#nhssm: IT in healthcare, how to champion its use for the greater good

I thought I would share a few useful links and hopefully thought provoking perspectives before tonight’s #nhssm chat on IT in healthcare, how to champion its use for the greater good…

First links…

Department of Health information strategy – It’s so important at the DH it got a bespoke URL: http://informationstrategy.dh.gov.uk/.

Success or failure of the strategy rests entirely on the IT underpinning it. Information technology that:

  • enables people to change smoothly (i.e. doesn’t put up barriers)
  • enables digital by default publication of information
  • includes software that doesn’t need a Masters in computational mathematics and computer science to use it.

So how to go about laying down those exacting foundations? The Government Digital Service has blogged on procuring the right systems across government and it is highly applicable to the NHS too – Chris Chant’s post ‘The Unacceptable‘ is a breath of fresh air, and make sure you read his follow up, ‘SMEs – we need to talk‘.

Onto championing…

The NHS revolves around its patients. Staff in patient facing and non-facing roles ensuring patients receive the best possible care is the main driving force behind the continued success of the NHS. This is the key to championing IT in the NHS.

Ask yourself, “How can this IT solution improve patient care and experience?“. If you take this with you as you show colleagues what is possible with good IT I don’t think you’ll go far wrong.

And finally…

All healthcare staff must take with them to work an understanding of IT. If we aren’t aware of what is possible we’ll never create the pressure for change. Is your work computer as good as your 3 year old laptop at home? If it is I applaud your organisation!

By working with your IT colleagues to make sure future procurement decisions are based on end user need and not the past you can start on the road to fulfilling the information strategy’s vision.

In my experience a good IT system leads to happy staff, and happy staff are best for patients.


#HSJTwitchat: A few thoughts

Unfortunately a meeting today will stop me from joining in the oddly but hopefully not ironically hashtagged #HSJtwitchat. So here are a few things reading the Cogitamus report made me think about.

Section four (thought leadership) is absolutely key

I don’t think this can be overstated. In my three years in the NHS nothing, other than the statutory reforms, has lead to change not matter how big or small without leaders championing the cause. Having a range of individuals who can lead the discussion, provide viewpoints, evidence and counterpoints to detractors enables the rest of staff to see the need for change and start to work towards it.

Who ‘owns’ social media

This question breaks down into control of what is said and control of publishing.


Communications teams role is to be the hub of expertise on how these things work, interact, damage and improve. They should be enablers. They can’t own the social media brand but they can lead it.

Social media is here to stay

This will be said time and again. The point being that this has reminded me that social media practitioners across all organisations surveyed are coalescing around this point and are realising its implications.

If social media is here to stay then for organisations to take advantage of its benefits it needs resource, capacity and capability given to it. How is the NHS going to build these things around social media (whatever platforms exist now and in the future) when comms teams are being decreased in size and social media expertise is spread thinly across it’s 1 million plus staff?

Finally here’s the link to ‘that’ Taunton meeting in the report’s preface: https://attdigital.wordpress.com/2012/05/16/thoughts-from-a-social-media-chat/ 

Enjoy the chat!

#nhssm: Staff social media engagement

I can’t make tonight’s #nhssm chat on ‘Staff social media engagement: what are the barriers and how to overcome them’ so I’ve written the below to help me think it through. Hopefully it can add a little to the chat too. Then again I may have got completely the wrong end of the stick!

Telling the world what you organisation does

Social media gives the organisation and staff a free publishing tool with the potential to reach a number of targeted people, e.g. local councillors, the local paper, and local people.

I find showing staff how social media can help promote the work they are passionate in is often a good way of introducing them to new channels.

Helping staff understand how the organisation’s is perceived

All communications teams should be constantly horizon scanning and picking up on how the organisation is perceived outside of their four walls.

While this is a basic comms rule very often the information gathered doesn’t get much further than the comms team. By bringing social media in to the four walls of the organisation you can help educate people as to how the organisation and their work is seen, why it’s seen that way and how to maintain or improve that perception.

A round up of tweets to relevant teams by week (if you have enough to do that) or just passing on positive and negative tweets to teams would be a big start. A Twitter feed of mentions on the intranet is a good one, but can run into problems with people wanting to moderate which tweets appear.

Enabling staff to make better decisions at work

On both the commissioning and provider sides of the NHS social media offers people the chance to get customer feedback. If that feedback is negative it can be a good stepping stone to catalysing a discussion on what the service can do to improve. If it is positive it can help reinforce good service and behaviour.

But for now where I see the greatest gains to be made is on the commissioning side. By showing staff the wonders of the networked web and how it can bring useful information to them as they need it I see a time when commissioners aren’t sat together in a room with a few spreadsheets, but online with interactive maps, tweets bringing in relevant evidence and online discussion spreading best practice. That would be a giant leap toward evidence based decision making and continuous professional development via social media.

#fluscenario – how would you help in a pandemic?

Over on the #nhssm blog we’re running #fluscenario – a speeded up version of 2009’s swine flu pandemic and asking you how you could help spread factual messages by using your online profile/social media accounts.

Social media has come a long way since 2009 and it has been interesting from my perspective to answer the questions including in the blog posts knowing that two years or more ago we would still have been hung up on whether doctors would be struck off for tweeting anything medical!

Check out http://nhssm.org.uk for more and scroll through the #fluscenario posts.

#Digitalday – an excellent Race Online 2012 esq idea from Tim. How could you open up your comms team’s digital skills to your colleagues? Lunchtime masterclass? Informal network of bloggers comfortable to share content? Staff Twitter lists?

Clear message

Lately, there’s been lots of discussion in the office about new guidance for civil servants using social media.

You can read it here. No big surprises; all very practical, positive stuff.

The question raised among our team was what this guidance meant for people who blogged, filmed or pinned, in a personal capacity. The interpretation was that all online activity by civil servants should be attributable, regardless of whether it was professional or personal. This seems fair to me, but I can also understand how it might be of concern for some.

What this discussion revealed is that lots of my colleagues do interesting things online. However, because the content is nothing to do with Government digital, they don’t feel it appropriate to share their experiences.

Now, I am on a mission to help my colleagues celebrate the work they do online, away from work, and reassure them…

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Thoughts from a social media chat

T’other day I went down to the South West of England to have a chat with comms leads from the regions hospitals about social media.

First and foremost, despite growing up round there the journey down there was a happily recieved reminder of the beauty of that part of the world. The pace of life is also different to London. Better than London in my eyes and more friendly of course. I digress….

All-round I felt the meeting was a success. People in the room were open and honest with their level of experience on social media and some great lessons and case studies came out of that.

For my part I was really motivated to hear how far down the road most people were with social media. 18 months ago it was all about getting executive sign off to use social media, or IT clearance for comms teams. Now I was hearing about how people have been building online communities and integrating social media into their media relations work for a few months or more.

Below are a few Q&As I picked up from the chat. Pardon the strange style it is copied and pasted from an email. I also apologise for breaking *all the blog post length rules*; bare with it I think there is some useful stuff hidden away in there for you all.

Questions and answers from a social media chat in the South West

Writing for the different platforms. This only comes with practise! I would take some time to look around at how people you follow/are friends with are writing. What writing styles make you happy/sad/annoyed, click on a link, RT a tweet, like a post? How can you use those styles in your work? Using active verbs and plain English are obviously a must.

Making your organisation’s news more topical. The key here is to join in with region-wide and national topics. For example, the PiP implant scandal – what could your hospital say to its followers about it? Could you RT the DH info? Remember it needn’t be original content all the time with social media.

Increasing Twitter followers is an odd game. There is little use in using follower number as a marker of quality. You could have 2,000 followers but no real influence or interaction. On the other hand you could have 10 local bloggers follow you who subsequently blog about your organisation news and help you get your messages out to the local population. Don’t fret about follower numbers. Here are a few tips to increase the number over time:

  1. Tweet regularly. The nature of Twitter means the more active you are the more chance people have of coming across you.
  2. Network with your local public sector organisations and get them to RT your tweets, RT theirs in return.
  3. RT local people and organisation tweets (you may want to think about a Twitter policy which makes it clear a RT doesn’t equal support)
  4. Join in on local hashtags. Is there a local tweetup (online or offline meet up of people on Twitter) you could join?

Increasing conversations online. Activity and topicality is key here. People won’t talk to a silent account much and it’s difficult to get people to talk about something they aren’t interested in. What issues and concerns are in your area? Perhaps maternity service redesign… in which case can you tweet/update Facebook with news of the proposals, consultation, key dates and facts? Your organisation will of course cop some flack but that is the role of comms. If we’re doing it right we can then feedback the concerns of online followers to the appropriate clinicians and managers in inform the decision making process. Finally, don’t try and lead the conversation all the time, go looking for others’ active conversations about health and join in.

Capacity issues with a 1.5 WTE team. The key here is to remember the broadcast-reactive stages of my ‘sliding scale of [online] conversation’ diagram (below). Don’t try and do it all online. Just maintain a presence. This can be done easily using scheduling functions on Twitter (TweetDeck (software) and Twuffer.com (website) offer scheduling functionality). Perhaps you can plan the weekend and next weeks content on Twitter on Friday and schedule it in. Facebook updates should follow your press releases at this stage, just remember to personalise the content a little for Facebook’s very personal life culture. A friend of mine checks Twitter and Facebook for notifications each hour, it takes him two minutes (roughly 15 mins a day). He only uses more time when someone has interacted with the organisation’s profiles.

You won’t get left behind. Use your networks around the NHS to get updates on future social media ideas etc.

The colleague with the control of social media, you with little understanding of what goes on there. I’ll be honest, this scared me a little. If the comms lead hasn’t got an understanding of what is going out under the organisation’s name and brand there is a risk of issues arising. A weekly check-in of what is planned to go out and a daily 5 min update on any interactions on Twitter/Facebook would be useful to make sure you know what is ongoing and help you understand how the platforms work. No need to be an expert, just know enough so you can explain it to a director if something does go well or badly online.

Video quality. My personal opinion on this is that it is not worth us spending money on high-end broadcast quality video. News outlets around the world are now regularly screening mobile footage and Skype interviews. The public are used to slightly lower quality video. It is the content that counts. You can have perfect HD head and shoulder shots of a CEO banging on about what’s important but it is still boring to most people! This excellent urology robot example proves that. Save the money and spend it on training your staff in how to use a basic flipcam/digital camera and buy a cheap piece of editing software.

Social media turning into too much of a customer service channel. This is a tough one. There is the balance between reputational risk and wasting capacity. If I were to be cynical I would say treat the people with large and or influential online followings like customers and people with 10 followers less so. Shocking but one school of thought. This question also brings into focus the issue of teaching PALS teams to use social media and perhaps providing a suggestions and complaints specific Twitter account for people to contact.

Finally on this, remember the invention of emails allowing people to directly email the CEO? Twitter may follow the same grain, a busy start, slowing as people (who are more reasonable than we sometimes recall) realise Twitter isn’t the right channel to complain on. #waitandsee.

Apps. This most definitely should be done at a national level. If you are to look at it remember apps shouldn’t be costing £10,000+. They are quick and easy to produce for people with programming knowledge. Is there anyone in the NHS system in your region who could help you? Could your team provide the service to other acutes for a fee and start to satisfy the need for more income generation? Philosophically a strange argument but something to think about.

A few general issues were raised too…

EU Cookie Law – read these things and don’t worry to much for now.

Econsultancy’s Q&A with ICO’s Group Manager for Business & Industry http://econsultancy.com/uk/blog/9610-q-a-the-ico-s-dave-evans-on-eu-cookie-law-compliance
Government Digital Service’s theory http://econsultancy.com/uk/blog/9416-eu-cookie-law-uk-government-crumbles
Government Digital Service’s approach http://digital.cabinetoffice.gov.uk/2012/03/19/its-not-about-cookies-its-about-privacy/ andhttp://alphagov.files.wordpress.com/2012/03/gds-cookies-implementer-guide.pdf

IT issues – these often depend on local relationships. There may be some ground to be made in educating your IT colleagues as to the approach by other trusts in the South West.

Telling difficult stories online – In short – plan, plan, plan. Just the same at traditional comms and pr.

Twitter is now often the source of stories that get printed – how could you use Twitter as the hook for a boring story. #NHSXmas is a great example – we got a boring “don’t go to A&E when you aren’t dying/really ill or injured over Christmas” message into the London Evening Standard on the back of using Twitter.

The digital divide – SOCIAL MEDIA IS NOT REPLACING TRADITIONAL COMMS!! One day I will get a t-shirt printed with this on. It is merely being added to the toolbox. It is not the silver bullet to end all our comms problems. The traditional comms rules apply, particularly the go where the audience is one. You’re not going to communicate with me or the many people younger than me through quarterly magazines and leaflets.

Getting to know Storify…

Storify is a recent addition to my channel toolbox. I think it is an ideal place to create a hub of multimedia content around an event, topic or story.

It’s interface is simple to use and it allows embedding of content from across the most popular online platforms. It’s URL embedding feature is really useful as it allows you to embed presentations from Slideshare of Scribd. Furthermore it is easy to embed onto your blog, or so it should be…

I’ve popped an example of an embedded Storify on the #nhssm blog but for some reason this blog won’t except the ‘<script src=”http://storify.com/a_double_tt/nhsconfed-nails-it.js”></script><noscript>&#8217; code which renders the Storify with a pretty boarder. Perhaps this is because it is a WordPress.com hosted blog? I’m sure @colinwren will know!

Here’s the link to my Storify about some Twitter chat with @NHSConfed – view the story “@NHSConfed nails it” on Storify.

#reformten 73 essay challenge: Jeremy Browne

Today’s Reform Ten essay is from Jeremy Browne: Lib Dem, Taunton MP, Somerset Cricket Club supporter (good man) and Minister in the Foreign and Commonwealth Office responsible for:

• Far East and South East Asia
• India, Nepal
• Latin America
• Australasia and Pacific
• Caribbean
• Emerging Powers Co-ordination
• Olympics
• Human Rights
• Consular Policy
• Migration
• Public Diplomacy
• Drugs and International Crime.

His essay, entitled ‘Britain needs a wake-up call’, highlights what such a ministerial position requires – a wide, wide angle view of the world. A view of specific generalisations that help individuals as single nodes in the humongous worldwide system of business, economics, politics, workforces education and health understand what is going on.

There will always be friction between people who naturally look at change on an individual basis and people who naturally look at change as Jeremy has to everyday, on a big picture basis.

Take for example the withholding of expensive cancer drugs from individuals. One angle shows it to be a great injustice deigning someone a longer life, the other an injustice of spending limited money on an individual’s illness instead of many individuals illnesses or preventative measures. Extremely difficult indeed. I shall leave the rest of that point to the philosophers amongst you.

A few facts and more thoughts the essay sent my way

• Currently the British government is currently borrowing £400 million a day
• The British people are getting very close to spending £1 billion (£1,000 million) every single week on paying the interest on our debt <<< Wow!
• Schemes like ERASMUS and travel abroad will be key in the future to ensure the British workforce stays at the top of the tree through knowledge of the world’s different cultures and traditions
• Foreign languages will be very important in the future. The British’s general ambivalence towards foreign language at schools will come back to haunt us if we’re not careful
• Jeremy relabelled Western values as universal values – those of free speech, free trade and free societies. A good and clever linguistic trick perhaps?
• There is a change of mindset needed in UK society. A change to understand how globalised the world is and an acceptance that we are competing in a global workforce
• The logical conclusion of globalisation of the workforce (to me) is the commoditisation of professions. Doctors and engineers will not be able to hold onto the high regard of their profession once there are thousands of graduates from across the world with the same and better skills as British graduate, they just be another x or y. Commercial bodies will be able to salary off positions as they draw down from a global pool of highly educated talent. How can that fit with our societal views and values?
• And finally, how does the need for a better global understanding and position from Britain affect the potential devolution of Scotland and then Wales? Would these countries truly be able to compete in a global world?

Mind dump over! Please do place any comments below.

The start of a challenge: 73 essays and 73 blogs

Today with a simple tweet I set myself (and a few of you if you want to join in) a challenge to read 73 essays and write a short blog about each one.




The thinktank Reform have collated 73 essays by  all under the broad topic of the next 10 years in the UK. The essays cover:

  • Education
  • Government
  • Growth
  • Health
  • Public services
  • Politics
  • Law and order

I’m not sure of the best way of writing about these essays so I’m going to start with a few bullet points. I’m sure it’ll evolve over the next 72!

Today’s essay was Stephen Dorrell’s entitled ‘Reengineering the care model’. Here are a few things it made me think about…

  1. It is good to remember and celebrate successes be they in work or our personal lives. How can the NHS remind itself of the great improvements it has already achieved and how can individual staff find the time to remember these things?
  2. Every sector has it’s own set of scales but healthcare’s life/death scales are incredibly complex. Here’s a schematic:

The more life that is on the scales, the less death. Good. But more life means more healthcare spending as elderly patients get increasing numbers of co-morbidities. But spending on healthcare can’t increase forever. Complex.

3. Hospitals will close as healthcare moves into specialised centres (see London’s stroke care set up mentioned in the essay). How can the NHS help show the public this will lead to better care and outcomes instead of worse? How would you tell your Mum or Dad that travelling an extra 20 miles to hospital is better for them?

4. I’m very lucky to understand how only some of the NHS works, but only because I work in it. How can we all help people understand the basics better? Like what they can expect when seeking a GP appointment or NHS dentist, what health checks are available and how to feed in comments to the service to improve the system.

One essay down, 72 to go…!

ATTdigital’s weekly read-round-up #5: GPs are private contractors, a national patient experience challenge for engagement staff, making videos is easy and national service

“I honestly don’t think it matters whether that [NHS care] care is delivered in a state hospital or a privately operated GP surgery.”

This quote came from a Guardian Healthcare Network interview with Stephen Dorrell, chair of the Commons health committee.

I highlight it not because it is a very insightful article but because this is the first time I have seen a GP surgery being classed as private by a politician.

To often for my liking GPs are seen as the guardians of the NHS despite being private contractors. They are not part of the NHS but an extremely key partner, just like the private sector already is through contracts to help the NHS get through its elective waiting lists.

Politicians would do well to help the public understand that GPs don’t necessarily always hold the NHS’ best interests at heart. After all they too are running a business, a business that has to make a profit.

Why we need a national framework for patient experience

Jocelyn Cornwell from The King’s Fund has blogged on the new DH framework for patient experience.

This framework is designed to ‘to apply a single generic framework for patient experience to a wide range of health conditions and settings’. Jocelyn sets out well the challenges that stand in the way of getting the framework adopted across the NHS.

One she doesn’t explore fully is the engagement staff who may well own patient experience questionnaires as part of their work. In my experience NHS engagement professionals are often extremely wary of change preferring to stay within the comfortable boundaries of face-to-face meetings (during work hours) or presentations in town halls to audiences of older people and the usual community champion suspects.

Implementing the framework without a top-down dictat will require a huge amount of engagement work with NHS engagement professionals to teach them that their local population isn’t that different from others and that the same questions across the nation apply to them too. After all a knee op is a knee op in Newcastle or Bristol.

The framework is a great step towards pushing patient experience up the agenda and I hope comms and engagement staff across the NHS embrace it and become experts in it alongside their clinical colleagues.

Ruth Carnall give us her views on Health and Wellbeing Boards in London

This video was taken after Ruth had given a Greater London context at the first of four London health and wellbeing challenge events that bring together the people and organisations that will make up Health and Wellbeing Boards (HWBs).

While the context may not be of interest to many (even though HWBs offer a lot to think about and act upon, especially integrated care) the point of me showing you this is to break down how easy it is:

  1. Film Ruth answering 3-4 questions with a Flipcam
  2. Download the films to my laptop
  3. Use basic Windows Movie Maker to cut them together
  4. Insert a couple of fade outs and fade ins
  5. Publish (wait a while as your processor works hard)
  6. Upload to YouTube
  7. Promote: Tweet, embed and share with staff and colleagues.

Total time taken to get all this done? About 2 hours. Easy!

Hint: Make sure the interviewer asks the interviewee to repeat the question in their answer and tell the interviewee not to jump straight in after the answer has finished so editing is made easier.

NB: Windows Movie Maker is included on most, if not all, Windows laptop and desktop packages, but is nowehere near as good as Final Cut or Final Cut Pro on a Mac

National Citizen Service (NCS)

This government initiative is an opportunity for 16 year olds to explore their skills, likes and dislikes through outdoor pursuits, helping their communities and creative endeavours such as making short films.

A lot of thinking is currently going into how to make the most of the talent, energy and enthusiasm that British youth have and I like the sound of NCS as part of the answer.

It doesn’t  prescribe a right and wrong Q&A style education like exams, it enables participants to learn through making mistakes (e.g. do taking the right gear when hiking) and gives them the freedom to be creative and explore what makes them tick, something the school system doesn’t do very often. Additionally, as the programme looks to add value to their CV, helping them show the breadth of experience required these days on job and university applications.

If you know any 16 year olds looking to use their long post GCSE summer well this year send them to: http://nationalcitizenservice.direct.gov.uk/