NHS England » Pre-election guidance for NHS organisations Spring 2024

When and where are elections happening?

Elections are scheduled to take place in England on Thursday 2 May 2024.

These are:

district, metropolitan and unitary council elections
regional mayoral elections
Mayor of London and London Assembly elections
police and crime commissioners elections
some other local elections.

A list of any upcoming elections in your local area can be found on the Electoral Commission website.

What is the pre-election period?

The pre-election period, previously referred to as ‘purdah’, is the period of time immediately before elections or referendums. During this time, specific restrictions are placed on the use of public resources and the communication activities of public bodies, civil servants, and local government officials.

The pre-election period is designed to avoid the actions of public bodies distracting from or having influence on election campaigns.

The pre-election period has implications for all NHS organisations, although it is worth remembering that the NHS should always remain politically impartial.

When does it start?

The exact start of the pre-election period in your area is determined by when the local authority in question formally declares it. Typically, this will be 6 weeks before the election. The latest the pre-election period could begin in local areas where there are local elections (ie the latest date at which an election can be declared) is Tuesday 26 March 2024.

For the Mayor of London and London Assembly elections, the latest date that the pre-election period can start is Tuesday 19 March 2024.

The convention observed by national organisations is different to those observed locally. For national organisations, the pre-election period begins 3 weeks before the scheduled local elections. Therefore, restrictions on NHS England and other arm’s length bodies will begin on Thursday 11 April 2024.

Key considerations

You will want to ensure your organisation is acting and being seen to act impartially towards all candidates and political parties, and not seen to be influencing the election and its outcomes, whether inadvertently or intentionally.

Remember, not publishing information can be just as influential as publishing it.

Local organisations should continue to adhere to any processes and restrictions in place due to the current national emergency preparedness, resilience, and response incident level.

During the pre-election period, there should be:

no new announcements of policy or strategy
no announcements on large and/or contentious procurement contracts
no participation by NHS representatives in debates and events that may be politically controversial, whether at national or local level.

These restrictions apply in all cases other than where postponement would be detrimental to the effective running of the local NHS, or wasteful of public money.

Communications activities necessary for operational delivery purposes should continue as normal.

You should consider:

Requests for information: These should always be handled in an impartial manner so that information is made available to all candidates. Information should be factual, and candidates should be responded to in a timely manner.
Briefing MPs and ministers: These should be handled as per the usual process, ensuring any information shared is factual.
Consultations: No consultations should be launched during the pre-election period unless they are considered essential. Ongoing consultations should continue but should not be promoted. Consultation periods can be extended if it is expected that the pre-election period will impact negatively on the quality of the consultation. Consultation responses should not be published until after the pre-election period comes to an end.
Media handling: Avoid proactive media work on issues that may be contentious. Reactive lines should be factual and where possible, in line with previous lines.
Events: Avoid attending events where you may be asked to respond to questions about policy or on matters of public controversy. This may mean withdrawing from previously agreed engagements.
Visits from politicians: The decision to host visits is at your discretion. The same approach must be applied to all visit requests from candidates/parties to avoid any question of bias. This means, if you agree to a visit from a candidate, all other candidates should be invited to visit. Any visits should not interfere with the day-to-day running of your service and you should be mindful of patient privacy and dignity.
Social media and web: Nothing contentious should be posted on your website or social media accounts. Updates/posts, including blogs, should only convey essential factual information.
Campaigns: Do not undertake major publicity campaigns unless time critical (ie a public health emergency).
Board meetings: Board meetings should be confined to discussing matters that need a board decision or require board oversight. Public board discussions on matters of future strategy should be deferred.
Appointments of board members and non-executive directors: Appointments can continue as per the usual process unless you are concerned appointments may flare up local political sensitivities, in which case, you may wish to postpone until after the elections. Exercise sensitivity over the timing of any announcements.
Foundation trust governor elections: There is nothing to prevent foundation trust governor elections taking place. As above, exercise caution if there are concerns these may become political. Again, any announcements should be carefully considered during this period.
Marketing: Printed materials, such as posters and leaflets, promoting contentious policy or proposed policy should not be given fresh circulation, but can be retained and issued in small numbers on request. Films and other media produced by the NHS, including the NHS logo, should not be made available for use by candidates/parties.
Staff activism: NHS employees are free to undertake political activism in a personal capacity but should not involve their organisation or create the impression of their organisation’s involvement or endorsement.

A general election will take place at some point before 28 January 2025. NHS England will issue guidance for this pre-election period in due course on the basis of the same principles outlined in this document.

Useful resources

The Cabinet Office has published its own pre-election period guidance on conduct for civil servants for May 2024 elections. While the guidance applies to civil servants and not directly to NHS employees, the principles of this document are based on the Cabinet Office guidance.

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