marketing campaign starts with owned and earned

communications activity to publicly launch the service . This can only take place once theservice has been implemented and the process of service readiness testing is completed.


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The owned and earned communications activity is then to run continually from this point.Purchased marketing will be run in bursts at key times following the public launch.

Owned communication activity includes; displaying posters and making leaflets availablein public areas of NHS services, in particular GPs surgeries; publishing information onwebsites; and handing out material at engagement events.

Earned communication activity includes; local PR; and arranging for the distribution ofmaterials through key stakeholders. Local PR is particularly important, as it is not onlyessential for generating awareness at the launch of service but it also has an ongoing rolein increasing understanding of the service through use of appropriate stories and casestudies.

Owned and earned communications channels are very cost-efficient and ensure that theNHS 111 marketing campaign has a long-term presence. They were used successfully inthe initial pilot areas

The purchased communications activity will be run at key times when call volumes needto be stimulated. This is to make best use of the available budget and channels, and

enable the marketing to be as responsive as possible. This activity is divided into twomain phases:

Launch phaseThe launch phase purchased marketing activity will start after the local PR of thepublic launch to ensure that call volumes are grown in a manageable way. The launchphase campaign aims to raise public awareness and understanding of the service bysetting NHS 111 in context with the 999 service as the way of accessing NHSservices when the need is urgent but not a 999 emergency.

Phase 2

Phase 2 of the purchased communications activity aims to build on the awareness

and understanding generated by the launch phase of the campaign. Phase 2 coversall the bursts of paid marketing activity that will follow the initial launch.

The creative for this phase of the campaign uses common medical scenarios toengage with the audience and make the service relevant to them. The second phaseof the campaign will also run specific messages concerning the use of NHS 111, suchas encouraging people to call NHS 111 before going to A&E.

5.8 Campaign phases diagram

The diagram below illustrates the sequence of the phases of the strategic approach for

the NHS 111 marketing campaign.

Service inoperation

Launch paidmarketing campaign

Phase 2 paidmarketing campaign

Owned and earned communications activity

Service development

Work to implement the

NHS 111 service in a

new area.

Soft launch period

NHS 111 service

operational to allow

testing but not

launched to the

public.

NHS 111 marketing communication campaign

Campaign activity using owned and earned channels

with different phases of paid for marketing

Public

launch

Service inoperation




Service development



new area.

Soft launch period

NHS 111 service


testing but not

launched to the

public.




Service inoperation




Service inoperation




Service inoperationService inoperation






Service development



new area.

Soft launch period

NHS 111 service


testing but not

launched to the

public.




Public

launch

Public

launch


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6.1 Introduction

This section sets out quantified objectives that are to be used to measure theeffectiveness of the NHS 111 marketing campaign and provides details on how they are tobe measured.

6.2 Marketing communications objectives

Quantified objectives for the NHS 111 marketing campaign have been agreed to ensurethe effectiveness of the communications activity in achieving the strategic aim.

They have been developed based upon the awareness tracking research conducted in theinitial NHS 111 pilot areas in 2010/11. Ranges have been given to cover both the smaller

pilot areas where media availability and spend is low to the larger areas where mediaavailability and spend is higher:

To raise awareness of NHS 111 to 40-50% (prompted) within six months of launch inthe new pilot areas and increase this by 20% points in the current pilot areas.

To raise awareness of NHS 111 as being the first NHS service to be contacted forfast, not life threatening medical help to 10-20% (unprompted) within six months oflaunch in the new pilot areas and increase this by 15% in the current pilot areas.

To increase understanding of NHS 111 to 60% within six months of launch in the newpilot areas and maintain this figure in the current pilot areas. (Measured by those ableto give a correct detailed description of the service).

To increase those agreeing that they would be likely to use NHS 111 if they neededfast, non-emergency medical help to 80% within six months of launch in the new pilotareas and to maintain this figure in the current pilot areas.

To increase those agreeing that they would be likely to tell other people about theNHS 111 telephone service to 75% within six months of launch in the new pilot areasand to maintain this figure in the current pilot areas.

These objectives will be measured through the awareness tracking research and relatedirectly to questions that are included within the questionnaire and asked of participants.

Awareness tracking research will continue to be conducted to evaluate the marketing

communications against these objectives. A benchmarking wave of research will becarried out before the service is launched in any new NHS 111 area, to determine existinglevels against for each of these objectives so that any increases generated by themarketing can be measured in further research waves.

6 Marketing Campaign Objectives


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7.1 Introduction

This section details the target audience for the marketing campaign in 2011/12 and thekey insights that have been gained from the evaluation of the previous campaign.

7.2 Target audience

The NHS 111 service is being launched to improve access to urgent health services foreveryone, though while the service is being rolled out it will only be available to peoplecalling from within the areas where it has already been introduced.

The primary audiences for the NHS 111 marketing campaign in 2010/11 are all membersof the public within the new areas where the NHS 111 service is expected to be launched

and the current live NHS 111 areas.

New NHS 111 areas expected to launch in 2011/12:

Isle of Wight Primary Care Trust area;

Bakewell and Matlock within the Derbyshire Primary Care Trust area;

Cumbria and Lancashire Primary Care Trust areas;

London (Hillingdon Primary Care Trust area and WKCHF cluster area - WestminsterPrimary Care Trust area, Kensington and Chelsea Primary Care Trust area,Hammersmith and Fulham Primary Care Trust area);

Oxfordshire Primary Care Trust area;

Northamptonshire Primary Care Trust area;

Bedfordshire Primary Care Trust area;

Nottinghamshire Primary Care Trust area; and

Buckinghamshire Primary Care Trust area.

Current live NHS 111 areas:

County Durham and Darlington Primary Care Trust area;

Nottingham City Primary Care Trust area;

Lincolnshire Primary Care Trust area; and

Luton Primary Care Trust area.

7.3 Target audience segments

The focus of the NHS 111 marketing communications on the general public living in theareas where the NHS 111 service is available, is supported by existing audiencesegmentation research.

7 Target Audience


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This has been used to develop an audience map using a basic grid of peoples knowledge

of NHS services and their correct use of NHS services. This highlights that the majority ofthe public do have an understanding of existing NHS services and or intend to use themcorrectly.

This group are likely to be attracted to the NHS 111 service as they want to use NHS

services correctly and recognise that misuse is a problem. They would also include theearlyadopters of the new service.

However, a number of key target audiences segments have been identified who are morelikely to use NHS urgent care services incorrectly: young people; parents; BMEaudiences; and the DE socio-economic group.

Young people and parents are not especially hard to reach audiences and will be

reached by communications activity that targets the general public. However BME and DEaudiences are less likely to be reached by mainstream communications and will need to be specifically targeted by the marketing campaign.

BMEs

BMEs also require particular consideration for 111 marketing BMEs are far more likely torely on A&E - only 64% agree strongly that they only use A&E when seriously ill vs 76% ofnon BME community and 32% strongly agree that it's the place to go to get a problemdealt with then and there (vs 21% non BME) and trust A&E doctors more (26% vs 17%).44% go because they know they won't get sent elsewhere (vs 33% overall). BMEs useA&E for reassurance - 25% admit to doing so vs 11% overall. Just 38% of BMEs thinkcarefully about the alternatives on offer vs 47% overall. BMEs are significantly more likelythan average to have called 999 (19%) and NHS Direct (30%) in the past year.

60%

15% 15%

10%

Good serviceknowledge

Poor serviceknowledge

Uses servicesincorrectly

Uses services

correctly

A small number ofpeople use services

correctly withouthaving a good

understanding of

them

Around two thirds ofpeople have areasonableknowledge ofservices and or

intend to use themcorrectly

Around 15% ofpeople use services

incorrectly, mainlydue to poor

knowledge of them

Around 15% ofpeople have areasonableknowledge ofservices andconsciously use themincorrectly

60%

15% 15%

10%

Good serviceknowledge

Poor serviceknowledge

Uses servicesincorrectly

Uses services

correctly

A small number ofpeople use services

correctly withouthaving a good

understanding of

them

Around two thirds ofpeople have areasonableknowledge ofservices and or

intend to use themcorrectly

Around 15% ofpeople use services

incorrectly, mainlydue to poor

knowledge of them

Around 15% ofpeople have areasonableknowledge ofservices andconsciously use themincorrectly


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Furthermore, if they found themselves with a non-life threatening health issue and neededNHS advice they would be more likely to turn to the emergency services than othergroups: 11% would dial 999 if they were at home during the day (compared to 4% onaverage), 10% would dial 999 if they were at home out of hours (compared to 5% onaverage) and 18% would dial 999 if they were out and about (compared to 9% on

average).DEs

DEs are another specific target audience

DEs are more likely to turn to A&E for relatively minor conditions - and are most likely toperceive there is no good alternative in their area - trusting A&E more or wanting theconvenience of a one-stop shop - 55% would use A&E or call an ambulance for a deepcut vs 50% overall and 29% would use A&E / 999 for deep cut vs 23% overall. 22% ofDEs strongly agree that there is no good alternative to A&E in their area vs 19% overall(possibly related to car ownership levels) and they are more likely to trust A&E doctors(19% overall vs 16%). 28% agree strongly that A&E is the place to go if you want to get a

problem dealt with there and then v 22% overall and 39% go to A&E because they knowthey won't get sent elsewhere (vs 33% overall). 15%of DEs use A&E when they knowthere's nothing seriously wrong vs 12% overall and 45% think that GPs and A&E are theonly places to go when you're ill (vs 36% overall).

Phase 2 of the purchased communications activity will make use of targeted channels andmessages for these segments. Earned and owned communications activity can also betargeted at these groups following the launch phase.

7.4 Internal audiences

The primary professional audience for NHS 111 communications are GPs, frontline NHS

staff and other clinicians who have regular contact with patients in the areas served byNHS 111. It is essential that people working within the services that NHS 111 will referpatients to, are aware of and supportive of the new service. They also have a key role toplay in promoting the service to the public and are key opinion formers.


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8.1 Introduction

The NHS 111 marketing campaign messaging aims to explain the service to ensureappropriate usage when people have an urgent medical need, rather than generate animmediate response to the marketing. The messaging has been developed and refinedfrom the lessons learned from the initial NHS 111 pilots and through the evaluationresearch.

This section details the different messages for the each phase of the NHS 111 marketingcampaign. The campaign creative is included in Annex A.

8.2 Launch phase campaign messages

The launch phase of the NHS 111 marketing campaign aims introduce the new service tothe public. The campaign messages aim to convey information about what the service isand what is does:

Its not a 999 emergency, but you need medical help fast. Theres now 111 number tocall.

NHS 111 assesses the help you need and will direct you straightaway to the localservice that can help you best.

If you do need an ambulance, one will be sent immediately.

The NHS 111 service is available 24 hours a day, 365 days a year;

Calls to NHS 111 are free, including from mobiles;

The NHS 111 service is now available to callers in (insert specific area).

8.3 Phase 2 campaign messages

Phase 2 messaging is intended to deepen the publics understanding of when and how touse the service:

Before you visit A&E, call 111;

Youre miles from home, you need medical help fast, but you dont know where to go.

There is now 111 number to call;

Scenario messaging such as:

Youve got bad stomach pains and its getting worse. The surgerys closed. Theresnow 111 number to call.

Youre in agony, the dentists closed. Theres now 111 number to call.

8.4 Detailed messages

Where the marketing campaign used channels that allow more detailed information to becommunicated, for example the door drop leaflet, the messaging will also include the

emotional and practical benefits of the service. These messages are intended to energiseearly adopters to help create the social norm of appropriate use.

8 Messaging


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These more detailed messages are:

NHS 111 makes your life easier: 111 will get you through to a team of highly trained advisers supported by

experienced nurses who will assess your symptoms; The NHS 111 team will book you an appointment or transfer you directly to the

people you need to speak to;

NHS 111 gives you peace of mind, because you no longer have to worry whether youare contacting the wrong service and overburdening the system:

If NHS 111 advisers think you need an ambulance, one will be sentimmediately just as if you had originally dialled 999.

It can help the NHS to free up 999 and local A&E departments so they canfocus on emergency cases.


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9.1 Introduction

While the NHS 111 service is being implemented across England, the media channelsavailable for the NHS 111 marketing campaign will be restricted to the geographic areasin which the service is available. This section details the channels that are will be used.

A full media plan will be developed for each NHS 111 area.

9.2 Media selection

Media channels will be selected based on their ability to:

raise awareness (be noticed);

to raise understanding (carry a complex message);

be geographically restricted to within the area where the NHS 111 service isoperating; and

be flexible to maintain the quality of the service.

9.3 Media recommendations

The following media recommendations are based on their ability to meet the above criteriaand on previous experience and the lessons learned from the marketing campaign run inthe initial NHS 111 pilot areas:

Owned and earned channels

PR (selected local press, and where possible local radio): public launch event to raiseawareness of the service in a new area and ongoing media engagement work usingcase studies to increase understanding.

NHS public areas: Posters and leaflets in GP surgeries, hospital waiting areas (A&E,MIU, WiC).

On-line: targeted at those within the NHS 111 areas only - use to provide details ofthe full scope of the service. NHS websites NHS Choices, SHA, PCT andstakeholder websites. Also social media channels.

Purchased channels

Outdoor advertising: 48 sheet and 6-sheet posters and phone kiosk to raiseawareness.

Local press advertising: to build awareness (can include maps to describe servicearea).

Local radio advertising: to build awareness and provide some detail about the service.

Door drop leaflets: delivered to all households within an NHS 111 area to provide adetailed explanation of the NHS 111 service.

Life Channel advertising: screens in GP surgeries within NHS 111 areas to raiseawareness.

9 Media Channels


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10.1 Introduction

The role of NHS 111 marketing campaign evaluation is to look at the effectiveness of thecommunications activity in raising awareness, understanding and appropriate use of theNHS 111 service. Evaluation of the service in terms of its delivery and effectiveness isunder the remit of the work being carried out by The University of Sheffield.

The marketing campaign will be evaluated in line with DH best practice (see DH MarketingEvaluation Handbook, Feb 2009). The results will be used to continue to refine themarketing strategy for the future roll-out of the service.

A summary of the evaluation of the launch campaign in the initial NHS 111 pilot areas in2010/11 is included at annex B.

10.2 Evaluation plan

The evaluation plan for the NHS 111 marketing campaign will use both quantitativeresearch and operational data to provide the best possible indications of the effectivenessof the marketing campaign activity. This will build on the evaluation work carried out forthe marketing campaign run in the existing NHS 111 pilot areas.

The evaluation plan will look at outputs, outtakes and outcomes:

Outputs

The campaign outputs (measure of number of people who saw the activity) will be

measured through total reach figures by region, incorporating purchased, owned andearned activity.

Outtakes

Campaign outtakes (the effect of our activity on awareness, understanding, andattitudes to the NHS 111 service and intention to use) will vary slightly between thenew and existing NHS 111 pilot areas and will be measured as previously withawareness tracking research.

Outcomes

The measures described below will ascertain whether we achieved the final outcomes

of our communications objectives, as these are framed in terms of recall, word-of-mouth and advocacy, and the awareness tracking will give an indication of theselevels across each region. However, in terms of overall usage of the service (the finaloutcome of our campaign objectives) this will be ascertained through call data inparticular this will be useful to ascertain levels of out-of-area usage through matchingpostcode data.

10.3 Research approach

The approach to be taken for the awareness tracking research to evaluate thecommunications strategy in each of the new NHS 111 areas is to conduct both pre/postcampaign research. The design of this research will reflect the pre/post approach adoptedfor the evaluation of the four existing NHS 111 pilot areas.

10 Evaluation


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This included face to face in home interviews with a representative sample of adults in theeach of the four pilot areas, using an identical questionnaire at both the pre and poststages in each area. This enabled evaluation of the campaign in each area andcomparisons of campaign performance between all 4 pilot areas and the differing media

schedules. The use of the same approach will ensure costs of designing an alternativeapproach is minimised.

The same pre and post questionnaires will be used for the new NHS 111 areas as wasused for the initial pilot phase. As the marketing campaign will use the same mediachannels as for the initial pilot areas, the questionnaire will only require slight revisions toreflect any variations in each new areas media plans.

The research sample size for the 8 out of the 10 new areas will be slightly reducedcompared to the research conducted in the initial pilot areas. The sample size will be 150pre stage and 300 post stage. For Cumbria/Lancashire and Nottinghamshire the samplesize will be slightly higher sample size at 200 pre stage and 400 post stage. For

Cumbria/Lancashire this offers a slightly more reliable sample in this larger populationarea. In Nottinghamshire, the larger sample size allows for a substantial number ofinterviews to be conducted specifically in Nottingham City and for results to be comparedwith the survey undertaken in Nottingham City as part of the initial pilot study. This willenable the evaluation of what is effectively a second stage of campaign activity inNottingham City. The timing of fieldwork in each area will fit with the associated mediaplans.

The approach to be taken for the other 3 existing pilot areas is for one wave of research tobe conducted immediately following the end of campaign activity. A sample of 300interviews will be conducted in Durham/Darlington, Luton and Lincolnshire. This willenable not only the effectiveness of phase 2 of the campaign to be measured, but will also

enable an examination of how awareness and understanding of the NHS 111 service hasdeveloped over the months since launch phase.


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11.1 Introduction

The NHS 111 marketing communications campaign creative must follow the NHS brandguidelines and the identity guidelines developed for the NHS 111 service.

11.2 NHS Brand

The NHS Brand is one of the most recognised and trusted in the UK. To ensure that theNHS 111 service is quickly recognised as being part of the NHS and a quick and simpleway to access NHS services, it is essential that all NHS 111 campaign material includesthe NHS logo and is consistent with the NHS brand.

11.3 NHS 111 identity

An identity for the NHS 111 service has been developed to ensure a consistent highquality service is provided to customers and all communications are consistent andconform to the NHS brand.

The NHS 111 identity also describes the brand values of NHS 111 that define thepersonality of the service:

ClarityOur conversation and advice should be clear and understandable, using plain Englishand avoiding jargon and detailed medical terms, ensuring our callers are in no doubt

about the advice or services we are providing. Empathy

We need to ensure that anyone calling 111 feels that they are treated as an individualand with respect, their problems are listened to and understood, regardless of race,age or gender. Our tone should never be patronising or dismissive, always positiveand encouraging.

ResolveWe are determined to provide all our callers with an effective solution to theirconcerns. They should end the call with a clear plan of action of what to do next and aconfidence that we have done everything we can to respond properly to their needs.

All marketing campaign material must follow the NHS 111 identity guidelines.

11 Branding


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12.1 Introduction

The marketing communications strategy outlined in this document is to be delivered by theNHS 111 Programme Team and the SHA NHS 111 teams. This section outlines the rolesand responsibilities of the NHS 111 Programme Marketing and Communications Managerand the SHA NHS 111 teams Communication Leads.

12.2 NHS 111 Marketing and Communications Manager

The NHS 111 Marketing and Communications Manager has overall responsibility fordeveloping and implementing the NHS 111 marketing communications strategy workingwith the Department of Healths Marketing Team. This includes managing the majority of

the purchased marketing activity of the NHS 111 marketing campaign (some local paidcommunications activity will take place).

The NHS 111 Marketing and Communications Manager is responsible for overseeing theNHS 111 Programme communications budget held by the DHs marketing team andsecuring the required approval for all marketing activity (including preparingCommunications Freeze exemption forms for the Efficiency Reform Group in the CabinetOffice).

The NHS 111 Marketing and Communications Manager has responsibility for managingthe NHS 111 identity and ensuring that all communications and marketing materialcomplies with the NHS 111 identity guidelines.

The NHS 111 Marketing and Communications Manager works in partnership with theDepartment of Healths Marketing Team on all NHS marketing activity and ensures that all

NHS 111 marketing activity is coordinated with other DH marketing campaigns.

The Department of Healths press office is responsible for national media engagement onthe NHS 111 service.

12.3 NHS 111 SHA Teams Communications Leads

The SHA NHS 111 teams Communication Leads are responsible for developing and

implementing local marketing strategies to complement the DH funded NHS 111marketing strategy. This includes managing the majority of the owned and earned

communications activity. All locally planned marketing is to be funded by the SHA teams.

The Communications Leads are responsible for ensuring that all marketing activity, bothDH funded marketing and local activity, is co-ordinated with the NHS 111 serviceoperations. They must also ensure that all locally produced marketing material follows theNHS 111 identity guidelines and is approved by the NHS 111 Marketing andCommunications Manager.

The Communications Leads are also responsible for all local media engagementconcerning the NHS 111 service. National media engagement should be in liaison with theDepartment of Healths media centre and the NHS 111 Marketing and Communications

Manager.

12 Roles and Responsibilities


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12.4 NHS 111 Communications Working Group

The 111 Communications Working Group (CWG) has responsibility for coordinating allNHS 111 marketing communications activity across the NHS 111 areas. The CWGapproved the NHS 111 identity and will be responsible for approving the marketingcampaign creative and media schedules.

The CWG is chaired by the NHS 111 Marketing and Communications Manager andincludes each of the NHS 111 SHA Teams Communication Leads.

The group also includes communications representatives from Connecting for Health andNHS Direct to ensure that their communications activity is coordinated with NHS 111communications work.

12.5 NHS 111 Communications Governance structure

The governance structure to manage the NHS 111 communications is as follows:

NHS 111 ProgrammeBoard

NHS 111 CommunicationsWorking Group

SHA NHS 111 Teams

Partner OrganisationsCommunications

SHA NHS 111 Teams

Communications Leads

Phil BastableNHS 111 Marketing and

Communications Manager

Dept of HealthMarketing Team

External CommunicationsAgencies





SHA NHS 111 Teams


SHA NHS 111 Teams


SHA NHS 111 Teams

Communications LeadsSHA NHS 111 Teams

Communications Leads





Dept of HealthMarketing TeamDept of Health

Marketing Team




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13.1 Introduction

There are a number of risks that have been identified for the NHS 111 marketing strategyto address. These are outlined in the earlier challenges section, but the risk table belowprovides further details, including likelihood, impact, the mitigation plans andresponsibilities.

13.2 Marketing risks

The identified risks for the NHS 111 marketing strategy are as follows:

Risk

No

Risk Description Likeli-

hood

Impact Mitigation Respon-

sibility1 Insufficient resources to

implement the NHS 111marketing strategy.

M H Request additional funding fromDirectorate.

SHA NHS 111 teams to requestadditional local communicationsfunding.

PBSHA CommsLeads

2 NHS 111 marketingcampaign increases calldemand above the callhandling capacity of theservice.

L H Closely monitor call demand andmarketing activity.

Halt marketing activity if call demandnears service capacity.

Review marketing strategy.Local PR to focus on explaining

scope of service (case studies).

PBSHA CommsLeads

3 Launch publicity withinthe NHS 111 pathfinderareas increases calldemand above expectedlevels.

L M

Closely monitor call demand throughlaunch period.

Gap between launch and start ofmarketing campaign.

Review and adjust marketing activity.

PB

4 NHS 111 marketingcampaign doesntgenerate enough calldemand to effectivelyevaluate the service.

L M Closely monitor call demand andmarketing activity.

Increase marketing activity.Review marketing strategy.

PB

5 Non-emergency calls(category C) to 999 arenot reduced.

L M Review marketing messages andamend creative if necessary.

Local PR to focus on explainingscope of service (case studies).

PBSHA CommsLeads

5 Admissions to A&E arenot reduced.

L M Focus phase 2 marketing on the call111 when you think you need A&Emessage.

Review marketing messages andamend creative if necessary.


PBSHA CommsLeads

6 NHS 111 servicereceives large numberof calls for non-urgentissues.

L M Review marketing messages andamend creative if necessary.


PBSHA CommsLeads

13 Risks


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14.1 Introduction

The timing for the 20011/12 marketing communications strategy in the new NHS 111areas is primarily governed by when the service is launched in each of these areas. Nomarketing can appear before the service is available. However marketing activity willwhere possible be run at the same time in different areas to simplify the media buying andproduction.

The timing of the phase 2 marketing campaign in the existing live areas is planned to

14.2 Timing plan

The current timing plan for the 2011/12 campaign is included at Annex C. This will be

updated as new areas launch dates are confirmed.

14 Timing


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15.1 Introduction

The marketing communications budgets for the NHS 111 service are detailed below.

15.2 Financial Years

2010/11

The total marketing budget for FY 2010/11 is 560,000.

This is to fund creative development, production, media within the 4 pilot areas andcreative development and campaign evaluation research.

2011/12

The total marketing communications budget for FY 2011/12 is 1,300,000.

This is to fund the further creative development, production, media in the new pilot areasand the existing areas, and campaign evaluation research.

2012/13

The budget for this financial year has not yet been agreed.

15 Budgets


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Annex A Campaign creative

Launch phase

6 sheet poster


35/41


Full page press advertisement (County Durham and Darlington)


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Door drop leaflet (County Durham and Darlington)

Front cover Page 1

Page 2 Back cover


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Annex B

Launch campaign evaluation

This is the executive summary from the final report of the NHS 111 campaign awareness tracking

research produced by Jigsaw Research, published on 29

th

June 2011.The pre-wave research was conducted between 7th and 25th February 2011, before the marketingcampaign was run in the initial pilot areas, but after the service had been publicly launched and thefirst door drop leaflet had been distributed. The post-wave research interviews were conductedbetween 21st March and 13th April 2011, after the marketing campaign.

Executive summary

The research demonstrates that most elements of the campaign have worked well. The campaignwas well received and has had a positive impact on awareness and knowledge levels of NHS 111.It is clear that those who recognised the ads (and particularly the radio ads or leaflets) had betterlevels of awareness and knowledge of the NHS 111 service, were more positive about the service

and were more inclined to use it in the future and talk about it to others.Although it is early days for NHS 111, these results are promising and bode well for the futurerollout of the service.

Awareness of Advertising & Recognition

As a result of the campaign, awareness of advertising/publicity for NHS 111 increased in all four ofthe pilot areas, with significantly more recalling it in the post wave versus the pre wave.

Spontaneous post-wave recall of the campaign ranged between 18-29% (depending on pilot area higher in Lincolnshire and Durham & Darlington and lower in Nottingham and Luton). Overall,18% recalled a leaflet delivered to their home (again higher in Lincolnshire and Durham &Darlington) and 11% recalled posters or billboards.

Campaign recognition was high with between 41% and 61% recognising the leaflet and/or adswhen shown (depending on pilot area highest in Durham & Darlington, followed by Lincolnshireand then lower in Nottingham and Luton).

Following the campaign, more people were aware of advertising for NHS 111 than for NHS Direct.In fact, over the same time period, awareness of NHS Direct advertising / publicity actually fell inDurham & Darlington and Luton.

Just over a quarter of all post wave respondents could accurately describe key elements of theadvertising or publicity for NHS 111 (significantly higher than accurate recall achieved in the pre-wave). Accurate recall was highest in the Durham & Darlington pilot area.

Engagement with the NHS 111 Campaign

The campaign itself was well received respondents rated it well for being clear, standing out, itsrelevance and trustworthiness. Engagement was particularly strong in Lincolnshire.

More than 8 in 10 agreed that they trusted the ads, that the ads were clear and easy tounderstand, make it clear when to use NHS 111 and that NHS is an NHS service and that the adstell them something new. 8 in 10 agreed that they would be more likely to use NHS 111 as a resultof seeing the ads, and almost three-quarters agreed that they ads are relevant to them. A slightlysmaller proportion (although still representing around two-thirds) agreed that the ads stood outfrom other advertising and that they would tell others about the ads.


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Since the campaign, NHS 111 word of mouth has improved and the proportion of people claimingthey are likely to tell others about NHS 111 has risen significantly in 3 out of 4 pilot areas. Thosewho recognised the campaign (and particularly the radio ads or leaflets) were more likely to tellothers about the NHS 111 service. Actual usage and word of mouth of the NHS 111 service as aresult of the campaign is still low although it is early days for a service very much reliant on specific

circumstances under which the need to use it might arise.Knowledge, Belief & Attitude Changes

Total awareness of NHS 111 increased significantly in three out of the four pilot areas since thecampaign, with the largest increase occurring in Durham & Darlington. Spontaneous awareness ofNHS 111 is low compared with other NHS services, as would be expected given that the service isso new and dependent upon specific circumstances for usage.

Knowledge of NHS 111 has increased since the campaign with more people able to describe NHS111 accurately as well as being able to differentiate when to use NHS 111 as opposed to 999,NHS Direct, A&E and GP. The level of confidence in describing NHS 111 has increased from thepre-wave to the post-wave across all pilot areas. Those who recognised the campaign (and

particularly the radio ads or leaflet) were significantly more likely to be knowledgeable about NHS111 and more confident about describing it to others. Around a fifth in the pre-wave rising to a thirdin the post-wave were able to give a correct detailed response when asked how they mightdescribe NHS 111 to others; with the most common description being for non-emergency/non-life-threatening/non-urgent.

Knowledge of NHS 111 has increased since the campaign with more people able to describe NHS111 accurately as well as being able to differentiate when to use NHS 111 as opposed to 999,NHS Direct, A&E and GP. There is some misunderstanding about NHS 111 being a service thatshould be called when needing medical help fast. Although there was a significant increase inagreement from the pre to the post wave, only 3 in 5 agreed with this (true) statement in the post-wave, suggesting that the message could be clarified further when differentiating NHS 111 from

A&E and 999.The campaign has enhanced understanding of why the NHS 111 service has been introduced andincreased confidence and trust in NHS 111. Respondents in 3 out of 4 pilot areas are more likely tounderstand the need for NHS 111 in the post-wave versus the pre-wave. Across all pilot areasrespondents are more confident post-campaign that NHS 111 would be able to help if they neededurgent medical help and that they would trust NHS 111 to provide help quickly.

The campaign seems to have had a positive impact on claimed intentions to use NHS 111. Inparticular there has been a large increase in the proportion of people who say it would be NHS 111they contacted first if their GP was closed and they needed fast (non-life threatening) medical help.NHS Direct has dropped as the first port of call over the same time period. Actual usage is low, butsatisfaction is very high amongst those few who have trialed the service.

Individual pilot areas

Durham & Darlington was generally the highest performing pilot area in terms of awarenessand knowledge levels. In part this is due to radio ads and also for being in service for longer.The pilot area shows high levels of intended usage and word of mouth.

Lincolnshire saw many significant increases in awareness and knowledge levels. This ismainly due to radio ads (which raised awareness levels higher than in Luton andNottingham). The pilot area displays high levels of intended usage and word of mouth.

Nottingham City saw rises in awareness and knowledge levels, but lags behind Lincolnshireand Durham & Darlington in this respect (mainly due to the lack of radio ads). It performed

better than Luton and saw large rises in intended usage and word of mouth (but from a lowpre-wave base).


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Luton was generally the lowest performing area in terms of awareness and knowledge levels(and a lack of increases since the pre-wave). Although this pilot area still saw increases inawareness and knowledge, there were lower levels of intended usage and word of mouth.


40/41


Annex C

Campaign activity within the new NHS 111 areas.

1 8 15 22 29 5 12 19 26 3 10 17 24 31 7 14 21 28 5 12 19 26 2 9 16 23 30 6 13 20 27 5 12 19 26

ACTIVITY ACROSS ALL REGIONS

OWNED ACTIVITY

Briefings, newsletters, leaflets - targeted to key stakeholders - production costs

PR

ACTIVITY ACROSS NEW PILOTS

PUBLICITY REGISTER MAILING - healthcare environments

3k volume (incl. production and postage)

DOOR DROPS (3.9m total volume, cost i ncl. production)

Isle of Wight, Matlock/Bakewell, Cumbria/Lancashire, Oxfordshire, Northamptonshire, LondonBedfordshire/Hertfordshire, Nottinghamshire

Isle of Wight PCT

OUTDOOR

Max Passenger Panels (ferry)

Street Liners (buses)

48 sheets

RADIO

Isle of Wight radio

REGIONAL PRESS

Isle of Wight County Press

Derbyshire PCT (Matlock and Bakewell only)

OUTDOOR

Phone Kiosks/Roadside 6-sheets

REGIONAL PRESS

Matlock Mercury/Peak Courier

Cumbria and Lancashire PCT areas

OUTDOOR


RADIO

CFM/Lakeland/The Bay/Radio Wave 96.5FM/97.4 Rock FM/2BR/107 The Bee

REGIONAL PRESS

Multiple titles

Northamptonshire PCT

OUTDOOR


RADIO

Heart Northants/Gold Northampton

REGIONAL PRESS

Northampton Chronicle & Echo/Northants Evening Telegraph/Daventry Express

Bedfordshire

OUTDOOR


RADIO

Heart Bed/Bucks/Herts

REGIONAL PRESS

Multiple titles

580 panels

35% @ 10 OTH

4 ads

December January February March

951 panels

40% @ 10 OTH

4 ads

5 panels

7 panels

Activity

38 panels

6 panels

August September October November

40% @ 10 OTH

4 ads

122 panels

4 ads

45% @ 10 OTH

4 ads


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Note that Nottingham City PCT, which is an existing NHS 111 area, is included within the

expanded Nottinghamshire NHS 111 area for the marketing campaign.

Campaign activity within the existing NHS 111 areas.

1 8 15 22 29 5 12 19 26 3 10 17 24 31 7 14 21 28 5 12 19 26 2 9 16 23 30 6 13 20 27 5 12 19 26

Nottinghamshire PCTs

OUTDOOR


RADIO

Trent FM/Gold Nottingham/Radio Mansfield

REGIONAL PRESS

Nottingham Post/Mansfield and Ashfield CHAD/Newark Advertiser

Oxfordshire and Buckinghamshire PCT

OUTDOOR


RADIO

Heart Oxfordshire/Oxford's FM107.9/Jack FM

REGIONAL PRESS

Multiple titles

Activity August September October November December January February March

336 panels

40% @ 10 OTH

4 ads

4 ads

80 panels

40% @ 10 OTH

1 8 15 22 29 5 12 19 26 3 10 17 24 31 7 14 21 28 5 12 19 26 2 9 16 23 30 6 13 20 27 5 12 19 26

DOOR DROPS (all regions)

500k volume (costs i ncl. production)

FIELD MARKETING TEST

3 events

DIRECT MAIL TEST

DE/BME mailing using Healthy Start, Change4Life and NHSAIS data - 45k volume

Durham and Darlington PCTs

OUTDOOR


RADIO

Real Radio/Star Radio

REGIONAL PRESS

Multiple Titles

Lincolnshire PCT

OUTDOOR


RADIO

Lincs FM

REGIONAL PRESSMultiple Titles

Luton PCT

OUTDOOR


REGIONAL PRESS

Multiple Titles

Activity August September October MarchNovember December January February

147 panels

40% @ 10 OTH

4 ads

60 panels

40% @ 10 OTH

4 ads

82 panels

4 ads

Documents

NHS 111 Marketing Communications Strategy v2.0