Tuesday, 17 April 2012

NHS Branding and Twitter twibbons

 In August 2009 an ongoing debate on US healthcare reform jumped across to our side of the Atlantic. Club for Growth, a network which believes in prosperity and opportunity through economic freedom published the following advert.

It attacked the NHS and plans for 'government-run healthcare' in the US, and provoked a backlash in support of the NHS in the UK. Graham Linehan, the writer of Father Ted, started using the hashtag #welovetheNHS and spoke on Channel 4 about why he thought it was important to defend the NHS- and the power of Twitter to do this.

Many people- over 10,000 also added a 'twibbon' banner to their Twitter profile pic to demonstrate their support for the NHS. I was one of them.

I didn't remove the twibbon from my profile because there never seemed to be a right time to do that. I haven't stopped loving the NHS, or the principles which founded it.

Fast forward a few years and I was a surprised when today I received an email from the DH (English Department of Health) Branding and Identity Department, informing me that the use of the NHS logo on my twitter profile picture had been brought to their attention. As the NHS letters and logo should only be used by NHS organisations, or where NHS services are being provided (and my twitter account is certainly not providing an NHS service) they therefore asked that I removed the NHS logo from my Twitter profile picture. They asked me to confirm that I was able to do this, and thanked me for my cooperation.

In part I was surprised because I received this email to my university email address. Recently I started using about.me as a landing page from my Twitter profile, and this enables people to email me without making my email address public. But I use a personal email address for this service. It is how I would have expected someone to contact me with regards to my twitter account. But of course with a little googling my university address is quite easy to come by.

I tweeted about the request of course. And this provoked quite a lot of discussion. My original tweet above has been Rt'd more than 50 times. The response (storified by @evidencematters) was a mixture of amusement that the DH had time to monitor the use of their logo in this way, and anger that the NHS seemed to be no more than a corporate brand.

I replied to the email explaining why I had added the Twibbon to my twitter profile and why I had not removed it. I asked :
"Do you think that having 'I love NHS' on my profile picture suggests that
I am a provider of NHS services or an NHS organisation? Do you think that
my use of the logo in my profile pic is damaging the NHS brand?

If you think that I am in some way demeaning or harming the NHS through
the use of this Twibbon, I shall of course remove it."

The reply suggested that we have a quick chat about this by phone. Stephen Hale, head of digital at the Department of Health had also kindly sent me a tweet offering to organise a call from the branding team. So I managed to get speaking to someone who had time to look into what had happened. He explained that the person who had sent the original email was not familiar with the #welovethenhs campaign. He agreed that it was clear that I was not trying to impersonate an NHS service or organisation. The branding team were very heartened by the support shown for the NHS. But it was also important to protect the logo which is trademarked so that when it was used the public and patients could be assured of the service that they would receive.

So this episode is resolved. I have not removed the twibbon from my account. A few hundred other people have added it to their own twitter profile pictures.

Many organisations and companies are considering how they should use social media to protect and promote their brand. And it seems that the Department of Health and the NHS are learning just like everyone else.

Edit 18/4/2012
This morning I received the following tweet:
Alex is one of the co-founders of the #nhssm (NHS and social media) chats which happen on Wednesday evenings. I would like to reply to Alex's comment. I am not an expert in brand management, and will be very surprised if I ever am as it in not one of my aims or objectives, I therefore would never comment on how good or bad the DH are at it. I have told this story because yesterday it caused quite a commotion on Twitter and I wanted to share how it had come about and how it had resolved. But I'd like to make clear that I do not think that this episode is about just one person. I don't think that the person who sent me the email is at fault. They were clearly following guidance which stated that if the NHS logo was being used by someone who was not an NHS organisation or providing an NHS service (in England) then they should ask for it to be removed as this was trademark infringement.

It is my impression that even if this Twibbon had not been part of a larger campaign, and I had in fact designed it myself to show my support of the idea of the NHS, then it is unlikely that I would have been infringing. I think this because I am not using the logo to identify a trade or service. This is unless someone would think that 'I heart NHS' indicates that I am speaking on behalf of the NHS. I don't think that the history of the 'I heart X' meme tends to suggest that someone using it is speaking on behalf of X, instead it says that they like/love/appreciate X. In fact, the city of New York has trademarked ' I heart NY' so they might have a bigger call over trademark infringement!

My use of the NHS logo on my avatar is non-commercial. I presume that the DH branding and identity department  will be reviewing their policies on the non-commercial use of the NHS logo.

I should also note that Twitter has a policy on trademark violation. In the case of fan accounts it states that logos should not be used in avatars or background images without permission as a way of reducing confusion that the account is speaking on behalf of the organisation. They do not mention the meme of Twibbons which are about showing support for causes/ideas rather than for companies.

Professor Trish Greenhalgh has suggested that it might be better just starting from scratch:

What do you think? Is it time for a new twibbon?


  1. Is NHS a trademark? Is it a brand? I though it was a National Health Service! Although perhaps the DH are keen to protect it ahead of using it on the letterheads of private companies to lull the public into a false sense of security over impending privatisation of many NHS services. Perhaps it's more like 'National Express' or 'National Lotter' now.

  2. Interesting post! I would hate to think that the NHS brand could be used by unqualified quacks to promote 'treatments' or 'services' which were not evidence based or within NHS guidelines, so I understand the need for stringent brand management. However, to ask for the 'I love the NHS' Twibbon to be removed is rather strange, as its about supporting our healthcare services. Perhaps Trish is right and we should have a CC licensed new 'I love the NHS' logo :)

  3. Don't we need a redesign anyway? "I loveD the NHS"?

  4. What a waste of time by some bureaucrat!

    The NHS Alliance uses it and they don't provide services, apart from being cheerleaders for Lansley and for quackery.

  5. Thanks- @anon Yes NHS is a trademark- not only the logo but the word NHS is a trademark as far as I know. http://www.dnforum.com/f26/can-trademark-holder-seize-my-domain-if-i-own-good-faith-thread-350227.html#post1647875

    But my understanding is that because something is trademarked it doesn't stop others using it for non-commercial purposes.

    In this case the story is positive about the NHS, unless the DH did not want to be associated with a campaign supporting a health service funded through general taxation and free at the point of use! But what would happen if the NHS logo was used in other ways. For example, in the recent campaigns around the NHS Act, if someone was using the NHS logo in campaign material would that be infringement of trademark? I don't think so as it would be a non-commercial use. But I'm not an expert so I don't know.

    Would it be an infringement of copyright? Interestingly this Wikipedia entry suggests that the NHS logo is so simple that it does not meet the threshold for copyright and should have a commons license. http://en.wikipedia.org/wiki/File:NHS-logo.jpg
    However, my understanding is that in the UK there is a much lower threshold for originality justifying copyright than in the US. So it may very well be subject to copyright in the UK. So if it was being used in a negative way perhaps the DH would challenge over copyright rather than trademark.

    But yes, Trisha's suggestion is growing on me!

  6. Well, one good thing has happened.
    The NHSTA http://www.nhstadirectory.org/ which used to have the blue NHS logo on their website seems to have lost it.
    Although you still get CAM practitioners referring to it as the 'NHS Directory', e.g. http://www.lucilleleader.com/

  7. AnneMarie,

    Thanks for writing it up, as it has provoked an interesting discussion.

    To answer your questions, it would be good to have a new twiboon, just because my twitter profile could do with a change ;)

    On a more serious note, it sounds like this incident has given the I Love NHS twibbon more and good publicity (if it wasn't the NHS I would have speculated if it had been deliberate). Anyhow, I wonder how many people have adopted the twibbon due to this incident?

    1. Not sure how many additional twin ons there are- I hunk a few hundred!
      With regards to a new twibbon- do you think an officially sanctioned one would work? Would it have the sane resonance? This twibbon is of a certain time and place. It's political rather thn just saying, 'I like the NHS'.

  8. Putting the shoe on the other foot: how would you feel if tweeps started to misuse your twibbon?

    Infringing your brand, denigrating your values, muddying the waters. How? Check it out: http://www.telegraph.co.uk/technology/twitter/9207657/Creeping-Sharia-trend-shows-what-Twitter-thinks-of-the-EDL.html

    Yes I'm being facetious but it shows just how social media can create a groundswell and undermine what it is you are trying to achieve.

    And if that objective is primarily to signpost patients to services, is it helpful to patients when staff use your brand in a way that is unintended?

    1. Hello Devil's Advocate,
      Thanks for your comment. I'm not 'staff' as I work in Wales not England. And I make your point about negative use of trademarks a few comments above. But the fact remains that as far as I am aware a company is not allowed to use the trademark legislation to protect themselves from negative publIcity. Do you know different?
      Thanks for the discussion.

  9. I'm no legal eagle but suppose it depends on whether someone / business reaps benefit from misrepresentation / adverse publicity to the NHS, or if that impacts adversely on the brand and consequently services to patients.

    Public sector branding is never black and white because of the emotional value attached is so much greater than private sector. Can present real conundrum though when you take a step back and look at the bigger picture.

    1. Hmm I don't think it can go both ways. A commercial organisation can not protect themselves from negative publicity by dissatisfied customers by saying that they are not allowed to use their logo as it is trademarked. This is my understanding but I might be wrong. So let's look at the bigger picture. Say Virgin starts running a hospital in Bristol. They are allowed to use the NHS logo. If people think the service is bad or are unhappy with the political decision, could they use the NHS logo in campaign materials? Would that be trademark infringement? My understanding is that it would not be. It would be great if someone else could join the discussion to clarify. I'll try and find someone!

      Next, would use of the brand for that kind of campaign affect negatively on the brand? Yes, possibly. Would it lead to a risk to patient safety? Who knows. The campaigners might think that they were acting in the wider public interest.

  10. I agree, can't go both ways. What is central to the NHS brand is care free at point of need, with logo primarily signposting patients to services, as well as providing accountability for provision of services. Encroachment of those principles then affects the brand, diluting and eroding what it is used and stands for, ultimately affecting business perception / how audiences engage with that brand. Not about publicity. Publicity may be a side effect or catalyst to brand dilution.

  11. Hi, also just to also mention, its about reputation not publicity. PS saw this and thought of you!

    1. Sorry I think we are talking at cross purposes. My understanding is that trademark infringement legislation is to protect a company from competition by a commercial competitor. See:
      Yes it is about protecting reputation. If a commercial competitor is using your trademark then it may confuse the public and make them think that that competitors services or goods are yours. If those services or goods are poor it may take away from your reputation.
      Or your competitor may benefit commercially from being using your trademark and hence association with your brand.
      Do you agree with me that use of the NHS logo for non commercial purposes - and this means projecting the NHS brand in both positive and negative lights- has nothing to do with trademark infringement?

  12. According your link then, yes, it would appear a trademark applies solely to goods and services. Off to explore. And maybe read some of your other blogs. Interesting indeed.


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