In the rush to reform, NHS communications teams are once again under threat. Caroline Latta, CIPR health group committee and co-founder and director of Stand consultancy, argues that cutting this essential function is not only short-sighted, but risks undermining the very changes the system is trying to deliver.

NHS communicators are tired. Not just from the demands of a 24/7 news cycle, or the ever-expanding list of platforms they are expected to manage, but from having to keep justifying their existence. Again.

Across the country, Integrated Care Boards (ICBs) and provider trusts are being asked to cut costs and slim down functions. Too often, communications, engagement and transformation teams are seen as the first place to look. This reflects a persistent, and frankly demoralising, misunderstanding of what this function actually does, and more importantly, what it enables.

Comms in the NHS isn’t a nice-to-have. It’s not about glossy leaflets or reactive media lines: it’s about making the NHS system work. Safely, transparently, and with the trust of the people it serves.

It’s a misconception we still have to challenge: that communications sits outside the engine room of care. In reality, it’s part of the machinery. Communications professionals are the translators between strategy and real life. They help patients understand changes. They ensure staff are part of the story. They make sure stakeholders know what’s happening, and why.

They reduce risk. Build trust. Drive behaviour change. And when a service is changing, or public confidence is wobbling, they are the ones supporting boards to listen well, speak clearly, and act accountably.

During the COVID-19 pandemic, we didn’t ask whether communications was essential. We knew it was. Local NHS communications teams worked flat out to deliver rapid, accurate information in ways people could understand. They tackled misinformation head-on. They adjusted messages to suit different cultures, languages and literacy levels. They stood between panic and clarity.

That’s not a luxury. That’s life-saving work. We’re in the midst of another major round of NHS reform, focused on productivity, integration, and place-based working. All of which sounds good on paper – but only works if people come with us.

NHS communications teams are essential to this. They are the ones who untangle the complexity to make it easy to understand and ensure the stakeholder conversations that build legitimacy and buy-in. In the new integrated care model, engagement isn’t a tick box. It’s the mechanism by which transformation is delivered. It’s how the public influences those decisions. It’s how NHS Boards meet their legal duty to involve the public in NHS change.

The ICB model blueprint names communications, engagement and transformation throughout its pages. These aren’t peripheral functions—they’re enablers of change. Cutting them now not only risks losing valuable skills, it actively undermines delivery.

The NHS is operating in a complex, sometimes volatile information environment. Disinformation spreads fast. Communities are fatigued, confused, and anxious. The British Social Attitudes Survey shows that only 21% of the public are satisfied with the NHS. If the NHS wants to maintain its social contract with the populations it serves, it must continue to invest in trust-building.

That means keeping expert communicators close to decision-making. We’ve already seen what happens when messages are unclear, when changes are announced without context, or when people feel excluded. It erodes confidence, stirs up resistance, ignites campaigns in opposition to change and slows down delivery.

Professional communications is not a skillset that can be handed off to busy operational leads. It requires strategic insight, political awareness, digital skills, legal understanding and empathy for how messages land. When done well, it makes everything else go more smoothly. When done badly, or not at all, it becomes a barrier to reform. If you’re a senior leader weighing up how to save costs, please stop and ask: what will it cost if we get the messaging wrong? If we lose public trust? If we breach our duty to involve?

Because the real cost of cutting comms isn’t in the budget line. It’s in lost understanding, delayed delivery, staff disengagement, and poor outcomes. There is, perhaps, some encouragement to be taken from the fact that communications, involvement and transformation are explicitly referenced throughout the model ICB constitution and operating model. This signals a growing recognition that these functions are not simply support services, but strategic enablers of a system working and accountable commissioning. Their inclusion reflects a maturing understanding of their value at the heart of integrated care.

However, mention in a blueprint is not a guarantee of protection. These teams still face disproportionate risk of cuts as systems seek quick wins on cost. To lose them now would be a serious misstep—undermining the very reforms the blueprint seeks to deliver and stripping out the expertise needed to connect policy intent with public trust.

As organisational behaviour expert Nancy Rothbard puts it: "The sinkhole of change is communication and motivation. It’s where change projects go to die." Without clear, consistent and trusted communication, the motivation to engage - whether from staff, patients or partners - drains away.

So let’s take this moment to restate the value of our work and stand firm on its necessity. Not just to protect comms teams, but because we know this: without good communication, there is no good healthcare.