#leadersforleeds- Civic leadership for our City

As many of my readers will know, I’m terrifically interested in what goes on in my City of Leeds. The event held at the Civic Hall to encourage civic leadership across the City was a great chance to meet with people doing interesting things- from small social enterprises and community groups to the CEOs of our major institutions.

Integrating Health and Social Care

I work constantly to attempt to influence health and social care organisations to work more innovatively and to offer a more integrated experience for people using the services. After all, who cares about whether a service they receive is delivered by a local Trust, by the Council, by the Voluntary sector or if it’s delivered within community groups or social enterprises? When experiencing services, what matters is the quality of the experience, not the organisational structure behind it. So I was pleased to be able to meet with so many others who were representing large and small organisations who work for social impact in the City.

Health Inequality=Social Inequality

Rob Webster, who is CEO of one of our Trusts and a great Twitter follow to boot described the situation perfectly;

“For every mile you walk from North West Leeds heading South, the life expectancy of the residents drops by a year. Residents in South Leeds live 10 fewer years than residents in North West Leeds.”

One of the challenges for people interested in healthcare is that so much about health outcomes doesn’t depend on health intervention AT ALL. I know this sounds a bit strange, but we know that social inequality, access to green space, whether or not a parent reads to you as a child, an countless other factors are really important for health (and life) outcomes. So actually, people who care about health care have a responsibility to act on social inequality and to improve health outcomes in this way. This is great because it means that the creative possibilities for collaboration are extended across sectors- whether it’s a youth project, a local church, a small business offering employment, or any number of other possibilities, we can collaborate to drive up health outcomes and reduce social inequality.

Digital Health Centre of Excellence

My goal is to ensure Leeds is seen as a centre of excellence in the development and delivery of digital health and digitally-enabled social care. Many people I met agreed that this forms part of our civic future, because the people of Leeds need to have efficient and effective services despite a financial environment that ensures we have to think radically different. Because people recognise that we have to work together to make an impact on this. Because it’s a great way to develop the City’s economic outlook and provide jobs. Because we have some of the best hospitals and health services in the country. Because we have all the structural advantage of the NHS Information Centre and the NHS Commissioning Board. Because it’s the right thing to do.

Recently, the local Shadow Health and Wellbeing Board have crowd-sourced information about how digital products and social media can support people in the city who  use health and social care services- expect to see more of this as we move forward.

We have a vibrant digital sector, both within health care and in other digital fields (did you know that Grand Theft Auto was written in Leeds?) We already have great initiatives such as GoOn Leeds, Leeds Social Media Surgeries (TONIGHT at the Civic Hall from 6pm, by the way!), and the fabulous Leeds Digital Festival. Let’s make it even better.

Digital Conference and Hack v2

I’m already working towards the Digital Centre of Excellence, as are many other people all over the city. This year, we held the first Digital Health Conference and Hack, and we’re planning another one for next April. This time, we’re going to look at open source solutions in healthcare, described today by Dick Vinegar as “the future of Health IT”. We already have the excellent open source portal developed at Leeds Teaching Hospital Trust by Tony Shannon- there’s a lot more we can do with this agenda.

We also have several totally original digitally enabled health innovations going on locally- and I can’t wait to share more details with you. We’re hoping you’ll join us.

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Posted in #sm4hwb, Conference, Leeds, Web 2.0

The Financial Challenge for #BarkerComm

The figures I’m using to describe the financial forecasts come from John Appleby’s King’s Fund work. Here is his Slideshare of projected costs:

What are the financial implications of forecasts in Health and Care?

Long-term forecasts suggest that spending on health and social care could consume as much as a fifth of our national wealth within 50 years, with significant implications for the public purse and for other government budgets

The Politics of Health and Care

How much we decide, as a Country, to spend on health and social care is a political decision that we must make. As we draw closer to the General Election, political parties will be proposing ideas about how to answer these important questions, and making promises about what they plan to do. It is hoped that the #BarkerComm will inform the options we are presented with, and the choices we must make.

This choice, about what is funded and how we fund it, is one of the most important and defining choices we make.  We now face different challenges in health and care than we did in 1948, but this political choice remains a defining one for our population. The decisions we make individually to these questions may influence our decisions at the General Election, and other political or activist action we wish to undertake.


Appleby, John (2013) Future Health and Social Care Spending Pressures. The King’s Fund. Available at: http://www.kingsfund.org.uk/time-to-think-differently/publications/spending-health-and-social-care-over-next-50-years [Accessed on 10/11/13 20.02]

Appleby, John (2013) Slideshare Presentation to accompany Future Health and Social Care Spending Pressures. The King’s Fund. Available at: http://www.kingsfund.org.uk/audio-video/john-appleby-future-health-and-social-care-spending-pressure [Accessed on 10/11/13 20.03]

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Posted in #Barkercomm, Society

Introducing The King’s Fund #BarkerComm

What is the background in health and care?

The Barker Commission seeks to solve a problem due to our historical organisation of health and care services. We currently have two very different services that we depend on. In health, a Universal (funded from general taxation) service, the NHS; and in Social Care, a means-tested and subsidised service provided by our Local Authorities. In brief:

..the NHS was founded to provide health care to all who needed it, free at the point of delivery.

…Social care (was founded) as a separately funded, means-tested service.

We know that people are living longer (which is a Good Thing), and this may mean increases in pressure both on health and care services. People may need extended periods of life where they are in need of health and social care services in combination, and we need to work harder to integrate the services people need around their lives.

We have to rise to the financial challenge of funding appropriate care and support, with a growing population predicted to need help.

What are the questions the Barker Commission seeks to answer?

The broad questions are:

Does the boundary between health and social care need to be redrawn? If so, where and how? What other ways of defining health and social care needs could be more relevant/useful?
Should the entitlements and criteria used to decide who can access health and care be aligned? If so, who should be entitled to what and on what grounds?
Should health and social care funding be brought together? If so, at what level (i.e., local or national) and in what ways? What is the balance between the individual and the state in funding services?

The Barker Commission seeks to look at the implications of this issue and answer these questions.

Kate Barker explains the #BarkerComm

Kate Barker: Introducing the Commission on the Future of Health and Social Care in England from The King’s Fund.

I am proud to be contributing my perspectives to the Expert by Experience Group for the #BarkerComm, which is just one element of the involvement approach of the Commission, as described in this infographic:

#BarkerComm Involvement Strategy

Infographic courtesy of The King’s Fund

Find out more about how to Get Involved.


Briefing Document about the Commission on the Future of Health and Social Care by The King’s Fund. Available from: http://www.kingsfund.org.uk/sites/files/kf/field/field_document/commission-health-social-care-england-jun13.pdf [Accessed 10/11/13 at 19.41]

The King’s Fund Commission on the Future of Health and Social Care: Engaging with the Commission. Available from: http://www.kingsfund.org.uk/projects/commission-future-health-and-social-care-england?tab=1#get-involved [Accessed 26/11/13 a 10.33]

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Posted in #Barkercomm, Society

Meet the Experts by Experience for #BarkerComm

I was delighted to be invited to join the Expert by Experience group advising the Barker Commission on the Future of Health and Care.

Who is in the Expert by Experience Group?

This group consists of ten people who have personal experience of using and caring for people who use health and care services. All of our group have developed a high degree of expertise within the system as it stands, and have experienced different patient, carer, or service user roles in different services; sometimes holding multiple roles. Some of our group also hold additional roles in the health and care system, as health and care professionals, as patient leaders, as activists, through working with the Voluntary Sector, or Social Enterprise, or as members of local Healthwatch organisations.

Portraits of eight people who form the Commission E by E Group

Portraits of eight people who form the Commission Expert by Experience Group         photo courtesy of The King’s Fund

It is a really impressive group, full of energy, great ideas and suggestions about how services could be improved. We had a wonderful opportunity to meet each other and get to know each other, last week, in London.

I’m pleased to say that several members of the Group are avid Tweeters, you might like to look them up! Here are their Twitter names and the current appearence of their profiles:

 @clentonf @patient_leader @LostTransport @claireot
 @nursemaiden      @clentonf         @Patient_Leader      @LostTransport       @claireOT

What work will the Expert by Experience Group be doing?

This is an important piece of work for The King’s Fund, and our involvement at this level shows a real commitment to co-production principles; which is wonderful to see.

We are co-designing the way we will be working with the wider #BarkerComm, so I can’t share details that, yet. I shall continue to blog this journey as it develops over the coming year. We do know that we will have an important role in the development of the final report that will be published next September.

There are other opportunities to be involved in the Commission’s work, which are detailed on their website. If you want to talk about the work of the Commission on Twitter, the hashtag to follow is #BarkerComm; do send useful information and opinions and take part in the Twitter debate!


The King’s Fund (2013) The Commission on the Future of Health and Care: Experts by Experience. Available at: http://www.kingsfund.org.uk/projects/commission-future-health-and-social-care-england#experts-by-experience [Accessed on 25/11/13 at 22.27]

The King’s Fund (2013) The Commission on the Future of Health and Care: Engaging with the Commission. Available at:  http://www.kingsfund.org.uk/projects/commission-future-health-and-social-care-england?tab=1#get-involved  [Accessed on 26/11/13 at 11.04]

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Posted in #Barkercomm

Leaving Healthwatch Leeds

It is with sadness that I announce today the end of my involvement with Healthwatch Leeds.

In the interests of the transparency, as I promised when I took on this role, I’m making this brief statement.

Vice-Chair of Healthwatch Leeds

I took on the post as Vice-Chair of Healthwatch Leeds in May this year, at the invitation of the Chair, Linn Phipps. The Vice-Chair role was meant to last for a year, and I have completed six months of that term.

The role involved being a critical friend to the Chair and Director, supporting them in the work of the organisation, and sitting on the Board. We aimed to:

“give people a powerful voice about health and social care services in Leeds and beyond”

and to:

“help citizens of Leeds to get the best out of their local health and social care services”

The work of Healthwatch Leeds has barely begun and I’m sorry to leave before our inclusive Board is appointed, and our Vision and Values have been co-produced and fully realised by the staff and volunteers.


A view shared by everyone in the organisation was that the participation of disabled people should be facilitated, and that we should use an asset-based approach to our work together. Unfortunately, this was not my experience in practice.

Advocacy and self-advocacy are often necessary to ensure Disabled peoples’ participation in civic life, or in specific roles, is facilitated. Despite repeated suggestions for reasonable adjustments, they were not available, and as a result I didn’t get my access needs met.

It became clear that it wasn’t sustainable for me to continue in the voluntary role I had, because of the negative impact it was having on my health and my disability, and the life of my family.

The Future

I really appreciate having this fabulous learning opportunity. I had never sat on a Board before, so it has been wonderful to get involved in this way in a health and care organisation.

I will be continuing to work as an advocate for social justice, particularly for the benefit of people in receipt of health and social care and Disabled people.

As the next stage of this work, I am proud to be part of the Expert by Experience group, working on The King’s Fund Commission on the Future of Health and Care.

I shall also continue to advocate within my local community to combat health inequality, and highlight issues related to accessing care services and quality standards.

We have many fantastic networks and organisations working together in Leeds to make it the Best City in the UK, and I shall continue to support these in my capacity as a private individual.

Any comments about Health and Social Care services that I make after today, will be solely from my perspective as a Disabled woman living in Leeds, who is dependent on Health and Social Care services.

Thank you to everyone who supported me through the (steep) learning curve, and my journey as Vice-Chair at Healthwatch Leeds.


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Facebook 101 for health and care organisations

Health and care organisations often ask about the differences between a Page and a Profile, so here is my usual response.

(TW: I use an example of someone posting on FB that they may have been assaulted later in this post. This section has a line of asterisks ***************************above and below it, so you may choose to skip that content)

Although these ideas are particularly relevant for health and care organisations. who frequently have a duty of care towards people using their services, they could equally apply to community groups, housing associations, and many other organisations.

Facebook is a hugely popular platform (1.15 billion monthly active users as of June 2013), no organisation with a social media strategy can afford to ignore Facebook.


Facebook Profile or Facebook Page?

Lots of people aren’t aware of some of the differences between Profiles and Pages on Facebook, so let me explain why in general, organisations would be well advised to use a Facebook Page over setting up a Facebook Profile.

Facebook Terms and Conditions

Facebook profiles are intended for use by individuals, not organisations. Its in the T&C (yes, I know people don’t often actually read them) which specifically state that FB Profiles are available to people (i.e. not organisations) “requiring that people use their real names“. If we don’t abide to T&C of websites we use, the company is able to delete them immediately. You don’t really need to read the rest of the post.


Facebook states:

Use your privacy settings to control who gets to see your posts and timeline.

When you post a status update or photo on Facebook, in-line controls enable you to select your audience at the time you post. However, many, many people don’t adjust any of their settings*, and its important that organisations with a duty of care recognise and acknowledge this, even as they work to educate communities about how to be more literate with safety settings.

This means for most people on FB, everything they post is visible to all their “friends”. If an organisation is your “friend”, this means they will be able to read all of your status updates, see all of your photos and videos, unless you have taken specific steps to lock down who you are sharing your content with.


People are encouraged to connect on FB, but you can remove a connection to a friend that you are no longer comfortable sharing with and I would encourage anyone to be quite strict about this, and keep connections only with individuals who are a positive and supportive influence in your life. I would encourage people to consider carefully if it is appropriate to be “friends” with an organisation, rather than “like” their page or become a “fan”.

What any organisation looking to build communities wants is connections and conversations. If you position your brand or product as a “friend”, you’re encouraging “all or nothing”: overfamiliarity (i.e. “friends”, reading all of a persons’ status updates and accessing all of their photo and video content: more of which in just a moment), or complete disengagement (i.e. “unfriending”).

What we’re aiming for is facilitating conversations that are safe and appropriate, and the best way to do this is through using a Page with “likes”. In this way, conversations are happening on your Page, and you don’t have a stream of status updates appearing about things unrelated to the point of your Page.


Facebook is designed to connect individuals, and part of this, of course, is to connect around shared interests, whether that’s a brand, or a health organisation, or even a pop star. However, the connections we make as “fans” are very different to the connections we make as “friends”, and this is entirely appropriate. I might be very happy with the service I get from a company, but I still recognise that a company is not my “friend”!

Reducing human relationships by attempting to make an equivalence with connection to your brand or product instinctively feels wrong, doesn’t it? It either makes your brand look needy, or demonstrates a lack of understanding of appropriate boundaries in social media.


If we work with vulnerable people, especially children and young people, we have to be very aware of safeguarding issues. As Facebook states:

Staying safe online is a lot like staying safe offline. Whether you’re walking down the street or connecting with friends on Facebook, it’s important to keep a few key safety precautions in mind. 

As an organisation with a duty of care, we have to be very mindful of the Safeguarding implications of the work we do, so here is an example of a case study.

**************************************************************************************Case study: Timmy and CAMHS Team Rocks

A health provider develops a Facebook “profile”, instead of a “Page”. They call it “CAMHS Team Rocks” and one of their “friends”, Timmy, posts something publicly that appears in our timeline.

Timmy posts that he’s consumed alcohol or illegal drugs, has lost his memory, and may have even been assaulted.

As a health and care organisation, we must be mindful of our responsibilities as we have a duty of care.

This means that if you became aware of someone doing drugs, or experiencing an assault, you would have a direct legal responsibility to flag this as a safeguarding issue. This would mean having to inform your line manager, and also potentially involving the police or social services.

How would you deal with this issue? Would you discharge your responsibilities? Are you prepared to live with the consequences of this decision?

If the aim is to engage with young people on their terms, would this help or hinder that outcome?

Now, lets look at the same case study, but where “CAMHS Team Rocks” is a FB Page, not a profile.

Timmy posts that he’s consumed alcohol or illegal drugs, has lost his memory, and may have even been assaulted.

This doesn’t show up on the “CAMHS Team Rocks” page, unless Timmy deliberately “tags” them, including them in the conversation, and inviting them to get involved to offer whatever assistance Timmy may require, in line with their safeguarding policy and the legal frameworks.

Here, the choice about the way Timmy uses his network to provide support in a difficult time is in his direct control.

I know which one of these case studies is more professional and more ethical, don’t you?


Page statistics

Finally, let’s look at the benefits of having a Facebook Page, for any organisation that’s strategic in its use of social media.

Admin Panel

All Facebook Pages have an admin panel, and this is where your most basic statistics can be seen, Now, as I’ve said many times before, social media isn’t about the numbers. But, they do serve as a guide to help you learn what appeals to your communities.

By checking your admin panel, you can see the “reach” of particular updates, and start to work out what kinds of content work for your community. Which post got people talking? Did having a photo or video result in more engagement?

You can also use content to boost traffic by promoting specific entries on the page, according to your budget (see Promoting your Facebook Page, below).


You also have access to the Insights centre, where you can see more detailed information about content you’ve posted, including “virality”, or the likelihood that your content is shared by people who see it. This single metric shows you if people who see your content are sufficiently interested to continue the conversation with their friends, and so on.

Of all the metrics you will see, this single metric is the one to spend most time thinking bout. What was it about a piece of content that interested people? Was it a video, or a photo? Does a 2 minute video get shared more than a 6 minute video?

You will also be able to see how many people actually talked about the information or opinions you share. What differences are there between posts that people talk about and ones they just ignore? Does the time of day, or day of the week affect who talks about your content? Which subjects create a buzz in your communities?

Promoting your Facebook Page

If you have a Marketing and Communication Strategy, you may have identified growing communities in social media as one of your goals. One of the advantages of a Page is that you can pay Facebook to “promote this Page”.

This means enabling it to be seen more often at the top of your Page Fans’ feeds, or even turning up as a Suggested Page in potential new Fans’ feeds. Whether you choose to use this facility or not, this is an useful feature, and one that Profiles have no equivalent to.

Further analytics

Its not just about people “liking” your Page, or even if they directly engage with your content. You can learn a lot from how people get to your Page, how long they stay, whether they come back, how often they come back etc. You can use products like Google Analytics for information like this, supplementing the granular information provided by FB stats to get an overarching view of how your Social Media Strategies are working on Facebook, or indeed any other Social Network.

It’s conversations that matter

Finally, I want to emphasise that ultimately all social media is a way of having conversations. If all that happens on your Page (or even on your Profile), is you posting updates that no-one comments on and no-one shares, then your Facebook presence needs a re-think.

The numbers don’t matter, compared to the quality of the conversation, but we would want to see general movement towards greater engagement, even if we didn’t particularly want thousands of fans.

It’s relationships that matter

Building relationships in social media takes time and effort, as it does in the real world, but the benefits of developing a community that cares about your brand, that is willing to comment on ideas you have or events you’re hosting makes it all worthwhile. Go on, try it!

What are your experiences?

I would love it if you would like to share some stories about how you approached the “Page” versus “Profile” debate in your organisation. What decisions did you make, and why?

I’m particularly interested to hear if you addressed Safeguarding in social media spaces in your strategic approach, but: please protect confidentiality, changing names and personal characteristics of people involved!


*FB Settings notoriously change continuously, so information about the rapidly becomes out of date and I am not including current info about how to adjust settings. For the latest information on your privacy settings, click Account at the top of any page and select Privacy Settings in the dropdown menu that appears.





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Posted in Digital Inclusion, Facebook, How-to, Social Media

I'm an OT called Claire. I write about health, particularly mental health, and also about Social Media and Web 2.0 technology. I am particularly interested where these two fields overlap.
I believe that we all hold the potential for Recovery- let's grow together.

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