Forget your enemies, it’s your Facebook friends you need to fear

Nearly a decade ago, Dan Gillmor described the transformative effect of social media on journalism “from a lecture to a conversation” (We the Media, 2004).

Other industries have seized on the power of the virtual dialogue with the customer to feed product development, market research, customer service and brand loyalty. The entertainment industry, marketing services, consumer technology and retail have used social media to change how they do business and how their customers perceive them.

Even the old media have been transformed by new media. As online publications drove down advertising rates and free information undermined paid-for circulation, print publishers have embraced new media to survive.

Social media has changed the course of history in even more dramatic ways. Skilful deployment of social marketing techniques by the Obama campaign is widely credited with putting America’s first black president in the White House. In the Arab spring, social media helped bring about the opposite effect and was instrumental in dismantling several regimes.

By contrast, use of social media in the NHS is – to put it kindly – in its infancy. The most common use of the technology is in distribution of public health messages – still a lecture – and while we exhort NHS colleagues to give patients a voice, we deny NHS staff the means to listen or reply by blocking access to social media in the workplace.

People who think there is no place for social media at work or that it should be left to the pointy heads in the comms team are missing the point.

Facebook isn’t the answer, but it shows what’s possible. Facebook is eight years old and has 950 million active users. That’s engagement to die for.

Social media promotes easy access to information, connects people in ways that were not possible before, enables collaboration and dynamic networks – virtual organisations able to form and disband at speed.

It doesn’t take a great leap of imagination to see how the same tools could transform conventional and expensive methods of consulting health service users, enabling many more people to take part and achieving the political aims of greater representation, transparency and accountability.

Harnessing people power is good for business – that’s the evidence from the commercial world, where companies that adopt social media enjoy a 50% increase in customer satisfaction, according to McKinsey.

At the other extreme is Netflix, an online entertainment company whose decision to change its pricing strategy provoked fury among customers. A revolt on Twitter and Facebook led within the space of a few months to the loss of 800,000 customers and two-thirds of the company’s market value.

Engagement has got to be an integral part of what you do. You hear the same message wherever the NHS is doing a good job of working with patients – not only is it everyone’s job, it is the job. Like or not, social media will be part of it.

The statutory duty to engage imposed on NHS organisations is irrelevant compared with the power of social approval and its equal and opposite destructive power. Commissioning organisations, hospital trusts and other providers don’t need to worry about regulators or government departments; it’s their friends and followers they need to fear.