The following is the text of a talk given by Mark Brown at We Get Together 2016 at Salford University on 29th February 2016
I want to share a speech that I first made at NHS Expo in 2014 about social media and public professionals, sharing a stage with our very own Teresa Chinn and Victoria Betton. (The full text of the original speech can be read here.) It was written in an attempt to define and to stake out a role for health professionals in social media in a period where they were running the risk of being shut down and hemmed in overly rigid corporate cultures. Once I’ve done that I want to bring us up to date a bit with where I think we are now.
At a time when the NHS is experiencing its biggest challenges for at least a generation, I want to talk to you about the way in which social media can help to root the NHS in the fabric of communities. I want to talk to you about the ways that social media creates an opportunity for a whole new generation of ‘public professionals’, professionals doing their jobs while maintaining social media enabled relationships with a whole range of people..
But first I want to take you on a little journey…
It’s Sunday evening. The house is filled with the smell of ironing and leftovers and the sound of grumbling kids and grumbling adults all counting down the hours to Monday morning. You and the family settle down to watch something comforting and gentle on the television.
It’ll be set in some time between about 1920 and about 1963-ish. If it isn’t set then it’ll be set in a rural community somewhere as if it were 1920 to 1963-ish. It’ll feature an affable public servant. It might be a police officer. Or a doctor. Or a midwife. Or a district nurse. Or a coastguard. They’ll spend each episode doing their job but also being involved in a whole variety of shenanigans. The message will be they are a valued part of this particular, peculiar community of people. Occasionally they’ll come to blows with someone from The Ministry or similar, someone who represents the far-distant bureaucracy ‘who don’t understand our local ways’.
What these Sunday night comforts all share is the nostalgic appeal of a world where public services were explicable, knowable and human sized. It’s the fantasy of the local GP having a few pints in the snug of the local pub or the beat bobby who slurps tea in the local cafe. It’s a yearning for the days when public services felt like they grew from communities, rather than being distant, complex structures that lurk at the edges of everyday life. It’s the wish to feel like there’s someone who is part of our world that can also help to understand the world of public services.
Social media is in some ways the latest village square or local cafe. It’s a place where people check in to hear the latest news, catch up with friends, debate, flirt, ferment revolution and/or swap dirty jokes. In short, it’s a place where people do people stuff. Social media is where people are.
It’s very easy to underestimate how much of how the NHS works is opaque to the public. It’s like a big castle with high walls. It’s very easy to underestimate how much of how the NHS works and what the NHS does is opaque to the people actually working for the NHS.
There’s a difference between giving health advice and discussing health issues, just as there is a vast difference between individual treatments and the service which delivers them. The NHS isn’t staffed by robots. In fact we’re so scared that the NHS might be losing its human touch that we’re talking about training people in compassion and empathy.
So, what’s this got to do with public professionals and social media?
Public professionals talk about their job via social media. They combine two things: they appear in the public realm talking about their job in way that used to only be possible if a journalist thought you interesting enough to interview. They talk about the pleasures, they talk about the joys, they talk about the difficulties, they talk about the issues that arise from doing it. They put a human face and a human voice to what otherwise might seem a semi-robotic function. They help the public to understand the process, the practice and the limitations of healthcare.
Public professionals inform the public of their practice and in turn have their practice informed by the public. This is the second thing public professionals do: Public professionals talk to each other, they talk to non-professionals, they carry information into areas where it isn’t usually found. Using social media they get ‘out and about’. Public professionals learn from the blogs, tweets, videos and discussions that they find themselves in and carry this understanding back into their work. It’s easy to forget just how much taxpayer funded knowledge and wisdom is currently sitting within the staff of the NHS. It’s awesome but it also ends up hidden from the people who paid for it. Public professionals jailbreak that knowledge and carry it out into the community via social media.
In social media, information doesn’t just flow outward from providers, it’s a two-way traffic. People increasingly expect that organisations will speak back to them and listen to them.
It’s hilarious to me that the NHS has a challenge with engagement and involvement. Public professionals mix with people via social media (and often in real life too): they’re the person you talk to who is also a nurse, or a the person whose blog you read who is also a doctor. Public professionals are engagers and connectors by nature. You can’t do social media well without connecting with people. For people like me, who aren’t in the NHS, public professionals are a point of entry, a way into understanding it better and a guide to navigating the complicated flows of information, misinformation, spin and rumour.
If we trust people to make life or death decisions over others we can trust them to have opinions. If we’re battling for hearts and minds, which I think we are with the NHS, then public professionals are the best ambassadors there are.
Public professionals are a two-way conduit. They take information out of its NHS castle and while they’re outside, in the bustling town square of social media they learn, and talk, and listen and they take information back into the castle, too.
And, being part of a social media communities and relationships means public professionals stick around through the good times and the bad times because they’re a person relating to other people. You can’t be all ‘share our good messages, retweet our opportunities, big us up’ and then lock down your twitter account when a scandal breaks.
Doing social media isn’t a separate job from doing a ‘proper job’. Public professionals fit in blogging, podcasting, tweeting around the rest of their work. You don’t need to be a social media expert to do social media. You just need to know your subject and just need to be really, really passionate about discussing it.
The rules for being a public professional via social media are really the rules for any healthcare professional: Listen, speak with respect and care, know your subject, don’t talk about the benefits of your work without discussing its limitations, don’t think you know everything, be proud of your job but not blind to its failings and be an advocate for the best of possible worlds by understanding where things are worst.
I’ll just leave you with this:
While social media isn’t the be all and end all of things: The public sector sometimes only gets the urge to engage with people when it wants something. How do you expect to engage the community, care for the community and be supported by the community if you’re not part of the community? That’s what public professionals do. And that’s why I love ‘em.
So, all you public professionals around the room, bask in the glow of my praise. That was me making the case for your existence.
Now, more specifically, I want to talk about now. And what you can do about now.
The three spectres: Cynicism, ignorance and minding your own business
In our national debate about what healthcare is, what it costs and where it should be in future years there are three great spectres haunting the land.
The first terrible ghost is cynicism. There’s a lot of people who feel disenchanted and disenfranchised. Patients. Professionals. Observers. Despite stated intentions that healthcare would never again become a political football; we’re living through a period where there is an ever increasing sense of panic, of imminent collapse, a feeling of siege and of mounting horror. People are losing their trust in public institutions. Everyone in power is suspect. Everyone seeking power is suspect. Everyone questioning power is suspect. In a social media age; everyone who wants to be is barraged by waves of spin and counter spin. Far from focusing people on what really matters it makes people feel so far from being able to change what really matters that they begin to believe that nothing will ever change.
Good things; things that people on the inside of healthcare believe in; work hard for and which really make a difference become drowned in a sea of political announcements and press releases. People begin to lose their faith in you; in healthcare professionals and in the possibility of things ever being better. It’s people like you in this room; people who work in healthcare who really care, who can help to change that. Not by being relentless cheer leaders or by arguing with every critic and rebutting every accusation of self interest and ‘wasting taxpayers money’, but by being people online. By showing that far from a distant professional class; you’re people doing vital jobs in difficult circumstances with diligence; thoughtfulness and humour. The healthcare that we have rests upon the belief of the public in the reasons for its existence. It’s you, out there in social media, thinking and learning and talking and promoting in public that are one of the strongest weapons we have.
The second spectre chilling the bones and turning all around it sour is ignorance. Healthcare is complicated. Healthcare systems even more so. If we don’t work in healthcare we will usually count ourselves as lucky that we don’t know how it works. Most people only have a passing knowledge of what the real engines of health care look like. This is perhaps as it should be. We don’t , after all, all need to be trainspotters to get on a train. We just want to trust that the healthcare we need will always be there for us.
When the money starts to falter, though, the public is asked to make choices about what is and isn’t important. What should and shouldn’t be funded. Who should and shouldn’t take priority. Even those of us who a deeply dug into the business of healthcare often shrug, crumple our faces and say ‘well, it’s, err, complicated’.
The public is regularly asked to make or to accept decisions regarding health care policy that they have no way of fully understanding. You all understand that how we do healthcare is as important as the individual treatments from which that healthcare is constructed. In the vacuum; tabloid newspapers get to set health policy and public debate becomes a battle between bullshits. You all, as health care professionals or healthcare professionals to be, have the power via social media to bring truth; to add light and shade; to explain; and to help give context and human faces to what might otherwise look like dry debates held by grey and faceless people in offices or thundering headlines above lurid scare stories. You are the people who can bring debate back to what really matters: how do we help everyone to have the longest time in life with the least suffering and pain.
Every time you talk about the realities of your job and the questions it throws up; every time you share with others the best ways to get the best outcomes; every time you tweet, blog or facebook as a professional that cares enough to add to people’s understanding of how things work and how things are; you are helping others to understand and to see what really is important.
When political pressure to do one thing or another intensifies, you can be a professional who brings real knowledge and value to public debate rather than being a corporate robot or a political flagwaver more in love with winning an argument than making sure people don’t suffer.
The third and final spectre wrapping its ghostly arms around us is austerity and minding your own business. When there isn’t enough to go around; everyone turns to their own plate. At just the time when we need to be finding new answers to wicked problems, there will be many who want to concentrate on the frontline. On keeping their head down. On avoiding anything that might distract from the job at hand. ‘Just do your job,’ they’ll say, “and everyone else will do theirs.’ The problem is that this is exactly what people do while things around them are falling to bits. They bunker down; focus; stop looking around them. The visible horizon shrinks and life becomes a series of tasks one after another after another until it’s time to go home.
At a time where it’s becoming clear that more of healthcare is about what happens outside of the hospital on the hill, social media is giving us a unique way of building new relationships; finding new things out and connecting with both professional peers and with people on the other side of healthcare. At the time when we need to be helping people, including ourselves, make sense of the healthcare challenges ahead of us; too often we will be silent, inaccessible, absent. We’ll withdraw into our professional shells at just the time when we need to be reaching out to each other and to the world at large. We’ll let connections wither rather than tending to them. We’ll become the very thing that others accuse of us of being: inward facing; set in our ways; aloof and out of touch. At the point where we need to be making the case for the best possible healthcare and putting our heads together to see how it might happen we’ll instead isolate ourselves further as things crash down around our ears.
What is to be done?
If you are a social media user you have access to things that your non social media using peers and the generations who came before us do not. Geography, time and space no longer limit who you can meet and converse with. You aren’t limited by what books are in the library or which reports are on the shelf. You have a freedom of movement and association that allows you the chance to be in many places at once; in many conversations; with many people you’d never have met in real life. You can jump barriers and ignore boundaries. You never have to be alone with your ideas and your concerns and your ideas.
You can be the people who bridge the gaps; the people who know how patients feel; the people who can see what effect the changes of policy and practice have on wider public opinions and sentiments as well as within your profession and within the systems they sit inside.
You can make things happen in ways that were impossible before. Social media makes relationships possible that would never have even begun prior to its existence.
In social media you can build the trust we need to make sure that good things can happen.
So, that leaves me with one final question, as public professionals just what is it we going to make happen?
In social media, through things like we nurses and the things that will come after it, we have the possibility of building what has always been more theoretical than actual: a living, breathing community of people, both professional and not, committed to making whatever healthcare system we have the best it can be.
Social media can’t solve anything on it’s own. But when it brings us together and when it makes the usually invisible visible, we might just be in with a fighting chance.
Mark Brown is development director of Social Spider CIC. He is @markoneinfour on twitter.