'I don’t want to be data, I want a conversation'

Data is important stuff and really necessary for any business if it's going to run efficiently especially one as big and unwieldy as the NHS.

But at a personal level no one wants to be data.

This gives rise to a real conflict in the way the NHS sees social media. The people giving their opinions want a conversation. Busy staff on the other hand just see data and ask 'what's the pattern in these 53 stories about our cardiology department? What do all these tweets mean?'

These are reasonable questions but step outside the NHS's mind-set and ask ‘why is the patient telling us this story? Is it to add to a database? Or to become a statistic? Once you do this it becomes clear that what patients want is a response, a conversation. They want to know what you, their particular bit of the NHS, think about what they have told you.

So when you get a gift of feedback from a patient (and it is always a gift!) the first requirement is to respond, to enter into a relationship. No one controls these new pubic conversations. You can not used words like 'owned', 'captured', 'mined', 'stored', or 'lost'; when you talking about conversations because they just dont work - they are all data words. Instead conversations are real, live, living human stuff. So they need to be discussed, argued about, laughed about, and generally taken seriously. More relationship, less tick box.

You can see all this on the site. For starters look up any trust or service and you will typically see that there are around 5 times as many stories than there are ratings. People will rate stuff, but they are doing it this for us. By contast they share their stories for themselves, their friends and their family - as well as us.

Or look at how Molly responds to this thoughtful hard hitting story about maternity services in South London, taking the points seriously, responding with thought and care.

Have a look at this fabulously quick improvement by Surrey and Sussex Healthcare (which won Ian MacKenzie our Patient Opinion Hero of the Week award!) and then contrast it with the 'Thank you for your comment please contact our PALS department' that so many hospitals default to. Human response vs. corporate monotone.

And if you think laughter was an exaggeration have a look at this conversation in rhyming couplets between a patient and a practice manager.

Making this leap is hard. After all data, ratings, surveys are so much safer than the intimacy and risk of public conversation. (Even when you're not conversing in rhyming couplets!)

Living with social media is a bit like living with a cat (good to have around, needs regular, intermittent attention, unpredictable, brings in the occasional dead bird as a present). The way the NHS handles social media by contrast is more like the storm troopers here (rigid, formulaic, tend to fall over, treated as a bit of a toy but surprisingly painful when you step on one in bare feet).

The NHS is a mighty thing but my money is still on the pussy cat.