Engaging People: The Fundamentals of Effective Workforce Communication

What would the NHS do with an extra £2 to 3 billion every year? Rachel Royall presents this as an estimate of the potential cost of poor communication, once you add up avoidable harm, legal payouts and lost productivity. In this interactive session from the Connected Health & Care Summit 2026, Rachel Royall, founder of Blue Lozenge and former Director of Communications at NHS Digital, uses real clinical scenarios to expose where communication fails, reveals a scenario in her own cancer diagnosis experience, and introduces the HEART model for rethinking communication in healthcare. 

Watch Rachel Royall use her own cancer diagnosis to show how poor communication costs lives and billions, then lead an interactive workshop on three real clinical scenarios and introduce the HEART model for healthcare communication. 

What the session covers and the scale of the problem

This session combines hard data, interactive scenario exercises and a deeply personal story. Figures discussed during the session include: 

• Poor communication is the sole cause of approximately one in 10 patient safety incidents and a contributing factor in roughly a quarter 

• 55% of people report experiencing poor communication from the NHS 

• Communication problems are the single biggest category of patient concerns about hospital care 

• Litigation costs in the NHS have reached approximately £3.6 billion, with a large proportion attributable to communication failures 

• Better goals-of-life conversations alone could save an estimated £3 million per trust per year 

• Everyday friction in information flow costs over £1 billion a year in lost productivity, equivalent to 20,000 full-time staff or 40 million patient appointments 

• All three workshop scenarios are real. Scenario one is based on Rachel Royall’s own delayed breast cancer diagnosis 

The three scenarios and what the room found

The room split into patient and staff perspectives to analyse three scenarios. In the first, a woman with a family history of breast cancer is told to use an online form, waits weeks, has her appointment switched to a telephone consultation, and is told the GP is too busy to read the comments. The room identified three triage points where the system failed, and an audience member suggested that an AI bot would have flagged the keywords immediately. 

In the second, a consultant changes a medication plan during a busy ward round without clearly communicating to the nurse or the patient. The nurse continues the old regimen overnight. The room identified missing handover processes and a lack of consent. 

In the third, a patient is discharged with a follow-up plan that never reaches the GP. The room described feelings of abandonment and highlighted that patients should never leave any area of care without understanding what happens next and when they will be contacted again. 

The HEART model and who this is relevant to

Rachel Royall reveals that she is scenario one. She contacted her GP about a breast lump with a family history, was directed to an online form, waited weeks, had the appointment switched to telephone, and the comments were never read. She is now being treated for cancer following chemotherapy and a double mastectomy. She describes assuming that of course someone would triage the comments box, and argues that if the form is not going to be read, it should not exist because it creates a clinical safety risk. 

She introduces the HEART model for redefining communication in healthcare. Hear with empathy to truly understand, not just listen at surface level. Explain with transparency using clear language. Accelerate operational impact by involving communicators in fixing the problems that generate complaints. Reputation as safety, because a safer organisation has a better reputation. And Transform behaviour through campaigns that change how people act. She argues that reputation management done properly is not burying bad news but making care safer, and that communication teams can have a much broader role than managing social media. 

This session is relevant to communications leads, patient experience teams, clinical governance teams, chief executives, medical directors, patient safety leads and anyone responsible for complaints, engagement or organisational reputation.