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Case study: Our NHS: exposing ‘secret plans’, mobilising public engagement

Persuading NHS leaders to engage public involvement

Published: 13 Jan 2018

Incisive health case study

Client: 38 Degrees

Agency: Incisive Health

Campaign: Our NHS: exposing ‘secret plans’, mobilising public engagement

Timescale: N/A

A quick look

In 2015, NHS England announced 44 Sustainability and Transformation Plans (STPs). Despite the importance of STPs to the future of healthcare delivery, by August 2016 little effort had been made to engage the public in the process. As people-powered campaigners, 38 Degrees became increasingly concerned that the public were being locked out of decisions about the future of their NHS.

Using an expert report from Incisive Health, 38 Degrees launched a concerted media campaign to expose the planned changes to the NHS to political and public pressure and to persuade NHS leaders to engage the public. As well achieving extraordinary media and political coverage, the campaign made a real difference in persuading NHS England to publish a guide which sought to address concerns expressed by the campaign, and highlight the importance of public involvement.


Sustainability and Transformation Plans (STPs) are the process for translating NHS England’s Five Year Forward View into local action. Despite the importance of STPs, by August 2016 there had been little local or national scrutiny of the process,
let alone public involvement.

As people-powered campaigners, 38 Degrees became increasingly concerned that the public were being locked out of decisions about the future of their NHS. With little engagement or scrutiny, there was a danger that the NHS would sleepwalk into irreversible changes without public consent.

Set against this, some STPs contain worthwhile plans that would attract support. 38 Degrees needed to balance the imperative to shine a light on STPs with a need not to be caricatured as opponents of change.


We used a twofold approach:

1. Commissioning an expert report examining the content and process of STPs

2. Hard-hitting media, political and public engagement to bring to life an otherwise dry and technical process. The report was designed as a solid foundation for the campaign to argue for increased engagement from parliamentarians, the media and the public in the STP process.

We needed to communicate complex proposals, expressed in opaque technocratic language, to a mass audience. Finding a balance between retaining the subtlety of a proposal and translating it into language everyone can understand was an important consideration. Summary paragraphs for campaigning - published online as an annex - were more hard-hitting in tone, seeking to mobilise politicians, the media and the public.


The report was referenced by The King’s Fund, IPPR and the Pharmaceutical Services Negotiating Committee as
well as a wide range of media. The campaign combined media coverage with activism - 35,000 people contacted their MP - and achieved all of its objectives.

The campaign made the front page of the Guardian and the Independent, secured the prestigious 7.10am slot on the BBC Today Programme and led the BBC lunchtime news. The campaign achieved 155,632 engagements on social media in two weeks and was referenced in over 50 local media stories.

Nine MPs tabled parliamentary questions calling for their local STPs to be published in the weeks following the campaign launch - a key ask from 38 Degrees’ parliamentary advocacy. The petition calling for the Health Secretary to publish STPs was signed by 286,969 people. Our campaign was also the centrepiece of a sought-after Opposition Day Debate in Parliament, with 49 MPs contributing.

Fallout from the campaign saw the Prime Minister reassuring the House of Commons that STPs “should be taking into account the concerns and interests locally...of local authorities and the public”. As a result of the campaign NHS England was forced to make major concessions on engagement, publishing a guide which sought to address concerns expressed by the campaign, and highlighting the importance of public involvement.

Client verdict

“The NHS is a top priority for 38 Degrees members but we needed a way to translate this passion into action that could shape policy. This campaign took a technical issue, brought to life why it mattered and held it up to public scrutiny. We carefully used the media to dominate the policy agenda and our members responded in their hundreds of thousands. Politicians were left with little choice but to respond.” Laura Townshend, Communications Director, 38 Degrees

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