Are NHS Identity Mangers killing my grandmother?

If you were to take this mornings Telegraph article at face value, you’d think the NHS just closed a hospital to open up a new in-house branding agency.

Every hospital ordered to change its logo by NHS “identity managers” in move which prompts ridicule

Are you angry? I’d be angry too if I read that article and didn’t have my background. I’ve got good news though. Your taxes haven’t been wasted, no ones time has been misspent and no one has to go out and replace all their signs, websites and headed paper tomorrow.

The truth is design is central to delivering good patient care. The Telegraph article is based on (probably conscious) misunderstanding of how design works.

It dosen’t take much research to find out the actual situation though. And you’re busy people, so let me summarise.

What the NHS has done

Firstly, I don’t work for the NHS. I had nothing to do with anything in this story. But I’m a designer who works in healthcare. I know how design works, and hopefully I can unpick this for you.

Like any organisation, identity guidelines are important to the NHS. They serve a few purposes:

Design consistency They (should) ensure a consistent aesthetic and experience across the organisation. You’ll notice this is letters, signage, websites etc.

Why is this important? If I have to go to a hospital in a new city I’ve never been too, I can quickly recognise that it’s an NHS hospital and what it’s called


Resource management They allow an organisation to have one set of guidelines that everyone can work from.

Why is this important? Every NHS trust employ it’s own top-notch design team. Each one could develop their own guidelines with beautiful typography, spacing, images etc. But that’s expensive. Better to have one team do it once, and then every local designer follow their lead.

The NHS has had these guidelines forever. And every once in a while, they need updating. For instance, the guidelines from 2005 wouldn’t tell me how to create a consistent Twitter profile for a hospital. The new ones do.

And that’s all that’s happened.

The NHS Identity team (or designers) just published their updated design guidelines. And like before, they have guidance on how the logo should be used:

Using the NHS logo for organisations. NHS Identity Guidelines

And they have examples on how not to use it, because like in this example, it’ll be hard to read:

Incorrect (left) and correct (right)

Why the Telegraph want you to be upset about this

So why all the drama? Let’s have a look at the Telegraph article:

Every hospital in the country has been ordered to alter its logo by NHS “identity managers” in a measure which has prompted fury and ridicule.

NHS Trusts have to follow countless guidelines, this is just another. I haven’t seen the email sent by NHS England, but I doubt Trusts have been ordered to make changes overnight. In fact, the advice notes provided by NHS England on their website says quite the opposite:

Implementation of the updated NHS Identity guidelines should be gradual. There is no need to go back and change existing offline materials. They should continue to be used until they need to be replenished or replaced to ensure there is no waste.
When new communications and materials are produced, these would carry the new format logo and follow the updated NHS Identity guidelines.

Okay, back to the Telegraph article

The measure has been introduced by the “NHS identity team” following 1,000 interviews and 28 focus groups with members of the public. It follows a two year review of the health service logo with nine workshops involving 100 communications officials.

I don’t know them, but the “Identity Team” have an important role. They certainly don’t deserve the harshest of Telegraph insults; the inverted commas. Turns out that they did some research too, with real people! You can read the research report here

But hospital managers and charities poured scorn on the exercise — saying it would divert precious resources at a time when the health service is attempting to find £22bn in savings.

Here we go. Now we’re getting into the meaty bits. But the article quotes no NHS managers. But the original Health Service Journal article does have some nameless sources:

Trust managers told HSJ the move was a waste of time and money when the service was under such high levels of operational and financial pressure.
One senior manager told HSJ: “Clearly NHS organisations aren’t very busy and have lots of time to amend their logos, and have lots of money so that won’t be a problem either.”
Another said: “When you look at the new one, you have to ask yourself why [the changes were made].”

Strong feelings then, how much did this all cost NHS England by the way?:

He added that the exercise, which applies to providers and commissioners, had only cost £23 per organisation.
The spokesman confirmed that the NHS identity team has two staff, paid at bands 8c (£56,000-£69,000) and 8a (£40,000-£48,000).
NHS England said the team’s work comprised only 5 per cent of the more senior manager’s job and 50 per cent of the junior role.

Sounds pretty cheap to me in the context of what design services can cost. Okay, back to the Telegraph:

John O’Connell, chief executive of the TaxPayers’ Alliance said: “Barely a day goes by without complaints from the NHS about a lack of resources or staff shortage so questions will be asked as to how changing a logo — at a cost to taxpayers — can really be essential for hospital trusts. “Too often in the NHS we see wasteful spending on non jobs like ‘identity managers’ when there really should be other priorities for limited resources,” he said.

Arh yes, that bastion of coffer protecting, the (definitely not a front for the Conservative party) Taxpayers Alliance.

Katherine Murphy, chief executive of the Patients’ Association, said: “I cannot believe that at a time when the NHS is under such severe strain and so desperately short of money that they can waste all this time messing around with stupid logos.”
“This is not what patients care about. Patients want good safe care and we simply cannot afford or justify wasting time tinkering around with this sort of nonsense,” she said.

And I think this hit’s on the biggest bone of contention in this story.

Design isn’t an NHS “non-job”

And I can understand why you might think it is. Imagine a hospital management team dealing with no beds, cancelled operations and stripped budgets getting an email about a logo update on Monday morning. How high is it going to be on their priority list?

But design is important. It dosen’t just happen. It takes care, experience, research, time and money. I have a lot of respect for the Patients Association, they’re a great charity that do a lot of important work. Katherine Murphy said,

“This [updating the logo guidelines] is not what patients care about. Patients want good safe care and we simply cannot afford or justify wasting time tinkering around with this sort of nonsense,” she said.

Design is central to ‘good safe care’. And does that mean that moving the logo around will help deliver safer care? Probably not. But other parts of the guidelines will. The leaflet guidelines ensure that partially sighted people can understand the content. The social media guidelines ensure that the public can access health information quickly, and trust that it’s coming for an NHS source . The signage guidelines ensure patients can navigate hospitals and find where they need to go.

Comments about “non-jobs” updating “stupid logos” are unhelpful, and probably hurtful too for those on the receiving end. But the real fault lies with the impression design has as a discipline in the NHS, and healthcare in general.

The article in the Telegraph is click-bait. It’s not about the logo. They’ve plucked a bendy banana story from what is a important update to the design guidelines for one of the worlds largest organisations.

To summarise:

YES: The NHS has new identity guidelines which include new rules on how the logo should be used.

NO: No one has to spend money updating signs, letters etc until they were going to be changed anyway.

YES: It did cost some money to NHS England

NO: It didn’t cost money to Trusts and was infact, a pretty cheap exercise considering what design can cost.

YES: Design is important to the NHS, it’s what helps people access services and engage with healthcare.

NO: Design isn’t a “non-job” you patronising arse.