Marketing occupational therapy: everybody's business.
Government reforms in the United Kingdom are introducing elements
of choice and competition to the provision of health and social care.
Responsibility for marketing occupational therapy rests with individual
practitioners and managers through a client-centred approach to service
delivery. There is a need for the profession to support the development
of a range of marketing skills. This will equip services to manage more
effectively with the uncertainties of the health care environment. It
may be timely to consider a multiprofessional marketing approach with
other allied health professionals in order to put the professions ahead
in the market and able to seize opportunities for innovation.
Marketing, promotion, collaboration.
Occupational therapy (Economic aspects)
Occupational therapists (Marketing)
Occupational therapists (Economic aspects)
|Publication:||Name: British Journal of Occupational Therapy Publisher: College of Occupational Therapists Ltd. Audience: Academic Format: Magazine/Journal Subject: Health Copyright: COPYRIGHT 2011 College of Occupational Therapists Ltd. ISSN: 0308-0226|
|Issue:||Date: August, 2011 Source Volume: 74 Source Issue: 8|
|Topic:||Event Code: 240 Marketing procedures Computer Subject: Company marketing practices|
|Geographic:||Geographic Scope: United Kingdom Geographic Code: 4EUUK United Kingdom|
Two decades ago, Penn and Penn (1990) stated that marketing was the imperative for the future for occupational therapists and would equip managers to deal with uncertainties, such as emerging health care markets. At the time, the article stimulated the present authors, along with others, to incorporate a marketing approach to their practice. There are parallels between the market environment of the 1990s and the current health reforms of the Government and it is timely to revisit the topic.
Following the consultation on the White Paper, the timetable for implementation has been revised (Department of Health [DH] 2011). Primary care trusts will cease to exist in April 2013 and new clinical commissioning groups will have a duty to promote integrated health and social care around the needs of users. These will not be authorised to take on any part of the commissioning budget in their local area until they are ready and willing to do so. However, a programme of consortia pathfinders is already in place and will be taking on commissioning responsibilities.
The message of the reforms is 'putting patients at the heart of the NHS' (DH 2010a, p3). This will be delivered by increasing choice of provider, consultant team, general practitioner [GP] practice and treatment. Choice, and the competition it brings, will help to improve quality, because providers will fear the consequences of letting quality fall, thereby losing contracts (Ernst and Young 2009). Patients will have greater information available to support choice (DH 2010a, 2010e). A National Health Service Outcomes Framework will develop outcome goals, financial incentives and model contracts (DH 2010b). Organisational income will be dependent on demonstrating clinical effectiveness, and payment by results systems are being extended to fields such as mental health (Morley 2009, Lee et al 2011). Occupational therapists will be expected to demonstrate their added value through the delivery of clinically effective and cost-effective services, using evidence-based interventions, pathways and protocols (Morley and Aveling 2009).
Commissioning consortia will be made up of groups of GP practices, who will be expected to ensure wider professional involvement in commissioning decisions (DH 2011). These consortia will be required to work with allied health professionals (AHPs) (DH 2010c). The Chief Health Professions Officer sees both challenges and opportunities in the reforms (DH 2010d). AHPs are often frustrated that their contribution is unrecognised and that services are often at risk when resources are cut. The Chief Health Professions Officer calls on therapists to be much more explicit about their patient-centred approach. Practitioners should challenge a narrow perspective to clinical outcome, ensuring that the message is heard that patient outcomes, such as optimising function and quality of life, should be paramount (DH 2010d).
The introduction of greater choice for service users, and increased choice and competition between health care providers, led the authors to revisit the literature within occupational therapy and to highlight steps that managers, practitioners and educators may take in order to respond to these challenges.
Marketing occupational therapy
Penn and Penn (1990) offered a definition of marketing that combined a total orientation towards consumers, emphasising that marketing was everyone's business. This moved responsibility beyond the occupational therapy manager, the marketing department or the professional body Instead, as Bannigan (2000) argued, 'Every occupational therapist needs to communicate passionately what it is that he or she does so that our vision shines through' (Bannigan 2000, p463). Others call for all practitioners to engage in the marketing agenda in the United Kingdom (Beaton 1995a, Finnegan 1997, Stewart 1997), in Canada (Harms and Law 2001) and in the United States (Jacobs 1987, 1998). The College of Occupational Therapists published a marketing handbook (Beaton 1995b). However, Finnegan (1997) raised concerns that occupational therapists were reluctant to use marketing strategies. Of 35 United Kingdom occupational therapists surveyed, 86% felt unable to market their skills successfully due to a lack of marketing knowledge. Only 6% had received training in marketing. Finnegan (1997) recommended that marketing should be both included in the undergraduate syllabus and provided as courses for practitioners. It may be vital now to include marketing as a core component of development programmes and of pre-registration curricula.
This approach may facilitate a shift towards a market-oriented culture within the profession. Without this, it will be difficult to seize the opportunities set out by the Chief Health Professions Officer (DH 2010d).
The marketing environment
Managers need to consider external drivers that may influence market trends, as well as to understand who their customers are. These drivers include those that are external to the organisation, but also internal factors that may have an impact on a local service setting. National political decisions clearly influence organisational priorities. However, local contracting and budget allocation are shaped by political decisions and by commissioners' and managers' perspectives of what works and is value for money. Economic factors, such as the public sector deficit, will shape marketing choices. There are a host of technological factors, including new evidence-based treatments. Demographic drivers have a major impact on the nature of service delivery, and the implications of an increasing older population are well rehearsed. Finally, sociocultural drivers should also be considered as trends towards social inclusion, for example, impact on how we deliver services. Every practitioner will need to enhance his or her awareness of emerging market trends to ensure a timely response, and also to take individual responsibility for his or her work and how it is secured.
Consumers and competitors
When developing local marketing strategies, occupational therapists need to determine who the 'consumer' is. In health care, consumers may include service users, carers, other service providers, taxpayers and GP commissioners. Each group will have different conceptions of value and needs.
Jacobs (1987) argued that occupational therapists should listen carefully to potential customers and then design services to match their needs. Service users' perspectives should define what creates value in health care. Sumsion (2000, p308) presented a United Kingdom definition of client-centred occupational therapy as being 'a partnership between the client and the therapist that empowers the client to engage in functional performance and fulfils his or her occupational roles'. This is consistent with the vision for greater choice and shared decision making articulated by the Government (DH 2010e). The Chief Health Professions Officer (DH 2010d) reminded AHPs of the power of patient stories. This echoes Finnegan's (1997) call to individual practitioners to engage in 'personal selling' of occupational therapy through face-to-face contact with service users. As Stewart (1997) claimed, each satisfied client becomes the greatest advertisement. The use of patient-reported outcome measures and service user experience surveys as quality indicators (DH 2010b) should provide opportunities for reporting on how occupational therapy makes an impact.
This practice-level approach to marketing is as important as other 'formal' marketing activities. Stewart (1997) argued that the two sit at ends of a continuum and require different skills. It may be important to design opportunities for therapists to become skilled in both levels of marketing activity as they complement each other and together create a marketing ethos.
Occupational therapists across the public sector, in other organisations or working as private practitioners will be expected to develop marketing plans and to bid for contracts in a competitive environment. The emergence of social enterprises as employers of occupational therapists will require marketing both internally and with external organisations. This is consistent with the environmental changes emerging in the United States (Jacobs 1998) and Canada (Harms and Law 2001).
Penn and Penn (1990) gave little consideration to competition. However, this aspect of marketing cannot be overlooked as health and social care services are commissioned from a range of providers. Those commissioning services will, for some services and in some areas, use competition to improve quality or reduce costs. This is more likely where there are relatively few barriers to entry, for example community AHP services, or where there is a pool of potential providers, as happens in many urban areas (Ernst and Young 2009). Potential competitors may demonstrate that they can provide all or some of a service by improving quality, delivering the service more efficiently or more flexibly, increasing productivity or designing the service in a way that fits the marketing environment better.
To ensure that occupational therapy services are equipped to deal with these challenges, managers and practitioners will need to develop an appreciation of the marketing mix: product, place, price and promotion (Jacobs 1987, Penn and Penn 1990, Wheeler 1994). Occupational therapy in the United Kingdom used such strategies to respond to the challenges of the 1990s. The current situation demands that we do so again, and perhaps look to other countries where a more mixed economy of care is already in operation.
Bannigan (2000, p463) reflected that marketing is seen 'as the answer to getting people to understand what we do [as occupational therapists]'. Ten years on, the College of Occupational Therapists (COT 2010) called on members to be active ambassadors for the profession, championing its unique contribution. This sits alongside a communication from the Chief Health Professions Officer (DH 2010d, p1). In order to exert influence, she proposed that AHPs organise across organisational boundaries on a multiprofessional basis. This raises a challenge beyond that made by Finnegan (1997), Bannigan (2000) and others to develop essentially uniprofessional marketing strategies. It may be that collectively managers, practitioners and educators should embrace a collaborative marketing orientation, drawing on the strengths of each professional group. This will call for, at the very least, new skills in collaboration and networking, and a reconceptualisation of our role and contribution, as well as a culture of trust. This would truly make marketing 'everybody's business' and put the occupational therapy profession, along with AHP partners, ahead in the market, enabling us to seize opportunities for innovation. The question is: 'Are we ready?'
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Mary Morley (1) and Jane Rennison (2)
(1) Director of Therapies, South West London and St George's Mental Health NHS Trust, London.
(2) Trust Head of Occupational Therapy and Social Inclusion, Central and North West London NHS Foundation Trust, London.
Dr Mary Morley, Director of Therapies, South West London and St George's Mental Health NHS Trust, Springfield University Hospital, 61 Glenburnie Road, London SW17 7DJ. Email: firstname.lastname@example.org
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