A decade or so late, I’ve been catching up on The Wire. Series three centres on an experiment in legalising drugs wtihin a free zone dubbed Hamsterdam, and gets some humour out of the cops having to bus junkies down to the dealers to provide them with customers.
In passing, I noticed that one of the vans they were using had an ad for 311 on it. 311 is the US service that enables the public to report issues of concern by phone or online.
The service started in Boston and is now used by a number of US cities, including Baltimore, which has its own 311 app to “help residents make their neighbourhoods more beautiful by reporting local issues, including potholes, graffiti, and streetlight outages.”
Residents can add geo-location tags and pictures to their reports, track their progress, and see who else has complained – in the hope that this will encourage people to sort out some problems for themselves.
311 has its fans in the UK, one of whom is Tim Kelsey, the director of patients and information at NHS England. He has been evangelising for its introduction as a way for patients to report issues and complaints, and to chip in ideas as part of the commissioning process.
Indeed, CareConnect now exists as a page on the NHS Choices website. However, only a handful of trusts seem to have signed up and there’s little evidence of either NHS or public activity.
The last three posts on the @CareConnectNHS Twitter stream, for example, date from March, July and August respectively – and one of those directs a reader to information on “moles” (the skin condition, not the animal).
So what has gone wrong? It can’t be that the public is unwilling to complain about the NHS. The HSCIC reported recently that written complaints are running at a record level, in an era when finding a pen, paper, envelope, stamps and post-box represent major barriers to action.
So it may be that the public has yet to find this particular service. CareConnect has certainly not been well-publicised; perhaps because it only covers 18 trusts at the moment, and perhaps because it was meant to be part of the NHS 111 helpline, and it has issues of its own.
But the bigger problem appears to be that the NHS has failed to embrace it. It is interesting, for example, that NHS England medical director Sir Bruce Keogh is talking about making NHS 111 into the “front door” for the NHS in his revamp of urgent and emergency services. Keogh never mentions NHS Choices or CareConnect, which are Kelsey’s front-door projects.
It is even more interesting that the Care Quality Commission is not using the service, even though it is running a big, Keogh-inspired programme of hospital inspections to try and stop scandals like the one that unfolded at Mid-Staffordshire NHS Foundation Trust.
Instead, it sends out press releases urging people to get in touch, hands out feedback cards, and runs meetings. All very analogue; but apparently effective – at least two trusts have been put into special measures because staff and patients came forward with concerns when the inspector called.
In short, CareConnect’s problem is that it isn’t connecting with the bits of the NHS policy agenda with which trusts are connecting.
The CQC says a trust should get a poor rating or Monitor should send in a new board; its management listens. People tell Google or a platform a bit like it that there was a long wait in A&E; not so much.
Or, to put it another way, voice platforms – even shiny new digital ones – only work if someone is listening.
PS: I fell over CareConnect while researching a piece on NHS IT targets and whether the health service was hitting or missing them that EHI ran over the bank-holiday weekend. The feature has picked up some nice comments, and is on the EHI website.