Published on January 31, 2014

NHS Citizen: Exploring the Discover Space

NHS Citizen

By Marilyn Booth

I'm spending five days (between 30/01/14 and 05/02/14) with Involve to learn a little more about their approach to public engagement. Normally, I can be found in the @bisgovuk (Department for Business, Innovation & Skills) Digital Communications team, where I'm focused on supporting policy teams to engage online. If you'd like to contact me while I'm here at Involve please do so through

NHS Citizen

The NHS Citizen project is about NHS stakeholders and citizens working together to co-design an Assembly space that will enable the NHS England Board to take the concerns of everyday citizens into account when designing and delivering services.  So, it’s very much based on an understanding that services are best delivered by listening to the needs and experiences of those using them.  It’s not a new structure as such, (there’s already a history of public input into NHS and health-related issues) as opposed to a new approach bringing people together in new ways.  And most importantly, it’s got the full backing of three key members of the NHS board, showing the importance of senior level buy in.

There’s not a predetermined outcome for what this Assembly will eventually look like – that’s being played out and developed in a very open and iterative way.


Building 3 spaces

I was particularly interested that the Assembly is going to have 3 distinct elements to it:

  • A Discover Space: as its name suggests, discovering what intelligence exists in both on and offline spaces on  health (or should that be health, the public healthcare system and how people interact with it?)
  • A Gather Space: a bridge between Discovery and Assembly. Here flagged issues from the Discover Space will be worked on and explored in more detail.
  • The Assembly Meeting: twice yearly meetings where the NHS Board will meet directly with citizens to consider a selection of issues in a deliberative and open way.


Discovering & Listening

From a digital perspective, the Discover Space concept is fascinating, and is in itself similar to what we’re trying to get to with our Listen, Engage,… model  within BIS,  bringing social listening and offline intelligence into the mix of evidence available to policy makers.




Why? Well, the Discover space is very much about  gathering and flagging opinions through both on- and offline engagement to give a “picture of the conversation” around public concerns about NHS- or health-related issues. I love the fact that it’s going to be “always on”, and that it’s place in the system represents a high level understanding of the importance of online insights.

Within NHS Citizen, listening will be driven in two ways:

  • Citizen driven listening: identifying what the public are discussing around the Health system.
  • NHS driven listening: when policy makers and the NHS itself  wants to hear more about particular topics.

Having the perfect combination of the two is probably something that most of us involved in social media monitoring and embedding digital are aspiring to.  So, in BIS, we know that – from both corporate and personal channels – we’ll be listening out for intelligence on particular policy areas.  Equally – if our ultimate ambition of getting all teams to listen online is met – this should see us moving towards greater citizen driven  listening by individual policy makers (in this case citizen including consumers, businesses, universities and the full gamut of possibilities dictated by our audiences).


Challenges for Discover

At the minute, there’s a deliberately open vision of what the Discover Space will look like.  The scale and breadth of the people and topics that could be embraced under such listening are huge.  And that in itself creates its own particular challenges for the success of this project, including:

  • The volume of sentiment that’s likely to have to be discovered, explored and analysed;
  • The fact that issues aren’t always likely to be discussed in the most obvious spaces;
  • How to frame the breadth of the necessary search criteria;
  • Where to set the boundaries of the listening process;
  • The impact that listening could actually have on existing naturally-occurring conversations;
  • Integrating the intelligence from online discussions effectively with that from offline discussions;
  • Balancing prejudices against “anecdote” versus data that’s been collected in more (traditionally speaking) robust ways.  Involve and the other partners are perhaps well-placed to advise on that issue given that similar arguments exist around the use of small scale deliberative projects versus larger-scale data collection methods.
  • Ensuring that the conversation isn’t deliberately skewed by people who may want to try and impact results.

So, for example if @NHSCitizen are going to listen beyond those “in the know” about the project, then it’ll be (hopefully) be a continuous digging exercise, with detailed drilling down into web-based conversations around health and the NHS happening beyond the usual suspects of Twitter and Facebook. We know, for example, that contentious employment issues are discussed in unexpected places, including online forums and networks where trust has already been built up:  how will the system be able to listen to those conversations. And does it matter if they don’t?

There were also a couple of interesting tweets from people in yesterday’s open session to shape the Gather phase  around people at work missing out on the conversation.  That doesn’t necessarily have resonance for a project where listening can take place at any time, but does serve as a useful reminder for those of us trying to actively engage with employees or businesses during the working day that there will be people who just can’t always be online.

I’m sure that Public-i, who are delivering on this part of the project, are already well-immersed in dealing with all these issues.


Finding out more

It’s still possible to get involved in helping shape the overall shape of the Assembly process  by listening in to and commenting on the live blog and Twitter feed from events


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