Public feedback - not a monologue

At the recent Scotweb2 Unconference, James Munro presented Patient Opinion, a website allowing users of the NHS to post feedback on their experiences - very similar to rateMDs.com, which operates in the US. It could be described as 'Trip Advisor for the NHS', in that you can check out a hospital or practice before visiting.

Munro stated that this process was about change, not choice. The aim is to create a dialogue between the service users and service providers. Actually, users were already talking about their experiences - on blogs, flickr, youtube etc - and Patient Opinion aims to provide a single platform to collate these comments and, crucially, to allow service providers to see and respond to the feedback.

The business model sees NHS services being asked to subscribe to get access to specific information, reports and the ability to respond to individual comments online. This then provides them with a platform to report the progress they have made in responding to a complaint, and further drives the idea of change.

The great advantage for the public is that they have a platform to report (often embarrassing) issues anonymously, whilst knowing that real change is also possible as a result. Because the site is independent, Munro claims that people are less inclined to leave the sort of rants that the NHS might expect to be inundated with should the site be owned by them. NHS Choices, the NHS's own site, rejects about 24% of the feedback it receives. Patient Opinion rejects only 5% - not because the standards are different, says Munro, but because people can see the real-life benefit of an independent site and are more inclined to leave legitimate, constructive feedback. And whilst positive feedback is great, the complaints provide the most value.

So what does this mean for other areas of the public sector? One problem is that we can not 'force' third-party independent solutions to come into being - they have to develop organically. Of course, they are already happening across the Web 2.0 platforms mentioned earlier. The trick is to tap into these - not trying to moderate or silence the discussions going on, but to contribute to the stream and show people that we are listening and that change is happening.

There is a major cultural shift required to get backing for this. Once out there, comments can not be taken back (you might be able to delete the original comment, but who knows where else it has gone). Anything you say must be honest, accountable and representative of the organisation. This may mean it has to go through levels of approval, which can ruin the pace and spontaneity of the dialogue (e.g. whilst you're trying you approve a response to one comment, five more have already cropped up). And there are dangers for those not playing by the rules - think of the recent story of the 13 Virgin Atlantic employees sacked for comments they made on Facebook which, their employers felt, brought the company into disrepute. Nevertheless, it is a whole new channel of communication which we can not afford to ignore.