Table 2 Theme 2 A unified communication strategy

2. A unified communication strategy

Consistent communication within the leadership group

Q1 “Cohesion at the management level and regular meetings, where all of the senior leadership team are in the room at the same time and are sharing information has been very important” (P2)

Q2 “The communication within the leadership group was quite good, the ability to rely on our infectious disease consultant and his expertise and availability was really quite a strong point” (P11)

Q3 “We tried to have a unified response so if we came up with something it didn't just mean going back to that individual going oh here's what you do, it actually meant we need to think about this from a broader perspective, here’s how we should implement it across the organisation” (P4)

Q4 “I met with the NUMS, and I held a couple of staff forums, and you know I met with the educators, I met with the grads, and you know started to try and slice an organisation so every was everyone was getting a consistent message, I think it's important (P8)

Discovering the need for a structured comms strategy

Q5 “In the beginning we did not know what was happening from an organisational level, you'd hear things were coming, but it's like so is anyone actually doing anything about that or do we just do it ourselves, well I can't sit here and not do anything because I’ve got a whole staff group that I need to take care of” (P5)

Q6 “Communications has got to be a key important strategy, and It's got to be timely and responsive and to the point for people so that they know” (P5)

Q7 “Comms was centrally driven, we had visual posters that we changed the message and changed the colours, so we were constantly refreshing the message” (P1)

Q8 “One of the challenges was we tried different forms of communication, people said they weren't getting enough, people said we're going too much” [….] We had visual posters that we changed the message and changed the colours, because after a while people stopped looking at them or couldn't see them” (P1)

Q9 “Situation reports and communications are good, even if you can go back to those and pull them out again and refresh them and send them back out to staff” (P4)

Q10 “Rather than me as a leader directly telling all the individual anaesthetists what to do, I’ve got a head of department using their ways of communication, so leave enough responsibility with people who are in positions of authority to use their usual ways of communicating, as well as what we needed to put out as a whole of health service on top of that” [….] “And not relying on single channels of communications, so if there is information that needs to go out, it goes through nurse manager groups, the CMO office, CEO communiques, sits on workplace by Facebook, in emails, so multiple channels of communication” (P2)

Q11 “we had to develop fairly quickly a communication structure, within the program that meant we could get managers and leaders the information that they needed in order to perform their roles in the safest possible way” [….] “We had daily forums with leaders, so that was our verbal communication structure, but you need written communication in order to support the verbal communication” (P9)

Q12 “I think the creation of completely novel subcommittees which have dealt with things like vaccination, rapid antigen testing, the PPE subcommittee which went on to respiratory protection, those structures have been absolutely critical in terms of sharing of information” (P2)

Q13 “Within 6 to 12 months, we had a lot of good subgroups, the frequency of meetings was good, the information was certainly better, I just don't think it was brilliant getting down to the staff” (P11)

Q14 “Communication was key, and you can tell people and tell people and tell people, and you will still find that not everyone checks their emails, and we have such a reliance on this email communication” [….]“But you're talking to a group of staff who are really busy, overworked, have a lot on their plate, and every time they turn around there's something new that they have either got to do, find, tell, get” (P4)

Q15 “We needed a dedicated COVID response manager to try and create some consistency of approach, to try to strengthen the comms and get visualization of what needed to happen out to the teams, and know where the resources were sitting. If you look at other bigger organisations and they got a team managing their COVID response” [….] “And we were under resourced and probably still are under resourced for what we're managing to be honest” [….] “But the COVID response, for what was needed, that just fell back on the local areas to magic up what needed to happen or to work out what to do. I could see we need to do this, we need communication in our local area because people are panicking if you don't give them anything” (P5)

Q16 “There were resources sitting in local areas everywhere, nothing was aligned, there were lots of local bits and pieces” (P5)

Q17 “I also think that the timeliness of communication coming out from the organisation at the highest levels from a Chief Executive space could have come out more rapidly” [….] “I found myself doing a lot of interim information to fill the gap in those early stages of communications that were coming out centrally, because staff needed to know, and it was a bit repetitious, but they felt comforted by the fact that we would send something out every Friday afternoon, so we know what to focus our energies on” (P9)

Q18 “And I think we could always improve our communication, I don't think we really put it out really regularly, I don't know if it was in the right format that everybody could take good points away from” (P11)

Q19 “There was a lot of information coming from different sources, even in email and staff feedback, it was what do we look at, I don't know what to look at, it's too much to look at, so I think in the programs we worked hard to try to condense it” [….] “And I make sure that every communication that’s sent as relates to COVID, I embed that in that meeting so everybody knows there is one place you can go to for everything in the week, so funnelling information for staff, I think we could have done better as a leadership group too” (9)

Q20 “I think the communication within the leadership team was good, maybe not so much down to the staff on the floor because there was just such a volume, we had to really filter and pick and choose a little bit” (P11)

Q21 “I think the communications came eventually, but they were difficult to work out from a manager perspective, they were really long, the important information was hidden in little paragraphs on page number 6 in paragraph number 4 or something, you know the key things” (P5)

Q22 “I tend not to accept in this day and age that people don't answer their emails if you can book a holiday online, that seems to come up you know that I don't access my emails, I tend to not put much weight into that these days” (P8)

Q23 “The ability to zoom has raised a different audience as opposed to try and pull everybody in from the wards into a big auditorium, this is a lot more agile, a lot more nimble of a communication style and we really should continue to do it” (P8)

Changing goalposts

Q24 “We were getting changes from the Department sometimes twice a day. So the rapid process of communicating changes in the organisation for that sort of response was incredibly challenging” (P1)

Q25 “It was a changing feast all the time and to try and get that communication out there to people” [….] “The staff were actually getting really frustrated with us because we were changing things, but we were trying to be agile and trying to get the right balance” (P6)

Q26 “There was a lot of trying to get that messaging out and around and using all those communication platforms to do that, and then also checking to make sure staff were doing it, and trying to find those resistors in the groups, and then find your adopters and spread the word” (P5)

Q27 “It was a bit of a no-win situation, trying to provide consistency, which was difficult because things would change, the goalposts are changing so quickly” [….] “Then we'd put something out, and then something else would come out, and there was conflict a little bit in everyone would go into ahhhhhh” (P5)