@NHS: How the NHS uses Twitter

Microblogging service Twitter, which allows you to post messages of up to 140 characters, has been around since 2006. NHS organisations have only recently started to unlock its potential, although many are now involved – Guardian Healthcare follows more than 120 through its NHS organisations list. So what are the benefits of having a presence on Twitter?

Perhaps the best reason for using the service is that Twitter allows NHS organisations to engage directly with stakeholders. This may be to respond to questions about services or to reply to patients who have had a negative experience:

"The benefits that NHS Direct and patients can receive from our use of Twitter include an increased level of feedback that improves the ongoing development of our services," says Roger Donald, head of digital delivery at the online and phone advice service (@nhsdirect – Twitter account names are signified by an @ symbol, and can be accessed by typing the name without the @ after twitter.com/). "We knew that conversations are happening about NHS Direct on Twitter. We felt it was better to engage with people interested in our service on Twitter than to ignore it."

Organisations can also respond to individual requests. Norfolk and Norwich University Hospital trust (@NNUH) was contacted by the sister of a woman who had given birth at the hospital last year and required further breastfeeding support. After providing advice, the sister then replied through Twitter's direct message facility: "Hi, not sure what you did but my sister is much happier now and has had lots of support. Thank you :)"

And even if questions cannot be answered in 140 characters, trusts can point users towards other more suitable channels of communication or the complaints process, which demonstrates a respect for stakeholder feedback.

To make updates more individual, those in charge of the Twitter account should put their initials at the end of tweets. "If you're planning on engaging in a more personal fashion (for sexual health for teens etc) then putting the tweeter's initials at the end of the message will help give the tweet a more personal touch and the user will be able to address that person directly," said Colin Wren, new media officer at St George's. The initials are then matched to staff profiles on the 'about' page of the trust's website, allowing the patient to see who is tweeting them on behalf of the trust and improving the relationship he or she has with the service.

Learning to share

Trusts are realising Twitter is an effective way to share information, including news releases, events and public health messages. NHS Direct shares links to its health and symptom checkers, one of which was retweeted 49 times and exposed to a potential audience of 32,000 Twitter users.

Norfolk and Norwich, which with more than 2,500 followers reckons it has the most followers of any hospital on Twitter, retweets messages from East Anglia Air Ambulance (@EastAngliAirAmb) and the South Norwich News site (@SNNews) to help establish a community of loyal followers. Similarly, NHS Manchester primary care trust (@NHSManchester) links to content from other sites, such as those run by charities Alzheimer's Society and Diabetes UK, to ensure stakeholders are well-informed about other areas of health.

"We use it as an educational tool to support people living with long term conditions by sign-posting them to blogs, podcasts and guides of patients living with the same condition," said Nick Gomm, head of communication and engagement at NHS Manchester. "Twitter is an additional way of engaging with patients and members of the public by providing relevant, concise information that they can readily access."

Twitter is also useful for tracking what people are saying about services and treatment, even if they do not get in touch directly. "We use Twitter to glean a better understanding of the public opinion of our services and the NHS as a whole," said Colin Wren at St George's. "The media love a negative story, and often paint the NHS as a cruel run-down institution where targets come first and the patient comes last. Our social media intelligence doesn't support this view – to date, for St George's Healthcare, positive mentions outweigh the negative by 300%."

Using appropriate searches, the trust has even found a kidney patient who wasn't eating correctly before raising the issue at their next appointment. The patient indicated happiness at being able to make a connection with a consultant.

Along with Twitter's own search function and search.twitter.com, Tweetdeck and CoTweet are useful desktop applications for managing various search terms, which can be cut down with 'Boolean' statements (such as using the + symbol to search for pages when both words appear) to avoid any mentions slipping the net.

Hashtags are a way in Twitter to link similar tweets, and have been used effectively by trusts including Berkshire East community health service (@BerksEastCHS). It uses geographical hashtags (#Maidenhead and #Slough) to tap into a wider network.

Primary care trust NHS Southampton City (@NHS_Southampton) also used hashtags to good effect when tweeting live from two public engagement meetings on the future of the Bitterne Walk-in Centre. The #bitternewic hashtag allowed people not at the meeting to keep track of the discussion.

"The overall objective was to make the way we communicated what has been a delicate subject as transparently as possible," said Jamie Shoesmith of Southampton City. "Using Twitter in this instance was an integral part of a wider web communications strategy to encourage public engagement. We would certainly consider doing something similar in the future if the opportunity arose".

NHS Peterborough (@NHSPeterborough) also tweeted from their annual general meeting in September using the hashtag #agmnhsp. This increased stakeholder engagement as people re-tweeted updates and asked questions at the end of the meeting.

Although hashtags soon disappear if not used regularly, twapperkeeper.com creates an archive of tweets whilst hashtags.org allows you to keep track of how often a hashtag is used.

Continual discussion about the developing use of social media within the NHS will be important as more trusts establish a presence on Twitter. The NHS social media account (@nhssm) provides advice for trusts overwhelmed with the idea of tweeting and further discussion (using the #nhssm hashtag) for those looking to develop their use of Twitter and other social networks.

Too many people are talking about NHS healthcare on Twitter for trusts to turn a blind eye. Trusts have to be where the conversation is and right now, that's on Twitter.

This article is published by Guardian Professional. Join the Guardian Healthcare Network to receive regular emails on NHS innovation.