Getting CSUs to click with social media

It is estimated around 500,000 online discussions regarding the NHS occur each month. But while the NHS tends to find it straightforward to involve older people, anecdotally we know it struggles to engage younger, more digitally active generations.

I have worked in and around the NHS for five years and during this time I have experienced and had explained to me the “sine wave” of configuration and reconfiguration. The basic premise is that new governments and NHS chiefs, keen to improve the service as a whole, continue to shuffle and reshuffle the pack until we return to our original starting point. 

‘Before rushing into a discussion of why and how social media can play a role within patient engagement, I would ask: “Why are we doing this engagement in the first place?”’

This poses an interesting quandary of how best to achieve meaningful engagement. On the one hand, small, nimble bodies that are tangible and within reach of patients are well placed in the community to make engagement meaningful and ongoing. This can be seen in clinical commissioning groups, local Healthwatch organisations and the plethora of voluntary sector organisations doing meaningful work with a positive impact.

On the other hand, this arrangement can lead to digital engagement going under-resourced and deprioritised − there is simply not the budget to see such schemes flourish, regardless of good intentions.

Online boom

In 2012, the UK was ranked seventh in the world for number of Facebook users with over 36 million. Also, 50 per cent of people now shop more online than on the high street, after tablet ownership jumped from 2 per cent to 12 per cent of the population in the past year. Meanwhile, a third of all advertising spending in the UK goes online. One has to ponder if such parity exists within NHS budgets. 

The beauty of social media is that it is naturally higher up the ladder of engagement. Patients, public and stakeholders will all be collaborating by virtue of their interactions. Gone is the era of “broadcasting” − and with it the tacit acceptance that just informing patients about what’s going on is enough. In fact, I would suggest it is no longer even the bare minimum.

‘The traditional methodologies that can often squeeze innovation out of the procurement process have been abandoned’

Before rushing headlong into a discussion of why and how social media can play a role within the scheme of patient engagement, I would ask: “Why are we doing this engagement in the first place?”

Here are some important points to answer that:

Intrinsic good: Most recently manifested in the popular slogan “no decision about me, without me”, commissioning support units, CCGs, Healthwatch and foundation trusts all have a part to play here.

Improving outcomes: By involving the public, we anticipate that not only the commissioning cycle, but the delivery of services will be improved. Through engaging the public, we can better understand the diverse needs of an area, bring unique patient perspectives to the fore and help local people understand the intricacies of how services are delivered.

Political incentives: The Francis report recognises how important commissioners are, describing them as “recognisable public bodies, visibly acting on behalf of the public they serve and with a sufficient infrastructure of technical support”. This is not to mention the trifling matter of the Health and Social Care Act and its resulting authorisation framework. In NHS England’s CCG learning and support tool, “domain 2” is called “Meaningful engagement with patients, carers and their communities”.

And what about drivers for choosing how it’s to be achieved? NHS England has recently been keen to remonstrate that times are changing in respect to the philosophy of procurement.

‘Social media is the business of sharing, be that feedback, comments or ‘likes’. CSUs are ideally placed to oversee this activity’

At an event designed to help small and medium-sized digital businesses enter the NHS marketplace and share their expertise earlier this year, Tim Kelsey, national director for patients and information in the NHS, and Beverley Bryant, NHS England director of strategic systems and technology, were keen to stress that the traditional methodologies that can often squeeze innovation out of the procurement process have been abandoned; there is a move away from the idea that past experiences of identical projects are the best yardsticks, they said.

Service drivers

I would suggest there are four key drivers relating to how services are bought, projects are launched and decisions are made. They are:

• Ease of implementation
• Cost
• Conferred legitimacy
• Innovation

CSUs have the size, reach and ability to deploy that an individual CCG cannot match. They are also charged with a commercial mantle; those that fail to offer relevant services that meet contemporary needs will ultimately fade away and potentially even cease to exist.

Bare minimum

When looking at the statistics regarding digital penetration, we have already reached a point whereby it is impossible to claim to have legitimately engaged with patients without doing so online.

Most CCGs and NHS providers have Twitter accounts, some have Facebook pages, and many are doing good things with them. The next question is: “How do we measure this activity?” and then, “How do these online conversations relate to the commissioning of services?”

‘By embracing digital, we can create the conditions for serendipity to occur. Who knows what fresh approaches to healthcare will prevail?’

A good deal of health services are highly unlikely to exist within the confines of one CCG’s catchment area, let alone be coterminous within these boundaries. By broadening out engagement activities to area teams, regions or even the whole country, patients and the general public will be able to influence commissioning in a much more genuine and meaningful fashion.

Social media is the business of sharing, be that feedback, comments or “likes”, and the digital landscape has no boundaries. CSUs are ideally placed to oversee this activity, covering a broader area within which care pathways weave from county to county, ward to ward.

What is innovation?

In regards to innovation, a digital and social approach meets both criteria of what innovation actually is. The dictionary definition is: 1. The action or process of innovating; 2. A new method, idea, product, etc, eg: “technological innovations”.

Harnessing the power of social interactions that are already taking place about the NHS will be a novel step-change to the status quo. What is perhaps more interesting is how this will encourage further innovation in relation to service commissioning and provision.

By fully embracing digital, we can create the conditions for serendipity to occur. Who knows what fresh approaches to healthcare will prevail when we encourage patients, clinicians, carers and the general public to interact online?

CSUs around the country are springing into action, responding to a tender for the regional provision of a communication and engagement programme issued by NHS England. In the cyclical nature by which it seems all things are achieved, or perhaps orchestrated at a national level, we have arrived back at a situation whereby CSUs will oversee engagement at regional level.

What is encouraging to see is the start of a new era, with the procurement process not limited to awarding a single winner and keen to stress the spread of good practice as the overriding objective.

Paul Mitchell is head of business development at Membership Engagement Services, part of Electoral Reform Services