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The 4 P’s of marketing reimagined for the NHS

By Rachel Allan, Delivery Director, ZPB Associates

Some years ago, when I worked in central government, a newly-fledged civil servant who had joined from the private sector complained to me that success in her role alluded her. There were no sales figures or shareholders. Instead, she was grappling with the mystery of public service. To the indoctrinated, it was clear what success was: delivery of the policy in a way which aligned to the changing politics which surrounded it.

A recent conversation with a client reminded me of how confusing working with the public sector can seem. And it has set me thinking that the infamous 1960s innovation of the four P’s of marketing: Product, Price, Place and Promotion, need a rethink for selling to the NHS.

The NHS customer is not like other customers. This type of customer boggles the minds of many commercial marketing directors – and for good reason – the tools of traditional marketing are thrust into the upside-down.

‘Customers’ are scarce, they don’t resemble a commercial role, they operate in a political environment, and they are not rewarded in the same way as their private-sector counterparts. The structures which surround them are complex, and they are not able to influence them. The checks and balances of the NHS mean they will never be the only decision-makers. Their motivations may be altruistic, and they may be rewarded for highly risk-averse behaviour and for maintaining the status quo.

So – to the four Ps in the context of marketing to the NHS.

1. Product Policy

Yes, product (branding, features, colours, size) does exist, and you can see that in the challenges around interoperability BUT it’s a weak lever for marketers reaching the NHS. So much of product falls flat – brands, for example, rarely get cut through. I think that the P that is more important in the NHS marketing mix is policy. What policy lever exists to align your product with the big picture? Without policy, you are a solution looking for a problem.

It is crucial to take time to understand how policy is created, and how it rolls out through operating plans, local delivery plans and even board meetings. Find the opportunity to align and make your product make sense to your NHS customer.

2. Price

Price is set via procurement (and ultimately via the spending review), so it doesn’t exist as a lever in the same way pricing strategy exists in real life. Price in the NHS marketing mix is what cost and value you bring with you. Value like the ease of implementation; support for training; reporting; usability; integration with existing systems all count in your favour. As does the value you bring to the NHS as a workplace: helping people realise flexibility and empowering staff groups without disempowering others (cost).

3. Place Purpose

Place is not applicable for the NHS, and I would replace this with Purpose. What is your purpose, and how are those values aligned to the NHS? For example: making patient care safer is a purpose many organisations will cite. But you must ensure that you can demonstrate that you make a difference through evidence, active engagement and high-value activity. You need to have a perspective and be willing to offer up your knowledge and insight for the greater good.

4. Promotion

Promotion is interesting because the more marketing evolves, the more the gap with the NHS is noticeable. For example, influencer marketing (as we saw by the cringe-inducing call for NHS App influencers) is difficult to realise in the NHS. The NHS may influence, but they rarely influence each other. Social media can create engagement, but your NHS customer base may be very small, so be aware of the wrong kind of expensive online outreach. Activating the NHS en masse begs the question – are you not just activating people? Activating people in the NHS in their professional roles leads back to who or what influences those roles – best practice, stakeholders, patient stories and their intrinsic professional motivations. This P is probably the most exciting and multi-faceted.

So – there you have it: the four Ps revisited for the NHS: Policy Price Purpose Promotion


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