Care homes seminar programme_final v4.DOCX (19.22 kb)

Conversations are the life blood of Patient Opinion – carrying your story to the heart of the NHS is, after all what we are all about. But why just the NHS?  Conversations are the stuff of politics and democracy too – why not share patient stories with MPs, local authorities and scrutiny committees?

From 7 July 2010 Patient Opinion will begin to do just that. We will be offering a free email alerting service to all Westminster MPs, so they can be automatically alerted to what their constituents are saying about local health services and post a response if they want. The new service is being launched next week at Portcullis House in London.

We hope that this will have many benefits. Patients stories and experiences will have greater reach and power. MPs will be able to monitor what local people think of their health services and, if they want, show that they are listening by posting comments.

Patient Opinion is already showing how stories are helping improve health care - and soon we will be able to show which local and national stakeholders are actively listening to any particular story too. Is your LINk listening? Is the provider using Patient Opinion? Is your MP in the loop?

All this is an exciting new development in online civic engagement – a way to use the power of voice to promote discussion and help bring a truly patient-centred health service into being.

The Big Society is often seen as being about two things: freeing data, so that it can be mashed up and better used. And freeing the energy of citizens, via social enterprises, to solve problems in new ways.

We think it is also about creating structured, helpful, local conversations that create more engagement and many more service improvements at much lower cost than has ever been possible before.

The Big Society is easy to lampoon but I wonder….

When Thatcher was elected in 1979 privatisation did not figure for several years but gradually became a core policy. This happened partly because it raised handy billions but also because it acted as a clear policy principle: wherever possible people not the state should end up owning stuff.

Clearly there are echoes here for the Big Society. In times of recession the Big Society may – perhaps - be a way to reduce the bills by outsourcing services onto citizens. Dubious but possible.
More important though the idea of the Big Society may turn out to be the same kind of divining rod for this government as privatisation did for Thatcher. Faced with a policy dilemma both wings of the coalition may find it useful to ask ‘will this policy increase the power of the state or decrease it?’

It might seem counterintuitive for the politicians to give power away – but then it was counter-intuitive to many when Thatcher gave away the family silver in her privatisation fire sales.

But perhaps this credits politicians with more power and insight than they deserve. I think the real importance of the Big Society is not because it tells where Cameron will take us, but what he is following. He senses incoherently that the relationship between citizen and government has already changed and the Big Society is his way of trying to ride the change. He hopes that this will lead to a renewal of civic virtue – that people will flock to start schools, car pooling and recycling. Well that might or might not happen but what sure IS happening, and what is driving the change that Cameron transmutes into the Big Society, is people’s willingness to share their stories via social media. Without knowing it perhaps Patient Opinion is already part of the Big Society!

Connecting people up is what Patient Opinion is all about. Connecting the insight and wisdom of past patients to future patients. Sending your story to the ward, and then getting their response back to you and the local PCT.  That’s what we do.   

So it was great to read hear Nicholas Christakis talking about his latest work on social networks on the RSA down load service. Christakis is a medic at Harvard but also a sociologist who has spent the past 15 year studying social networks.

Turns out that all sorts of things can be seen ‘flowing’ through networks – including many sorts of behaviour. If I’m obese then it’s more likely that my friends will be obese. What’s more if my friend’s friend is obese then I’m more likely to be obese. And the same effect works for happiness, or drug use, or altruism. People who know each other face to face create similar patterns of behaviour in each other and this effect is detectable for up to 3 degrees of friendship – in other words in friends of friends of friends who of course have mostly never met each other. Which is weird but if nothing else shows how profoundly social humans are.

So what’s this got to do with Patient Opinion? Well we’re thinking of making some of our connections more visible to everyone. First we want to explore letting ‘friends and family’ follow a particularly story. These will be people who the author has invited to follow their story and who have clicked ‘Yes’ on the invitation. Every time there is a response to a story these people will be notified of it, just like the original author is. We would then display the number of Friend and Families that were following each story.

Second we're thinking of doing the same for organisations and other stakeholders. So if the PCT, the hospital and the local LINk are getting automatically notified of that particular story then you‘ll be able to see them just by clicking on the ‘Who’s tracking this story?’ button. That way it’s clear to everyone whether we’ve succeeded in getting any given story to just the right people who need to hear it.

But perhaps we should let anyone, any member of the public, follow any story. Surely that could be even more effective. But Christakis work on networks indicates that this isn’t so. It might be gratifying to know that 63 people (or 263) are following your story  but FaceBook ‘friends’ are not real friends (and do not exert Christaki’s's network effects on each other). So what we’re really interested in at Patient Opinion is how to leverage each author’s network of ‘real’ friends and families on behalf of their story. And from the hospital’s point of view knowing that the mini-network of highly involved people around each story see the hospital's great response and the changes that have been made means they are likely to become real ambassadors for the hospital. Even when if in the original story things didn’t go so well.

Hey, you think I'm going to let myself be outdone on video? No way!

So here's me speaking at Nick Marsh's excellent recent Service Design Thinks evening.

Ten times as long, but only twice as embarrassing (to me, anyway).

James Munro, Patient Opinion - Service Design Thinks 3 from Nick Marsh on Vimeo.