“Now is the time to be safeguarding organizations from risk, not deprioritizing issues preparedness”: Ralph Sutton warns of potential reputational impact of healthcare communicators focusing their attention elsewhere.

Ralph Sutton

As a leading issues preparedness and management expert in the healthcare sector, with 35-years in the business, Ralph Sutton, AVENIR GLOBAL International Managing Partner and AXON President, addresses the growing trend of issues fatigue and talks about the types of issues that communicators should be preparing for now, instilling a culture of preparedness and the need for straight talk in today’s world.

The start of the COVID-19 pandemic brought crisis and issues management to the forefront for organizations across the healthcare sector – unsurprising given the scale and breadth of the impact of the outbreak. More surprising is that three years on, as life seemingly gets “back to normal”, the focus on preparing for the next “what if?” is dropping down the list of priorities. There is a risk that organizations are suffering from issues fatigue as they put the pandemic, and perhaps the significant internal change that went with it, behind them. Ralph Sutton explains why this is a risk and how healthcare communicators should be working with their leadership teams to safeguard their organizations from potential threats.

“Not surprisingly, in 2020 we received more requests for support in issues management than in any year I’ve been in the business,” said Sutton. This is no small statement from Sutton, having worked with healthcare sector clients for more than three decades and specialized in issues preparedness and management throughout this time. “But it was not just a matter of responding to issues and crises; companies recognized that they needed to equip their teams for being issues ready, even if they were not facing immediate challenges.”

Over the course of his career in healthcare communications, Sutton has worked with clients on a broad range of issues – from major litigation, corporate restructuring and job losses, sabotage and extortion and of course safety-related issues. Many of these can be issues that may not initially appear to be a big risk to a company, but which can, without a plan in place, prove incredibly damaging to a company’s reputation. As Sutton notes, a company restructure may just be an internal issue to prepare for – but it can quickly become an external issue and a risk to a company’s reputation if not managed well.

As for the types of issues organizations need to be preparing for right now, Sutton has several key recommendations for clients, from those that have been present for years, to those that are cropping up more frequently in today’s fast-moving environment.

“There are some issues that healthcare organizations have always faced – instances, for example, where product safety is a challenge. It is our experience that clients are generally well prepared and adept at handling these situations. There are of course protocols for managing safety-related situations, and in terms of reputation, when the client knows how to do the right thing, and does the right thing, then the company’s reputation is preserved.”

But sometimes it is not obvious what the right thing looks like, and of course what may be right in one stakeholder’s view, is definitely not OK to another.

“Compassionate-use programs, for example, tend to be an area where we see issues arising time and time again. No good deed goes unpunished as people say, and sometimes organizations set out to run a compassionate-use program to help patients, but get highly criticized for the way it's designed. Focus can shift from those who benefit from the program to those who are excluded. Of course, for people who are in desperate need of treatment, being excluded can feel devastating and consequently they feel they have no choice but to go to the media or tell their story on social media to change the access criteria. The fact that an individual may be unlikely to benefit from the treatment may get lost in the story.”

Another area where issues can be predicted is related to manufacturing and supply chain. This may include supply disruption, quality issues, even the risk of sabotage, and even a plant being shut down as a result of regulatory concerns, which can have a huge impact on the market and of course the company.

When it comes to emerging issues, we are seeing more and more the proliferation of increasingly sophisticated cyberattacks as a potential crisis with far-reaching repercussions. While healthcare communicators may not be involved in the logistics of cybersecurity, they are impacted by it and need to be prepared for managing communications from both an internal and an external perspective. It is important to recognize that no organization is immune.

The advancement of available therapies has also brought new challenges to stakeholders across the healthcare sector.

“With the emergence of new technologies and increasingly complex, and therefore expensive, tailored treatments, healthcare companies are facing growing scrutiny over pricing and access. This isn’t new. Pressure on healthcare budgets is a constant – there is never enough money to fund the high-quality healthcare people want, and manage the competing interests of different therapy areas, whether that be through state-funded systems or through insurance. But cost pressures are particularly acute right now.”

So, what can healthcare communicators do to mitigate the risks of such a breadth of potential threats?

Ultimately, there is not a comprehensive list of every possible issue or scenario an organization – healthcare or otherwise – should prepare for. There is value in identifying those issues that are likely and those that may be less likely but could have a significant impact if they occur. But you cannot prepare for absolutely everything that could happen. Which is why Sutton’s advice to clients is that they should be “instilling a culture of preparedness so that when an issue does arise, teams and individuals have the right instincts, know what to do and are able to preempt it or react to it in the right way.”

Putting in the work upfront to create this culture, identifying the most likely issues or those that will have the greatest impact on an organization and giving teams the tools and resources to respond safeguards an organization. “People compare issues preparedness to taking out an insurance policy, but there are significant differences. First, if preparedness planning does not involve the right team, then the company’s response is only as good as its weakest link. The insurance is invalid, so to speak. Similarly, if people see it as a tick-box exercise and don’t take it seriously, then it has little lasting benefit. But if teams and individuals commit to proper preparedness planning, including training that enables them to experience situations that they may face, then they can understand how issues can escalate, but most importantly, how they can be prevented from escalating. Then the company can benefit for years from employees with the right instincts.”

How organizations communicate around an issue is critical in terms of how they evolve. An organization that is seen to care, seen to be taking a situation seriously and is committed to addressing the situation, whether there is any fault associated with it or not, generally wins our trust. Organizations that adopt a defensive, evasive approach generally generate suspicion.

In a world where politicians have become less and less able to talk straight, people are craving open and honest communications. “Drawing on this idea, clients need to consider how they can genuinely answer questions and give straight answers. The instinct to dodge a question needs to be avoided. If you can't say something, it's OK to say you can't talk about it, but what we need to avoid is answers that muddy the water and confuse your audience. There is an old media training technique called “bridging”, where people are trained to answer a question and then use a phrase to bridge to the message that you want to deliver. Too often, people forget the critical first part of the bridge – actually answering the question. Bridging straight to your message just creates cynicism.”

There are going to be times when you cannot talk about a topic – it might be because there is litigation, it might be that it is commercially confidential or patient confidential. Those are good reasons not to provide information, but you can say “I'm sorry I can't give you that information because it's confidential. But what I can tell you is X, Y, Z.” By taking this approach, you build trust and credibility, often offsetting any negativity driven by the original issue.

During his time in the industry, Sutton has not only advised clients on issues preparedness and management, but he also has extensive expertise in media strategy and relations.

“External factors can also have a bearing on how issues and crises are interpreted and reported in the press and wider social media environment. We are seeing this now. In today’s media landscape, there is much less room for nuance. The media, and particularly social media, will often be dominated by extreme views, driving anger and frustration, and the reality is that these extreme views are not generally representative of society. People are being influenced to fall on one side of the fence or the other. But the truth is – we live in a world of grey.”

This tendency to hold and share extreme views can be extremely damaging for organizations if an issue has been made public and people have taken it upon themselves to exacerbate the situation. With access to millions of people via social media, incorrect information can spread widely and at lightning speed.

“Again, this is where straight talking becomes important. You must talk straight, share facts and explain what those facts mean in ways people understand. That’s what really matters. This is often difficult and needs preparedness planning”

Sutton’s view is that healthcare communicators should actively prepare for future issues. Accepting that people are a bit tired of firefighting and issues should not be an option. Many learned the hard way when the COVID-19 pandemic hit. There has never been a greater illustration of how good communications can help save lives, while poor communications can do the opposite. Three years on, with focus on issues management dwindling, but with potential issues at large and external factors weighing heavy, now is certainly not the time to be deprioritizing issues preparedness planning.

AXON’s years of expertise and suite of insights-driven issues and crises preparation tools and services will empower you and your organization to tackle any event with confidence and clarity. Together, we can help you navigate the complexities of issues preparedness and crisis management in this new world, with the simple reassurance of a credible and trusted partner.