by Cassie Zachariou
Giving broadcast media direct access to the inner workings of an organisation is a risk at any time, let alone during a pandemic. For healthcare trusts, patient privacy and dignity and the safety of all involved has to be weighed against the need to share a crucial public healthcare message. Here’s how it can be done.
You’ll learn:
• How important it is for the NHS that the public understands the impact of COVID-19 on the frontline
• The many ethical considerations that come with opening up ICU to broadcast media
• How trust between healthcare professionals and the media is important to help tell one of the most significant stories of our lifetimes
BBC News’s Fergus Walsh asked to film in our intensive care unit (ICU) as we were approaching the peak of the pandemic. It stopped me in my tracks. We were a week into lockdown and our main priority up until that point had been internal communications – making sure staff had the information they needed at a time when the situation was changing hourly. But Fergus’s request was about to shift my focus entirely and we had just a day and a half to turn things around before filming.
Managing risk
We had all seen the extraordinary scenes from hospitals in Italy but up until that point, no news crews had been inside an ICU in England. Which trust was going to be brave enough to be the first? When Fergus made his pitch, I knew straight away it would be us. University College London Hospitals (UCLH) has a healthy appetite for risk – one director once told me it was the mark of a confident organisation. I knew that my role was to mitigate the risk as far as possible in order to show the public what was happening on the frontline of the pandemic.
Fergus’s wish list was long and there were many logistical challenges to overcome such as how to film and move around the hospital safely. I needed to engage with many people across the organisation – in ICU, infection prevention and control, our COVID-19 wards, security and others – at a time when these people were having to deal with issues of much greater magnitude. One nurse looked on the verge of tears when I asked if we could film in her ward – it was one ask too many for her in the midst of the crisis.
I would be lying if I said I didn’t consider recommending pulling, or at least delaying the filming. I asked to see our chief executive to discuss the key outstanding issues. He is a big supporter of communications – he believes you can only ever have too little, or not enough comms.
There was only one matter I brought to him that day which caused him to pause – should we allow a news crew in when we were restricting visitors in all but exceptional/compassionate circumstances? His conclusion was yes, it was in the public interest to do so to help reinforce the message that people needed to stay at home to stop the spread of the virus and protect the NHS.
Leap of faith
The former journalist in me really kicked in – I made call after call, kept tracking people down, asking questions, finding solutions, persuading, influencing – whatever was needed to get this over the line. The following day, even up to an hour before filming, I was still on the hustle. But once the BBC arrived, I felt I’d done all I could and now we had to take a leap of faith.
Fergus and I had never worked together before so we had to establish a relationship very quickly. I could immediately sense the heavy weight he felt to get this piece right. He told me it was the most significant story of his career and it was at that moment it struck me the same was true of mine. The most important – and perhaps the hardest – thing was that we had to trust each other. For my part it was about giving Fergus the freedom and access he needed to tell the story when the stakes were high. For his part, it was about doing so in a way that was fair and preserved the privacy and dignity of our patients.
We spent eight hours together that day, filming in ICU, in surge capacity (theatres which had been repurposed to house extra intensive beds), in a COVID-19 ward and in front of our emergency department.
Our staff were so eloquent, so calm, confident and compassionate. They didn’t realise it at the time but they were speaking to the whole nation and what they had to say was going to cut through in a way that no politician standing at the podium could.
Like most things, you can try to plan filming as tightly as possible but you do need an element of good fortune on the day to make compelling television. A crucial piece of the jigsaw that had been missing from my prep was a patient who was able and willing to tell their story. While we were filming on ICU, one such patient was admitted to the unit. He was a lovable, 67-year-old bus driver who was determined to fight the disease to get back home to his wife, children and grandchildren. His story brought real human interest to the report and Fergus subsequently followed his recovery until he was back home safely with his family.
We can do this
There were moments during the day when we were all betrayed by our emotions. For Fergus it happened while looking down onto the Euston Road and realising that people outside had no idea what was happening within the hospital’s walls. The voice of our charismatic ICU consultant cracked when talking about the sacrifices his family were making to support him during the pandemic. My eyes filled when our chief executive, who is a doctor in acute medicine, gave a message of reassurance to staff in his interview. He told them: “We are professionals, we are the NHS, we can do this.” It really felt like we were all in it for the fight of our lives and everyone at UCLH had their part to play.
At the end of the day’s filming, Fergus, his cameraperson (whom I must praise for his outstanding work along with their producer) and I went to the ICU staff room where there was an incredible selection of food generously donated by local businesses. The sense of camaraderie among the team was heartwarming and they were so grateful to Fergus for coming to tell their story. They were so welcoming in fact that Fergus announced he would like to come back to do another day’s filming in a month’s time to which they all wholeheartedly agreed! I couldn’t quite believe it but as with his first approach, I knew we would do it.
Pride and purpose
Between April and June, Fergus produced five news reports about the care UCLH provided during the pandemic. These reports ran across the BBC’s channels – television, radio, online, social and sounds. His third report, which broadcast after the Prime Minister’s address about easing lockdown restrictions, had an average of 14.5 million viewers. For comparison, in 2019, the BBC News at Six and Ten had an average week day audience of 4.2 million and 3.4 million respectively.
Our own social media posts about the BBC’s coverage had significant engagement. On Twitter, the first of a series of tweets promoting the initial BBC report was seen by 556k people, retweeted 735 times and liked 4,110 times*. In comparison, our best performing tweet in 2019 was seen by 51K people, retweeted 100 times and liked 216 times*.
The BBC’s coverage was extremely well received by staff and helped pave the way for other trusts to open up their ICUs to news reporters. By working with a trusted journalist with a common purpose, we were able to demonstrate the value and need for good communications in a crisis. On a personal note, I have never felt a greater sense of pride and purpose in my work.
*Data as at 31 July 2020
Cassie Zachariou is head of communications at University College London Hospitals (UCLH) – one of the most prestigious NHS trusts in the country. Prior to this she held positions at Imperial College Healthcare and the Royal Free London. She began her career as a journalist focusing on health and social care.
Twitter: @CassieZac
LinkedIn: linkedin.com/in/cassie-zachariou-51877331/