What the Big Society means for patients, carers and staff. And why the government is not in charge of it. Paul Hodgkin FRCGP Chief Executive Patient Opinion

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The Big Government way Change is achieved by changing the rules Evidence base NICE and policy protocol Incentives clinician Individual journey Care Pathway ‘Variation destroys quality’ ‘Power enforces control’ Creative Commons Hodgkin/Patient Opinion non-commercial licence

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The Networked World way (aka the Big Society way) Voice-enabled, patient-led, loosely-coupled ‘Variation drives quality’ ‘Transparency gives bite’ On-line tools enable patients to act together +/- staff to achieve change

Voice has been democratised

Community is quicker, cheaper

It is easy to find people like me And cheap to collaborate

The web radically reduces the cost of: Having a public voice Finding people like me Collaborating All these are citizen-centric, not organisation-centric

So how does this fit with the Big Society? Cameron is following not leading Big Society IS the shift from hierarchies to networks Horizontal not vertical Resistant to external control Intrinsic motivation, not extrinsic motivation Voice more important than markets and choice People want to give because we want meaning

So what does this mean for how we relate to the NHS? We need to build systems for ‘us’ – patients and staff We can exploit the falling costs to do more for less We are in the midst of ideological regime change

Creating patient-led quality ‘automatically’ Rate providers for number of responses

Helping the patient voice ‘automatically’ drive up quality Rate providers for number of responses Get MPs involved Show who is listening to each story

Using Patient Opinion and NHS Local to create the Big Society Link with broadcast media Identify the thoughtfully passionate

Thoughtfully passionate people Number of people using a service Thoughtfully passionate people (who we can now find cheaply) Known/Complaints Indifferent Concerned Passionate Low strength of feeling High

Using Patient Opinion and NHS Local to create the Big Society Link with broadcast media Identify the thoughtfully passionate Support them to agree improvements Add Trust and PCT managers – on-line &/or off-line Agreed outputs published on Patient Opinion Future users verify that improvements are in place

Possible examples of ‘Big Society’ initiatives Yoosk Buddy - a social media radio from Sidekick FixMyHospital.org NameMyComplaint.org

Summarising the cultural shift From hierarchies to networks Citizen-centric, not organisation-centric Cheap tools! Much bigger than the NHS

Thank You Paul Hodgkin FRCGP Chief Executive Patient Opinion paul.hodgkin@patientopinion.org.uk

National government and MPs Patient Groups Regulators 3rd party payers Automatic notification Service User Relevant staff Story Response Comment s Improvements Comment from patient Local government National government and MPs © Patient Opinion 2010

Social value creation vs what the NHS will pay for Service User Relevant staff Story Response Comments Improvements Patients love it when they help create better services Social value is created throughout the conversation but the system will only pay for ‘data’ ie A B A Providers currently much more interested in data than in improvements