• NHS is very protective – it’s like a family. Previously had an impenetrable armour – you don’t complain about NHS because you might have to use it again – but you need to give feedback, the ony way to do that has been to complain
• As a frontline nurse i’d get immediate feedback from the patient and their family, – would be instantaneous, spontainious – once I moved into management role I got no feedback - nurses, patients tell you what you want to hear – as management how do improve services if you don’t get direct feedback?
• Opportunity into insight of patients journey – staff have to open up to level of scrutiny that is personal – complaints are usually 2 months old by the time you get them on the shop floor, with Patient Opinion it’s next day – it’s not about outcomes it’s about people’s individual experiences
• Our first posting was very negative about services – but it hit the nail on head about gut reaction of staff, culture issues, and attitudes – from that the engagement and involvement of staff was positive – especially as they saw it as personally scrutiny
• We have very strong service and user forum locally who have tried to make an impact and make change – before Patient Opinion they had real trouble, this gave front-line response – our stakeholders were ready for this improvement
• We never learn lessons in the NHS we keep repeating mistakes- however when it’s real and not in a book staff respond far more passionately rather than learning about change dynamics and leadership theories
• Our service users really grasped it – used it to communicate to us – and it gave us an opportunity to communicate back to them. Accessed and shared care plans and therapy techniques
• Posting goes to team, team then formulate response, goes to service manager, then to service as whole for sharing – can respond in 2wks

Discussion re how many stories you need a year to actually instigate change; need to manage #mps09
If gets to unmanageable level then suggestion to crowd source the top stories wld like to see response to #mps09 (tweets from GeorgeJulian)

Big problem with why councillors drag their feet = feel like they’ll be overwhelmed. Patient Opinion potential solution is crowdsourcing most important posts – how much of the response can be supported by the community?
Paul Hodgkin: We haven’t gone down the route of letting people come in sideways – in order to where appropriate we nee dto get info out of the staff - the solution in hull isn’t going to be the same as the solution in st helens

were does that link to patient choice? the stories help people decide a bit. why are PH – people telling their stories- to create change and give something bcak, that doens’treally fit with the consumerism approach
PH – ill people are  really lousy shoppers – you just want someone to care for you

Maria Slater  – drive wasn’t about targets or numbers, was about making life better for people. 5 main localities in 5 boroughs – because of strong user and carer focus they did the advertising for us so wasn’t advertised to a major extent – don’t know if that would make a difference.

Every posting was printed off for everyone who didn’t have acces to Patient Opinion to read – we advertised it internally so the spirit was ‘for those who are using it lets’ improve it’ – you’ve got to be a user to make change. For me as a nurse and also as a manager we are accountable to the public – a web-based feedback de-stygamises the myth and makes you accountable – is a realistic and effective model of change management

Mandy Wearne, NHS Northwest: working with strategic health authority – core group of PCTs looking at transforming services with web2 based services – ways to get stories, feedback or transform service for someone to get better experience

We need to trust front line staff more – sometimes it’s because feedback goes to PPI , PPE and complaints / litigation you reach wrong mindset – they have stock answers for things which defeats the object. (NHS litigation bill = 1.2bn per year) You need to hear the voice of the staff that cared for you if someone’s been brave enough to give the voice of the patient

George Julian – need to give people chance to learn, reflect, and then spread – people don’t get chance to reflect enough in their personal lives

Transition from one service to another is the current problem – can we translate this service into other uses… Patient Opinion is looking at the restorative justice system – can we feed these ideas into a restorative NHS?

In an engaging session they described as an ‘Un’ session Paul Clarke (@paul_clarke) and Mark O’Neill (@marxculture) looked at the issues of putting informal and formal processes together to create new services.  As one participant said “It was a cross between Socratic and Stand-up”.  Here’s the liveblog:

Richard Smith , chairman of Patients Know Best asks – is the main barrier actually us? how many of us have access to our medical record online? I do, but it’s total rubbish – you can find out far more about me on the web than you can from these

Q to Sam Hudson-what is your experience of the level of knowledge people want to use?

A – it’s about ‘my’ technology – how do we participate with health and social services? people want face-to-face interaction, still want paper, TV, and phones. We need to look at our audience – who do we want to listen to and where are they currently having conversations?

Glen – I help senior managers and clinicians have conversations – I got frustrated as an enthusiast as potential of web technologies to transform relationships with patients and medical staff – one of the things we’re doing is trying to accelerate the use of web technologies in general around clinicians and disease groups – small groups of people generated loads of ideas about how tech can make their lives easier and create more value in their relationships with each other. It was eye opening to see just how easy these things are – people just aren’t curious enough about how tech in part could transform the quality of relationships between patients and carers- we need to find ways to help them see the potential

Getting in touch with communities is really pertinent. Communities are designed in lots of different ways – can we use the same tools and tech for all? We need to identify what people are saying, how they’re saying it and where.

Paul Hodgkin, founder of Patient Opinion-  the issue is the technology almost too seductive – it takes time to work out what we are going to do with it. It is part tech, part business model, part a complex dance between NHS, population and providers like us – getting tension right between what only the state could do and where the place is for all these other initiatives – and how do we use these and the power of the web to transform this to be useful and productive. The combination of tech, people, business model, and balance between state and civil society is not easy

Gary Ashby, Programme Director NHS choices: Our role is not actually to be a website – you don’t go to the doctor for the building – you go for the content because you trust it. Having said that if you go on the web and you type in NHS you would expect to find an NHS website. We don’t actually spend millions of pound on the website – actually the site is cheap the expensive part is the money spent on making sure the information is correct.

I don’t think the competition should be one way or the other – it should be about both. But – how do you make that into a coherent story to help improve the services? We need to work together and share the information so we can feed it back into the NHS. I want to get the local NHS involved- this is where things like patient opinion can have big role- get local entities to understand what to do with all of this

Q- a lot of what we’re talking about applies to many pub services – is there anything intrinsic in NHS that means we need to think about differently?

Karen Dooley, Dignity in Care – we should use NHS to work in the way of upmystreet – information populating around your local area

Heather Leach – are we trying to build a relationship or provide info? roles are very different

Laura Bunt, NESTA – often ideas come from professionals and users within the service – what’s the mechanism for finding out what the issues are -do they come from outside the existing system?

We here are unrepresentative of the typical users- people who need these services the most are the most unlikely to use them – 10million people in UK not online (digital inclusion issues)

Departments within health service need to talk to each other – the communication problem is bigger than getting people to use online tools  – communication is key

There is a challenge over 3-5 years for public services, especially financially – we need to make sure we can say why this is important, what it’s going to cost, and have a clear offer about what we’re offering

Julia Holding – form needs to follow function – technology first is the wrong method. We’re commissioning a digital ecosystem which is about making info for opportunities for people to engage where they are and what they’re doing. We need to make sure that whatever we do makes a difference to quality of service, if it doesn’t we shouldn’t be doing it. Making sure we focus on content, to a large exent user-driven -  content not control. The NHS needs to be brave, remove the firewalls and harness the conversations that are going on

The opening session grabbed attention for me with the strong call from James Munro about the need for ‘Rethinking’ how we deal with public services.  Denise Stephens of enabledbydesign.org was inspiring in her call for much greater involvement by users in the design of services.  “Equipment provision feels like it’s a bit stuck in the Dark Ages a little bit” she said and she thinks there is scope for lots of innovation but it needs a much more open approach.  Tom Loosemore of 4ip called for a radical approach to hold ‘those in power to account’ and that this was a key role of the 4th Estate (the media) and the 5th Estate (us!).

What’s it all about?

The web has already transformed the way we book a holiday, buy a camera, and share the snaps. Whole sectors – media, music, finance, publishing – are being turned upside down. But where is the impact on our public services? Why (with a few notable exceptions) are they still so top-down, so inflexible, so hard-to-reach? In sum, so last century?

This conference is about how that can – and already is – changing. It is about how the traditional public sector values of fairness, solidarity and equality are meeting the new networked values of participation, transparency and usability to create new services or add to old ones.

The web has created a new digital gift economy in which everyone can be a contributor and new kinds of public service are becoming possible.

It won’t all be top-down any more (and neither will this conference). We won’t be defined any longer just by what we need from the services we rely on, but also by what we have to give, and how we each can contribute to making our public services better.

This conference is about all that and more. There will be plenty of new ideas – but also plenty of practical examples of how people are already using the extraordinary gift of the web to improve, extend or challenge our public services to be the best they can be.