Twenty years ago on December 31st 1999, I stood in the cold, counting down the seconds to midnight in Market Square, Nottingham. We were warned that the world may end (digitally speaking of course). The fireworks ignited, we raised our glasses and braced for the crash as we entered the new Millennium, but as expected, life went on as usual.

20 years on and another milestone. In 2019 Nottinghamshire Healthcare NHS Foundation Trust celebrated a decade of capturing online stories about patient and carer experiences on Care Opinion.

So, how have we changed and what did we learn? The gift of stories in a challenging, rapidly shifting world of healthcare means that in 2020 we have thousands of Care Opinion stories. We know what people think about us. Good and bad. This rich source of information, learning and data is essential to our reputation and how we deliver healthcare, but we must continue to learn from this gift.

The digital revolution is phenomenal. From ‘old school’ analogue to smart devices means we are hyper-connected. Lots of us (me too) welcome this transformation but for others, being connected (digitally speaking) still remains inaccessible or unwelcome. From poor social mobility to practical issues with connectivity, our digital footprint trails a permanent mass of information and data with every click. It also comes with a warning to be increasingly vigilant about online privacy and becoming ‘clickbate’ or worse still, the victim of a hacker. If we can’t tell the the difference between real and fake news today, what does the future hold?

However, it’s not all doom and gloom. We just need to adopt good online habits and think of the reputation we create by the clicks we make. Here’s the positive bit; the benefits mostly outweigh the bad stuff but that’s not to ignore the havoc it can create in a worst case scenario.

Now then, this this is the bit that makes me smile. We can connect in ways we never dreamed possible whilst continuing to improve our patient and carer experience. Stories on Care Opinion are so compelling! Connecting with people who may never have shared their experiences before creates an optimism. Because authors are anonymous it comes with a freedom to be open and honest and staff get a chance to speak directly to the author in their reply. It was and still is, another gift to add to the expanding list of why we need to keep telling stories.

From tackling loneliness to dating apps to shopping online and leaving feedback for all those Amazon purchases, in 2020 we are asked for our opinions more than ever but how we ask for those opinions really matters.

Care Opinion has in truth, been a ‘slow burn’ for Notts. Healthcare requiring tenacity and a bit of rule breaking! In 2020 there’s still only a small percentage of people leaving online feedback about their healthcare experiences but this is changing. We kicked off on our Care Opinion journey excited and full of hope that it would make a difference. Today, we know it has changed the culture of how we work within Notts. Healthcare for the better. Some of our services welcomed it with enthusiasm whilst some staff were initially resistant to change; human nature with anything new.

From the old to the new
Patient Opinion to Care Opinion

In the early days, we used mainly iPads to collect stories. One of the downsides to new tech (as it was in 2009) is that it quickly becomes old tech. When devices become obsolete they are unable support new software due to the operating systems. The NHS had entered into troubling economic times. Our IT department didn’t support Apple devices and they still don’t! We stumbled but we didn’t fall. Welcome to austerity in the NHS!

With any problem you have to find a solution. We stalled a bit with some drop off in posts whilst some of our teams stopped using Care Opinion as often in favour of our own in house feedback surveys hosted on Your Feedback Matters website (it’s brilliant by the way, go on, have a look) and it hosts Care Opinion there too.

We had to adapt. We reverted to collecting more stories using paper forms along with a reduced number of iPads, NHS laptops and desktop computers. This retrograde step wasn’t anticipated. We quickly found that we couldn’t sit back hoping that people would naturally share their stories online. We still use loads of paper forms making it hard to go paper free. Sometimes tech lets us down in the NHS and I don’t mind admitting it’s frustrating! When smart phones took over from the old style mobile ‘bricks’ it meant that Care Opinion can now be used on the move at any time. With 1.7 billion Smart phone users predicted for 2020 it changes the landscape again. New features such as single device kiosk mode can make the process easier. All positive stuff.

We still need to encourage our staff more than ever to reassure anyone using our services that it’s worth sharing their story. You have to ‘Show and Tell’ people where to go. The ‘how to‘ guide for staff and volunteers written by Care Opinion made it easier. Great communication from our Care Opinion heroes, those staff and volunteers who know that this approach really works has meant that we get stories from the heart of care. Stories that make you ‘well up’, worry, laugh and also fill your heart with pride. With 888 staff subscribing at Notts. Healthcare we must be doing something right but there’s much more we can do.

This is the good bit. Staff answer 100% of our stories. Anyone who can’t or won’t use the Care Opinion website, has a choice of paper forms or phoning Care Opinion to leave their feedback. Tell your story

Care Opinion won’t share your data other than your story on their website. careopinion privacy Our Involvement Volunteers can help people who may not want to write down their feedback. You can always draw your feedback or use the Talking Mats option on the website too.

Encouraging people to write candidly about their experiences is crucial if we genuinely want to improve the way we work in the NHS and deliver compassionate care. Feeling involved in improving care happens when we truly listen and actually do something about it. Online conversations are so plentiful that there’s a danger of complacency or worse still, self congratulatory feedback. There has to be a balance. If our staff, promised a change in their reply did they get the job done? Not always.

Inevitably, we don’t get it right and yes, it hurts when we read those stories. To date 187 stories are highly critical on Care Opinion about our services. Staff respond individually to each story often inviting the author to make contact to share more of their experiences by working together in the hope that we learn from this in a positive way.

In 2019 there was many things we could have done better but there was some brilliant stuff too. The 10 year Care Opinion event in April 2019 was a reminder of why we care, why we listen and why we must always do this together.

Our inspiring Care Opinion 10y Heroes with James Munro CEO of Care Opinion
(4th from left)

To date we have 6481 Incredible, wonderful, sad, shocking, highly critical and inspiring stories. We’ve been asked questions and offered suggestions to improve our services. Some posts have made us take a sharp intake of breath and in light of this we vowed to share more of them via our Twitter account and own them, hoping more people would see them and perhaps use Care Opinion to share their stories. @InvolveNottsHC #wearenottshc

Amy Gaskin Williams , Deputy Head of Involvement, Experience and Volunteering at Notts. Healthcare put it far better than me in this blog reacting-to-feedback-that-comes-with-a-sting

Anyone who wants to, can see what people think about us here. Notts Healthcare Stories

Looking backjob satisfaction and inspiration. I’ve always loved working with Care Opinion, they brought something new to the table for us as a Trust in 2008 (including cake). I’d heard on the grapevine that we were going to gather patient stories to find out what people really thought about our services and post them online. My heart sank. We were really going to encourage public feedback, warts and all? Too right. I heaved a sigh of relief when the penny dropped that most of our feedback turned out to be positive and still is in 2020.

The first reply I made on Care Opinion was a masterclass in procrastination. I was more than a bit scared. Responding to an author of a story now seems so natural. Saying thank you for every bit of feedback and saying sorry when things have gone wrong is the very least we can do. A real culture shift. So how should we respond? Avoid being defensive, don’t use corporate ‘NHS speak’, be conversational, be warm, however critical the story might be. Be human.

I was recently described in a presentation at a Care Opion event about our work on Care Opinion by Amy Gaskin-Williams, our Deputy Head of Involvement Experience and Volunteering in the our team as ‘dynamite, never lost an ounce of her enthusiasm’. In 2019, I was given a Care Opinion pin badge by Care Opinion at our 10 year celebration event. Actually it was named the ‘Terrier Award’ (not to be confused with the former Comedy ‘Perrier Awards’)

Yes. I’m tenacious. I keep the dynamite ready when needed. I try to offer support and advice. Care Opinion have given us opportunities like no other organisation. I asked their lovely team to sum up Notts Healthcare during our 10th year. This is what they said and its been an absolute pleasure to share that journey.

Gina Alexander – Director, Care Opinion Scotland For me, Notts is my go to place in challenging anyone thinking “we can’t “do” Care Opinion here” – you’ve proved that even in challenging environments, with a little thought and effort, that there are ways and means to genuinely involve people online. Well done Notts! 😊

Tim Hunt- Integration Development Manager, Care Opinion. ‘From our first meeting in a hotel in Leicester to explore online feedback for mental health services, Notts HC have been at the forefront of this journey.  Always enthusiastic, always starting with “why not” rather than we can’t do this.  As a valued partner, always pushing forward, giving Care Opinion feedback and challenging us to be better’.

Sarah AshurstSubscriber Services Manager , Care Opinion ‘Working with Notts HC throughout my time at Care Opinion has been one of my career highlights (long may it continue!). I have never felt like we are providing a Care Opinion service, the relationship is firmly a partnership. We both want to see the other succeed, and we push each other to develop in ways that always put the story teller at the heart of feedback.  The world of patient experience and involvement has changed so much in 10 years and I consider our work together as in integral part of that’.

Dr James Munro – Chief Executive, Care Opinion Working with Notts. Healthcare has been a true partnership: we have constantly challenged each other to go further and do better on this journey of listening and learning. Your decade of work with online feedback at Notts. Healthcare has inspired many others to set out on their own journeys of discovery. You have shown that even in some of the most challenging clinical settings, like prison healthcare and high secure mental health care, it is possible and indeed rewarding to hear and act on feedback from people. Working with you, we have always felt that your commitment to transparency and giving people a voice is genuine and determined. You have never said “we can’t do that”. You have often said “why can’t we do that?” Thank you for encouraging us to be the best we can be too!’

Miriam Rivas-Aguilar – Chief Operating Officer Care Opinion “I have always been both impressed and inspired by the dedication of the Notts. Healthcare team over the years. Your commitment to transparency, learning and doing things differently was evident from early on. I am very proud to be working with you all, you have shown us and many others what’s possible.”

Marie Goodwin

So why have I mentioned cake? The Care Opinion Team always provide cake at their learning events. The gift economy is about the exchange; the relationship. The giving of stories is priceless and should be rewarded with a decent, measured and fair response. The Care Opinion team work hard to convey this message with their subscriber organisations. They manage to nurture essential qualities from organisations by working together to improve digital patient & carer feedback and we thank them for it.

10 years of Care Opinion.
Thanks Care Opinion Team!
Julie Grant – Head of Communications
Jane Danforth – Involvement & Experience Team

With Christmas over for another year, it highlights giving and the extremes of people who have it all and those who have very little but being rich is not just about financial gain. The simple act of sharing cake and a cuppa can mean more than any grand gesture. The little things matter. Did you get a smile, were staff kind and understanding? Compassionate care is what matters and as we are all patients, we all need to be listened to. Thank you to our staff for wanting to give more even when they are stretched to capacity, their kindness and compassion stands out.

Our volunteer feedback collectors have made huge progress within our Forensic services. Without them I don’t think we would be where we are today. Thank you to our Communications Team at Notts. Healthcare for their constant support (we don’t half need their expertise at times).

In 2020, lets remember to listen to the quiet voices. The thousands of people young and old, struggling with their mental or physical health, loneliness, loss or isolation. A sad reflection of the times we are living in. Listen intently to those stories.

Read more about 10 years of Care Opinion via Amy Gaskin-Williams presentation. careopinionlondon-event-october-2019

Read more about why leaving feedback is important.

Feedback via Care Opinion is a dainty dish to set before the Trust www.careopinion.org.uk/blogposts/794/feedback-via-care-opinion-a-dainty-dish-to-se

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