Ambulance services use social media for many different reasons—education, public health messages, sharing knowledge, and supporting research in out-of-hospital care are just four of these. But there's so much more to it than that.
Yet sadly, we are sometimes criticised for our use of social media. A few have gone a step further, having made formal complaints to trusts or their regulator, usually on a charge of breaching confidentiality or publishing patient-identifiable information. Some of these criticisms are raised with genuine concern; others are abrupt and seemingly out to ruin the reputations of the authors—although none of these have ever been upheld after investigation.
In addition, there has been a rise in keyboard warriors, bullies and trolls, who hide behind the anonymity of fake or parody accounts to insult others and bring down ambulance staff by branding them as self-promoters. The experience of some ambulance staff—particularly those on the receiving end of more direct, aggressive comments on social media—has had a damaging personal impact on their mental health, and left many others feeling apprehensive about posting or disenchanted with social media altogether.
This is a sad state of affairs for those who are committed to working in a compassionate and caring profession. This behaviour is unacceptable, even if it reflects a wider societal issue of a population, angrier, divided and more polarised than ever before.
This was part of the reason why all NHS ambulance services in the UK chose to come together to work closely to develop our own guidance to protect our staff on social media.
Dos and don'ts of corporate tweeting
Communications leads and medical directors have collaborated over the last year to produce what we consider to be the most comprehensive document yet from the ambulance services on the dos and don'ts of being a corporate tweeter.
Our guidelines are not intended to replace existing social media policy within individual trusts, but to provide a consistent and safe approach for all staff using social media as an ambassador of their service.
There are currently 45 million social media users in the UK. Put another way, 67% of the entire population of our country uses social media. Every day, the average UK social media user spends 1 hour 50 minutes scrolling through social media sites. Yet we know from respected business reviews that almost three-quarters of organisations are not using social media to its full potential. This is squandering employee productivity in solving work problems, building relationships and publicly recognising employees who go above and beyond the call of duty.
One compelling reason to be on social media is to engage with the public and stakeholders about the work we do. On Twitter alone, the ten accounts of each of the English NHS ambulance trusts have a combined total of more than 356 000 followers.
As a publicly-funded sector, we have a statutory and legal duty to engage with the public. This not only provides assurance on our performance and reassurance of service delivery, but also improves our transparency and accountability and so, over time, has improved how patients, the general public and other health professionals engage with us.
NHS ambulance communications teams will do much of this work on social media themselves, but the authentic voice of our profession are the clinicians who deliver frontline patient care—as long as their messages are appropriate, relevant and never breach patient confidentiality.
In particular, we wanted to address the criticism against ‘live tweeting’ that has been levelled against some staff. We specifically sought views on live tweeting from interested groups including the Health and Care Professions Council (HCPC). The advice we received was that as long as staff had completed their clinical care, they had no issue with them tweeting.
So our guidelines are designed to protect both patients and staff in these instances. We make it clear to all corporate tweeters that we recommend waiting several hours before posting their update and use the time in a rest break or after the end of your shift to then go onto social media.
Our use of social media has seen a growth in the number of patients contacting us. Social media channels are now seen as an additional contact for patients who wish to complain about their care or our service, but are used even more by people who want to pass on their thanks and appreciations for our care. We are receiving hundreds more compliments from people who wouldn't have contacted us using more traditional forms of communication; and they are reacting positively because they see and hear our paramedics going about their jobs on a daily basis.
Social media has been a fantastic way to recruit new staff into our organisations. For example, the North East Ambulance Service had more than 300 000 views and shares for a social media post recruiting health advisors to their emergency operations centre. This resulted in a ten-fold increase in applications for the role compared with previous recruitment campaigns.
Power of storytelling
So what resulted in this difference? It was an existing health advisor posting about their job and the challenges they faced. By having real staff describing their roles, we have ensured that we not only fill our vacancies, but also that we recruit people with the right mentality and disposition to work in a high-pressure emergency service.
This is the other key point that is often lost on those who feel social media shouldn't be used beyond the topics of research or public health. Storytelling is a natural human instinct, although some will be better than others. When staff tell their own story, in their own words, through a series of posts that may stretch from a couple of updates through to a longer narrative lasting over weeks, they engage, inspire and connect with others.
Guidance
We spoke to frontline staff already involved in corporate tweeting to hear why they do it and the benefits—not just to them, but to patients and others. We then consulted with NHS England and the HCPC, and considered their feedback to include in our final draft. This was approved in April by the Association of Ambulance Chief Executives (AACE) Council, made up of the Chairs and Chief Executives of all ambulance services in the UK.
The guidance has been produced both for the benefit of our staff and our patients. The hope is that our nationally agreed standards, created to comply with NHS policy and our regulator's rules, will put an end to criticism. No one who works in the NHS sets out to do harm, but we are living in a society where the use of negative language, tone and sentiment seen on some social media channels has become an acceptable norm. We are sure if these individuals were seen to be shouting their abuse face-to-face, most of us would seek to defend and support, and defuse the situation. This is what our new guidance is intended to do in support of our staff, as well as encouraging them to use social media to its full potential, for the benefit of ambulance services and the public.
We have already trained and supported our staff to deliver excellent care to patients. There is no reason we should not trust these same people, with appropriate training and controls in place, to the talk about the work they do via social media.
Our hope is that this new guidance will not only support our staff to get it right, but also answer their critics when they are accused of getting it wrong.