Next week I'm off to talk to commissioners of maternity services about online feedback from users of the services they commission.

Maternity care is one of those parts of health care where "clinical outcomes" are vital but usually OK, and "experiential outcomes" sometimes forgotten. I've blogged before on what women have said on Patient Opinion about their care.

So I thought it might be interesting to construct a quick Wordle of the 1,000 odd comments on maternity care that we can find on both Patient Opinion and NHS Choices. And here it is.

Last week the King’s Fund ran an interesting day on improving the experience of patients in hospital, as part of its Point of Care programme. Lots of good people with plenty of expertise and good ideas.

But one thing struck me quite hard: whenever people start talking about “listening to the patient experience”, the question of measurement comes up – and sometimes takes over. Often, there seems to be an implicit assumption that just by measuring something, we’ll create change. So let’s measure the patient experience!

I’ve got nothing against measuring things (when I had a career, it was as a quantitative health services researcher). But we’ve got to gain some clarity over what measuring is for.

Measuring is fundamentally about the past. How are things now? How were they last week? Did we improve? But nothing about measuring changes the future in any radical way. If anything, measuring reinforces a future which is similar to the past, only “a bit better”.

More than that, I’d argue that measuring is an act of power, and being measured is an act of powerlessness. By measuring “the patient experience” we reinforce, rather than question, the patient’s status as object, rather than subject. Nobody with real power gets measured.

The rhetoric of understanding “the patient experience” is about listening – but the implementation is about measuring. At the event, I asked whether there was a conflict between listening and measuring. Now I think there is.

To me, listening is an act of compassion which recognises a common humanity and, I believe, holds the potential to create radically different futures. Measuring won’t change the world: it will only tell you whether the world changed.

Unless you think differently?

We were really pleased to hear Andrew Stott, the government's director of digital engagement, talking at the Talk About Local 2009 conference in Stoke over the weekend.

Not only a clear sense of what engagement means and what the web can offer, but a mention for Patient Opinion too. Nice! 

We've previously blogged about the idea of "sousveillance" - the idea citizens can keep an eye on those with greater power in society, using what are now everyday tools such as video cameras, mobile phones, blogs, and, well, sites like Patient Opinion.

But it's always been a little bit theoretical. Not such a big deal.

But now, here comes an example of sousveillance where it really matters - and all done with texting.

Let's hope it works.

A project called myPolice won Glasgow’s Social Innovation Camp last weekend (congratulations), and was soon being described as like “Patient Opinion for the police”. Becoming a cultural reference point for siCamp felt good!

But it wasn’t long before the good old British press brought everyone down to earth, with a fairly misleading piece in the Sunday Times titled “Warning over ‘shop a cop’ website”. You get the picture.

To their credit, the team behind myPolice have busily been blogging their own point of view, and others have stepped in with incisive commentary.

There’s always a certain fascination in watching how “old media” react to new media innovation. They seem to zig-zag between wide-eyed wonder and snide dismissal, depending on the time of day.

In this instance, the piece was predictable, if a little depressing. But coming from a health research background, what struck me was how negative the press can be about not-for-profit social innovation, while endlessly carrying uncritical and hyped-up reports of “medical breakthroughs” and new “wonder drugs”, with little solid evidence and clearly commercial motivations. Pharma innovation good, social innovation bad?

Somehow, the Sunday Times even managed to misrepresent us too, describing Patient Opinion as a site “which encourages online criticism of the NHS”. I mean, how hard is it to turn up at the site and see for yourself?

Nobody would deny that we've seen enormous improvements in healthcare in the last 25 years - and not just in medical and surgical interventions, but in the organisation of care. Look at those falling waiting times!

But once in a while (or maybe a bit more often than that) we get a posting on Patient Opinion that makes us blink and rub our eyes in astonishment. Like this one, which arrived last week:

Last week I had to wait for 2 hours to see my GP, 45 minutes of which I was standing in a queue. There was a heavily pregnant woman in front of me who was obviously finding standing for so long hard, so I had to tell her I'd queue for her and let her back in at the last minute.

Sorry? Did you say standing in a queue?

That can't be right. Maybe the relevant GP surgery could get in touch and tell us why we've misunderstood.

When a word moves from the realm of the geekerati into the mainstream media, it's often a sign that some kind of cultural shift is afoot.

And so it is this week, as Victor Keegan writes an interesting piece in Technology Guardian on "hyperlocal". And, satisfyingly, Patient Opinion gets a mention.

To be fair, although we do offer some kind of hyperlocal potential, I don't think we have yet delivered it sufficiently. Perhaps our new API and RSS feeds will help a bit (see blog post not quite yet written), although we'll need to find some lat/long data to make them properly useful.

But Keegan's piece prompted a different thought: so far, the emphasis of hyperlocal seems to be almost entirely on providing information, rather than supporting civic involvement or community action. Again not yet delivered, but very definitely on the Patient Opinion"to do" list, is something a bit more along these lines.

As always in times of crisis and upheaval, we must recall Marx: "Bloggers have only complained about the world, in various ways. The point is to change it."

I think this applies to hyperlocal too.

We're recruiting - again.

Recently we promoted Kate - the lynchpin of posting moderation - to head up our new pilot project on web feedback in social care (residential homes, to be precise). So now we have to replace her.

We're looking for someone enthusiastic, sociable, and not too scared of the web.

Here's the job description. Get in touch if you're interested.

Just a quick note to say that the intrepid Alex Stobart is holding the second ScotWeb2 event in Edinburgh on 19 June.

The last (and first) one, back in October, was a lively and informative affair with a great bunch of people. I feel we should be calling this one ScotWeb2:2.

Anyway, I'll be there talking about Patient Opinion's new programme of work with all the mental health trusts in England, which I'm extremely excited about. I do think the web offers extraordinary new opportunities to users of mental health services, and I'm hoping we can make a worthwhile contribution to the whole area.

And who knows - maybe we can work out some way of providing a similar service in Scotland? We just need to find some people who could help make it happen.

We've just published a posting from someone who spent a few days on a hospital surgical ward.

It includes the following eye-witness account:

"When this very frail old woman as asked if he could pass the tea to her that he had just poured into a beaker for her, he said, 'Sorry love I am not trained for that', and just left her."

Hard to believe. Could this be the most depressing bit of feedback we've ever had?