NHS reaction to online patient feedback is changing

In the early days the NHS thought the web was best ignored but it's learning that online feedback can be positive, says James Munro....

Health service staff are, perhaps understandably, cautious creatures and are taking their time in embracing the world of social media and online feedback. But, looking at how the NHS has responded to public feedback on Patient Opinion over the past six years, we are starting to see some welcome changes in how both organisations and staff regard the online world.



The starting point is perhaps best illustrated by a reaction to one of our first postings back in 2005. Within a couple of hours the director of communications from the local NHS trust was on the phone, demanding to know what we thought we were doing. "This probably isn't legal, you know" he muttered darkly.

In those early days many NHS staff we spoke with saw the web in the same light as their local newspaper: probably out for a fight, best ignored for as long as possible. "We'll only respond to stories on the web if they're really serious" we were told, "and we'll never apologise, for legal reasons".

We do still encounter that attitude from time to time – one NHS trust told us recently that the board had a policy of never responding to anything online (perhaps they think the web is just a phase?). Slowly but surely, though, more and more health services are realising that social media – and feedback from their patients and carers – may have an important part to play in modern healthcare.

Having said that, the difference between negative feedback, on the one hand, and complaint, on the other, is still one not often recognised by the NHS. People give their feedback – positive or negative – to the service because they want it to learn, and improve (not because they want to make trouble or gain compensation) as the relative in this conversation explains so clearly. Yet, time and again we see responses from trusts which seem to suggest they'd prefer a formal complaint (offline, of course) rather than simple feedback.

The other big learning point is in understanding that corporate language and defensive postures don't cut much ice in social media terms, where the emphasis is on informality, and empathy above all. Compare, for example, the responses to this deeply upsetting experience of suicide in a family, to the response to this experience of post-natal care. Where would you be happier seeing a loved one treated?

Progress from here on will depend on realising that online feedback isn't just a fancy new way to collect yet more data for the NHS. People want more than simply the ability to "rate" their local hospital as if it were a film – our healthcare matters far more than that – and formulaic responses from the "patient experience office" risk making things worse not better. But when real, respectful, exchanges occur feedback can lead to resolution.

Social media offers the NHS an invitation to a different kind of relationship with patients and carers – one which is more equal, more collaborative and yes, more transparent. And just as relationships with healthcare staff in the real world have the power to heal – or harm – those who depend on them, so we are learning that the way that the NHS responds online can also have a powerful impact, for good or ill, on its users.

James Munro is director of research and informatics at Patient Opinion, a non-profit organisation recording patient feedback on health services 

This article is published by Guardian Professional. Join the healthcare network