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    Digital Engagement

    Department of Health

    April 2010

    E-Communications & Publishing

    Communications Directorate

    Skipton House

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    Table of contents

    page

    1. Executive Summary..................................................................................................................3

    2. Digital engagement: opportunities and tools..........................................................................3

    3. The context of digital engagement for DH ..............................................................................5

    4. Digital engagement: DHs strategic objectives ........................................................................6

    5. Why engage digitally at all? .....................................................................................................6

    6. How to make the decision to engage in digital channels ........................................................6

    7. Why is a Departmental approach to digital engagement necessary?.....................................7

    8. Relationship to other initiatives...............................................................................................9

    9. Defining a digital engagement approach.................................................................................9

    10. When and where to engage ..................................................................................................11

    11. Implementation considerations.............................................................................................12

    12. Evaluation ..............................................................................................................................12

    Annex 1: Digital engagement in relation to social media .....................................................................14

    Annex 2: Example initiatives .................................................................................................................15

    Annex 3: Implementation guidance ......................................................................................................18

    Annex 4: a Framework for Digital Engagement in DH...........................................................................20

    Annex 5: Glossary of terms ...................................................................................................................21

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    1.Executive Summary1.1. This document describes digital engagement (DE) and social media1, sets out the context

    and background to their use in the Department of Health, and develops a framework forthe future development of digital engagement. DE already exists within the Department,

    has been used with varying degrees of success, and is going to become more prevalent

    with changing demographics and emerging technologies.

    1.2. DE brings new opportunities to engage audiences in their health and healthcare in better(and often cheaper) ways and allows more to be achieved with engagement enabled by

    digital technologies, usually in combination with other media.

    1.3. In addition, the outside world is engaging with DH (and topics relevant to DH) in digitalchannels in any case, using blogs

    2, comments on media sites, social networks and more.

    Having an approach and supporting materials to respond to this is important.

    1.4. The document presents criteria that can be used to assess whether, and how, DE maydeliver benefits, along with guidance on terminology, strategic principles, operational

    practice, and examples of use. Annexes include a detailed Glossary of Terms, and further

    guidance on the application of DE in practice.

    1.5. A simple set of strategic priorities forms the heart of the document. The relationshipother relevant strategies and initiatives across government, and within DH, is described in

    this paper.

    1.6. The document focuses on engagement in the context of digital communications. Theterm digital is also used to describe other technology applications, such as informatics,technology for remote monitoring and patient self-service, and many other examples.

    These uses of the term digital are not within the scope of this document.

    1.7. This document is owned by the e-Communications and Publishing team (ECP) within theCommunications Directorate, and is hosted online, via a Quickr (Digital Engagement). It

    forms the Departments contribution to the Permanent Secretary, Government

    Communications objective of an approach to Digital Engagement in place for all

    departments by the end of March 2010.

    2.Digital engagement: opportunities and tools2.1. The capability to digitally engage already exists. Active discussions are happening in social

    media. Comment threads exist in forums and blogs. Fan pages, groups, forums and lists

    already exist in relation to particular audiences. The common characteristic of these

    examples of engagement is that they involve conversations. Engagement moves

    communication beyond the transmitting of information in one direction or other, and

    into conversational territory, where information flows faster and more fluidly. Annex 2

    provides some examples of DH experience in these areas.

    1The relationship between these terms is discussed in more detail at Annex 1.

    2This and other terms are described in the Glossary at Annex 5.

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    2.2. Digital engagement is relevant to DH policy leads, campaign managers, marketers,commissioning policymakers, internal communicators, press officers and in most other

    areas of Departmental activity.

    2.3. DH has a range of its own channels available to support digital engagement, including: an external corporate website: http://dh.gov.uk a public-facing website, NHS Choices: http://nhs.uk Delphi, the Departments intranet: http://delphi.dh.gov.uk/delphi/index.htm Commslink, an internet-based network restricted to communications professionals

    across the NHS: http://www.nhscommslink.nhs.uk/

    a YouTube channel for video content: http://www.youtube.com/departmentofhealth(as does NHS Choices: http://www.youtube.com/nhschoices) each channel having a

    different content focus

    a Flickr stream: http://www.flickr.com/photos/departmentofhealth/ several Twitter accounts: one for the Department as a whole

    http://twitter.com/dhgovuk; others with specific objectives, styles and content

    its own presence within other public-facing sites, such as the Care and Supportcontent within Directgov

    Facebook pages for relating to different policy areas and campaigns a Civil Wiki page: http://wiki.gsi.gov.uk/index.php/Department_of_Health the capability to host blogs on its internet and intranet sites, with features such as

    commenting and moderation available

    online member communities and forums as an example, the Social Marketersnetwork, sponsored by DH (http://socialmarketers.net)

    DH also has the ability to engage in other channels outside its own control, where there is

    value to be gained from doing so. It is a rich and complex environment.

    2.4. To give a sense of scale to these channels, the following tables shows examples of metricsassociated with them.

    Channel Example metric

    DH website (dh.gov.uk) 850k visitors/month

    NHS Choices website (nhs.uk) 9m visitors/month

    Delphi, the DH intranet 170 pages updated/month

    Commslink 3,700 users

    YouTube DH channel: 322 subscribers ;

    156,000 views

    Flickr 189,903 views

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    Channel Example metric

    Facebook Example: HPV page has 2,500+ fans

    Twitter @dhgovuk 2364 followers

    3.The context of digital engagement for DH3.1. Before considering digital engagement in more detail, the characteristics of DHs

    communications context are worth noting:

    3.2. Widespread general interest: health matters are of interest and relevance to a wideaudience, with many individuals ready to engage. This differs from, for example,

    international trade, science or agricultural policy matters. Everyone is a healthcare

    stakeholder.

    3.3. Diverse audiences: DH audiences include managers, medical professionals, othergovernment departments, the general public, media, social care stakeholders, patients,

    special interest groups and its own staff. Different audiences also have different

    capabilities to engage, and some use intermediaries to do so. This wide variety means

    that this overall approach to digital engagement is necessarily set out at a high level.

    3.4. Overlaps between health practitioner and patient interest: whilst the principal focus ofsome communication activity may be on healthcare professionals, the nature of health

    issues means that it is always likely that this information will be consumed by a lay

    audience to some extent. Further complication occurs where communications areintentionally targeted at mixed lay and specialist audiences, and where they are delivered

    through intermediaries.

    3.5. Existing areas of interest: from healthcare consumers to healthcare professional groupsto the pharmaceutical industry strong networks and online forums of interest already

    exist (parents is a good example). These groups are better versed in engaging digitally

    than government. As with large organisations generally, government has some catching

    up to do in practising effective digital engagement.

    3.6. Fast-moving, unpredictable and high-impact content areas: issues ranging from newdiseases (such as pandemic flu), to treatment concerns, to health scares (real orperceived), can frequently appear with a combination of little notice, high public interest,

    and potentially high impact on health outcomes. Emergency communications as a whole

    are an area of both challenge and opportunity for digital engagement. The real-time

    potential of digital communication to be flexible and responsive in real-time can be very

    well suited to emergency situations. An example might be the healthcare implications of

    a major terrorist attack requiring rapid communication with a broad, geographically

    dispersed audience.

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    4.Digital engagement: DHs strategic objectives4.1. We will use DH-hosted tools and channels, as well as external channels, to listen and

    respond to our audiences, and to give them opportunities to interact with us and each

    other online, where there is benefit from doing this.

    4.2. We will ensure, through evaluation, that our digital communications are effective andmaximise the use of DH communications resources.

    4.3. We expect a consistent set of operational principles (described in detail in thisdocument) to be adopted and applied to the practice of digital engagement, and for

    this to become seen as a core communication skill rather than a specialist discipline.

    4.4. We expect digital engagement (and the use of digital communications generally) tobecome seen as part of overall communications planning in all media. Digital

    engagement does not have to represent a revolutionary change it is a natural

    extension of, and support to, engagement in other channels.

    5.Why engage digitally at all?5.1. Digital engagement is a strategic choice, rather than a box to be ticked as part of

    communications planning. It serves in two broad contexts:

    5.2. Firstly, digital engagement offers the opportunity for planned interaction with new,specific audiences, using channels that enable feedback and responsiveness to an extent

    unachievable using traditional media. Changing patterns of channel use in certain

    demographics in favour of digital channels mean that digital engagementopportunities are continuing to increase over time.

    5.3. Secondly, digital engagement around public services happens, whether planned or not.Peer-to-peer networking, the creation of interest groups, and the ability of social

    networks to spread messages virally and quickly are all examples of digital engagement.

    By not participating, DH misses opportunities to counter misleading information, to

    influence debate or to interact with audience sectors who increasingly view digital

    channels as their native environment. Issues that surface in digital channels can readily

    cross over to more traditional media at speed, giving widespread attention to matters

    previously of only niche interest.

    5.4. An approach to digital engagement does not start from the presumption that moreopenness is always better or digital engagement is the answer to every problem.

    Neither should it dictate how specific areas of communication could be conducted. This

    will be a factor of objective, audience, content and media. Instead it reflects

    opportunities and risks of digital engagement as an enabler of better communication, and

    provides how to proceed where it is advantageous.

    6.How to make the decision to engage in digital channels6.1. Digital engagement is not currently a standard part of communication planning in DH.

    Current DH practice, experience and expertise vary widely across directorates. Nor, forreasons set out in this paper, should it necessarily feature in allcommunications

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    planning. However, the disposition of audiences to engage in digital channels does show

    a general increasing trend, and DH will and should become more active in its practice.

    Some examples of DH digital engagement can be found at Annex 2.

    6.2. Indications that digital engagement should form part of the communications mix include: An understanding of the audience. In terms of its demographic is it young, old,

    technology-literate?

    An understanding of theplatforms that are being used do they have a particularculture or pre-existing user community? A recent government crowdsourcing of

    images used Flickr; falling foul of Flickrs active professional photography community

    who reacted to the seeming amateurisation of their market.

    An opportunity to co-create. Is the subject being communicated one whererepresentation, creation and amendment can genuinely be offered?

    A need for openness and scrutiny. Is the historical or broader context of the topicsuch that openness and engagement may be particularly appropriate? (A non-DHexample would be the crowdsourcing of ideas for a new approach to MPs expense

    processes).

    An appetite for some level of risk. Digital engagement can offer the unexpected.Platforms that arent under direct control always have the potential to be used for

    purposes that werent predicted.

    Ability to think laterally: some of the most successful digital engagement has comeabout by taking an indirect approach to a topic. Leicester City Council achieved a very

    high level of engagement on Facebook by operating a fan page for Leicester as a city

    rather than the Council as an organisation. Similar, a current DH example about

    social care recruitment is exploring whether its Facebook page could focus on moregeneral recruitment conversations, rather than just solely on social care as a theme.

    Resource availability: from staff with the right skills, to enough time to cope with thework arising from engagement, to a commitment of resource for the whole life of a

    period of engagement. Communicators at all levels (and the policy teams they work

    with) need to be aware of the principles of digital engagement not just those at the

    front line of communication.

    6.3. If most of the conditions in 6.2 can be met, these provide good indications thatproceeding with digital engagement will have value.

    7.Why is a Departmental approach to digital engagementnecessary?

    7.1. Digital engagement, particularly that involving social media, changes the way wecommunicate. It is:

    Far more widely distributed: all those involved, whether as public service providers oras users, have the potential to publish on a very wide scale

    Direct: digital engagement has the potential (for better or worse) to redefineintermediation in communication often removing intermediaries entirely, but also

    creating new challenges for those without access to digital services

    Real-time in nature: feedback and reactions are often immediate

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    Unpredictable: events and conversations frequently cross between channels inunexpected ways e.g. a face-to-face experience may lead to a user-generated video

    being uploaded to a blog, whose comments then become the subject of a traditional

    media news story. In 2009, the story of a London Underground worker who abused a

    passenger was on the front pages of national newspapers the day after he was caught

    on another passengers video camera and the content uploaded to social networks.

    Viral: social media are capable of transmitting onward messages at very great speed,reaching an exponentially increasing audience; if things go wrong, they can go very

    wrong, very quickly; and cross channels in doing so, often into traditional mass media.

    The story of a death initially (and incorrectly) thought to be linked to HPV vaccination

    reached a large audience very quickly through the passing on of links to the story

    through social media.

    Complementary to traditional media: DE can often deliver most benefits when used inassociation with traditional media

    New: not yet embedded into ways of thinking or working; meaning that somemistakes are inevitable, and a great deal of duplicated learning may occur

    Increasingly popular: as a personal preference for a communication channel Inverted: in the relationship between the experience and expertise of practitioners:

    more junior officials may be more skilled in the use of social media than those more

    experienced and senior in a policy area

    7.2. All these factors combine to make DE complex, requiring sound underpinning principles.DE does not provide a solution to every problem. Traditional communications and the

    expertise accrued in using them have a very strong role to play. But the increasing

    potential of DE, whether as an intended part of communications, or as a consequence of

    other events, means that an appreciation of DE is now an essential part of policy

    planning.

    7.3. As an example of this, Eurostar service failures in December 2009 exposed the lack of adigital engagement approach. Eurostar had a social media policy based on using social

    media to deliver marketing messages. But in the event of an operational crisis, the

    resulting storm of negative feedback showed that digital engagement is now an essential

    consideration for any organisation facing a large public audience.

    7.4. Any long-term digital engagement approach carries a significant caveat thetechnologies and media involved change rapidly. In the early years of public participation

    on the internet it was easier to track and manage engagement monitoring a fewsignificant forums and blogs, and having an understanding of the most popular social

    networks, was achievable without a large commitment of resources.

    7.5. At the start of 2010 this landscape is showing signs of change. As ever, the popularnetworks and forums are in flux, but there are new strategic issues at play with the rise of

    geolocation where the place where data was generated (or which it references) is at

    least as important as its content and utilities which make it easier to participate in

    numerous channels at the same time. Cross-platform identity services also support

    engagement between parties in which content can cross easily between media and

    platforms. For example, a Facebook log-in can now be used to register on other sites,

    meaning that content can be created and those sites, and automatically update pages in

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    Facebook at the same time. This makes monitoring and management of online activity

    more difficult.

    8.Relationship to other initiatives8.1. The Power of Information Taskforce was commissioned in 2008 by the Cabinet Office,

    and reported in 2009 with a series of recommendations on digital engagement3.This

    document is an extension of that guidance, tailored for the Department of Health,

    bearing in mind the Departments priorities and role.

    8.2. This document covers the business use of social media for digital engagement not theuse of social media in a personal capacity. The Cabinet Office has published guidelines for

    civil servants using social media through the Central Office of Information (COI)4.

    8.3. The overall cross-government engagement strategy, as set out by Cabinet Office anddocumented by COI, sets out to:

    Communicate where people are present

    Put information in the places where people go already Participate where people are present, particularly through forums, wikis and blogging Deliver access to online services where people goCreate better user experiences for government services

    Enable people to find the information and online services they require by having fewercommunication channels and focusing them around audience needs

    Bring relevant information together into one place on government sites rather thanacross several sites, saving users time and effort

    Create a consistent high-quality experience through a dedicated set of standardsEnable non-governmental bodies to reuse information

    Help non-governmental bodies to build new services by structuring information sothat they can combine public data with private data

    Avoid replicating what is already being undertaken by non-governmental bodiesThese general objectives have been used to develop more specific principles relevant to

    the work of the Department, set out in section 9.3 below.

    9.Defining a digital engagement approachAn identifiable relationship to overall organisational strategy

    9.1. For Department of Health, this means an alignment of DE to the overall strategicobjectives of:

    Better health and well-being for all: helping people stay healthy and well;empowering people to live independently; and tackling health inequalities.

    3http://poit.cabinetoffice.gov.uk/poit/

    4http://www.coi.gov.uk/guidance.php?page=264

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    Better care for all: the best possible health and social care that offers safe andeffective care, when and where people need it; and empowering people in their

    choices.

    Better value for all: delivering affordable, efficient and sustainable services;contributing to the wider economy and the nation.

    ...and values:

    We value people: We care about people and put their health and well-being at theheart of everything we do.

    We value purpose: We focus our actions and decisions on achieving our shared goals. We value working together: We work together as one department and with our

    partners and stakeholders.

    We value accountability: We take responsibility and are open to challenge.9.2. Good digital engagement must demonstrate relevance and contribution to the delivery of

    these objectives, and be practised in line with these values.

    Underpinning strategic principles

    9.3. As important as the relationship to organisational strategy are the principles that supportall engagement in practice, strategic and tactical:

    a. Set objectives for all planned engagement activities, and be clear in the desiredoutcomes from unplanned, responsive activities.

    b. Build a business case quickly and adjust it in the light of experience it may not beright first time. Build in agility to the process of developing the business case quickturnaround may be more useful than a perfectly-formed product.

    c. Be consistent: across different channels, over time, and across topics/campaigns/themes.

    d. Have a recognisable tone of voice.e. Be realistic about where and to what extent DH can engage on a particular issue: if

    content is taken and embedded in thousands of third-party sites, all of which could

    then feature follow-up comments and discussions, it will be unrealistic to interact in

    all of them.

    f. Be clear about the audience being engaged, and why. Engagement works best whena communitys character and needs are understood, and particularly if it has been pre-

    engaged in other channels (including non-digital).

    g. Leaving is harder than arriving if you have to close a channel, plan the exit carefully.For example, a Twitter channel set up as part of an overall campaign may have an

    intentionally fixed lifespan. Prepare for its closure so that those involved in

    conversations arent taken by surprise. Above all, dont abandon a channel and leave

    it publicly visible and unattended.

    h. Similarly, co-production sets a tone for future activity. Once audiences haveexperienced co-production in a particular policy area, it may be hard to revert to

    previous approaches.

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    i. Remember the effectiveness of DE as complementary to traditional media plandigital activities as part of an overall approach.

    j. Follow the code for civil service online participation.k. Dont think of the channel first and then try to find a use for it.l. Ensure that channels are accessible and suited to the needs and capabilities of those

    engaging in them.

    m.Prepare for the unexpected run scenarios to test DE. Be creative in: what couldhappen if... thinking.

    n. Measure and evaluate engagement activities.o. Be prepared to rethink established metrics and role of existing assets, notably web

    sites. Engagement involves being where the conversation is, not necessarily bringing

    others to a destination.

    p. The best place for engagement may not be DHs place.q. The best organisation to lead co-production may not be DH. For example, a third

    sector partner may provide a more effective setting.

    r. Be aware of the skills required: beginning DE without them is likely to fails. Approvals processes and timescales from non-digital channels are unlikely to be

    suitable for DE

    t. Take risks if nothing ever goes wrong, it may be a sign that genuine DE is lackingu. Dont ignore digital engagement, whether planned or not it wont go away

    10. When and where to engage10.1. This refers to active choices of channels as well as decisions made in response to

    feedback from monitoring and listening.

    10.2. There are three basic approaches available in planning where to engage; approacheswhich can be used in combination:

    On ones own channels bringing the conversation to you On other sites taking the conversation to where the audience is, and where

    conversations are happening anyway

    Through allowing content to be used elsewhere providing the ingredients forengagement to take place, anywhere; e.g. allowing content assets to be embedded in

    third-party blogs

    10.3. An example of using these approaches in combination would be the hosting of a webcontent where direct feedback can be left, also containing embedded video content (i.e.

    content appearing in the site itself), which can either be viewed in situ or by linking back

    to an external video hosting site (such as youtube.com). The content is also made

    available for other, non-government, sites to take and use, allowing further engagement

    to take place on those sites.

    10.4. Such an approach has benefits and drawbacks. By offering content in numerous settings,different audiences and communities can be reached. However, there is a corresponding

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    increase in the workload required to monitor, and especially, participate in, the

    numerous conversations that ensue. Effective use of monitoring tools, such as a social

    media dashboard, can offset this to some extent.

    11.

    Implementation considerations11.1. Resourcing: one of the most significant strategic issues to consider is the impact on

    traditional resourcing models that DE may bring. Large-scale interaction, 24 hours a day,

    on hundreds of sites covering dozens of topic areas maybe possible in theory. But this is

    unlikely to be achievable with realistic resources.

    11.2. Instead, engagement opportunities can be prioritised: in a recent exercise, ECP workedwith the QIPP team to review 40 recent stories, in digital channels, mentioning topics

    which might have relevance to the QIPP agenda. The stories were reviewed for the

    degree of relevance to QIPP, and the impact which the topic might have on the delivery

    of QIPPs objectives. This led to a balanced choice for each story on whether engagementwas appropriate, and if so, in what channel.

    11.3. The use of social media is becoming better understood. More is known about the natureof building communities, managing interaction and reacting to the unforeseen. Social

    media tools are, by and large, free of up-front costs, although they do of course incur

    significant amounts of management time in their establishment and operation.

    11.4. As DE continues to grow in volume which seems likely so the use of smarterresourcing approaches should be explored. For example, rather than having a dedicated

    social media manager for each project it should be possible to deliver operational

    economies by specialising and sharing such skills across a number of projects.

    11.5. Quantifying resourcing for digital engagement requires the establishment of clearengagement goals and monitoring frequencies. Passive monitoring can be conducted

    with very little resource, once initial tools have been set up, but once response has been

    entered into, an ongoing resource commitment needs to be established. For planning

    purposes it may be useful to distinguish between set-up resource (establishing a

    strategy, choosing platforms, preparing content, building a community or network) and

    operating resource listening, responding, escalating.

    11.6. Accessibility: in both the technical sense (provision for users of different capabilities) andthe network sense (any form of connection to digital platforms such as the Internet). It is

    not the role of an approach to DE to define future infrastructure provisions, but clearlywe must bear in mind the realities of access when planning for digital engagement.

    12. Evaluation12.1. Given the resources that digital engagement can consume, evaluating its effectiveness is

    essential. However, its evaluation is complex. There is a temptation to focus on

    intermediate metrics (number of followers or subscribers, the size of audience that will

    have seen online content, the number of blog posts and comments generated etc.) rather

    than tangible outcomes. Yet tangible outcomes may only be indirectly attributable to

    digital engagement, such is the nature of influence.

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    12.2. Tools fit for the evaluation of digital engagement are required: this may mean the designof dashboards (suites of tools which show evidence of performance in a number of

    areas, together in one place). Examples of these already exist in central government, and

    have been developed by ECP to suit particular DH requirements. As well as measuring

    obvious metrics such as frequency and extent of coverage, tools also exist which can

    track sentiment the tone and context of online commentary on a particular topic.

    12.3. This document does not propose a single evaluation methodology to span all instances ofDE across the Department. Given the range of communication and engagement activities

    such a methodology would be unlikely to exist in practice. However, the setting of

    objectives (and corresponding measures) suitable for each example of DE, and the

    periodic review of progress against them (with swift corrective or fine-tuning action taken

    where necessary) are essential.

    12.4. As a minimum, evaluation should include:

    a core set of hard measures, including numbers of subscribers, estimates of audiencereach, and volumes of content generated;

    sentiment analysis (some degree of sampling is inevitable) as evidence of audienceperceptions of engagement; and

    assessment of overall achievement of campaign or policy goals, where engagementhas played a part.

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    Annex 1: Digital engagement in relation to social media

    Although these topics are related, and often interchanged, they have different meanings. Digital

    engagement is defined as:

    Digital engagement: the use of interactive techniques to improve service

    delivery and information provision via digital technologies (the internet,

    mobile telephones and digital television) [defn: COI]

    The Cabinet Office commissioned the 2009 Power of Information5

    report, which described three

    categories of digital engagement in practice:

    Helping people online where they seek help Innovating and co-creating with citizens online

    Opening up online dialogue

    Interactivity and improvement are important here. In contrast to digital communication the use

    of any digital channel or technique to communicate DE must6

    have this two-way element of

    interaction (for example between service provider and service user). Merely publishing information

    in a digital format, or presenting an electronic transaction without any ability to provide comment or

    feedback, does not constitute DE.

    In addition, DE may well facilitate engagement within peer communities. An example might be to

    provide a space for carers to share their experiences and advice with each other, rather than

    offering top-down guidance. Social media can be used to provide such spaces.

    Social media refers to particular digital technologies that are frequently associated with, and very

    suitable for, digital engagement.

    Social media: digital tools that permit people and organisations to interact

    freely with low (or no) barriers to entering a conversation

    Social media is less concerned with broadcasting messages to mass audiences; and more about

    engaging specific groups in some depth, building strong and ongoing relationships between people

    and a brand, campaign or policy.

    Digital engagement refers to a general philosophy of operating; social media are a particular set of

    tools that enable this.

    5http://www.cabinetoffice.gov.uk/reports/power_of_information.aspx

    6

    There is arguably a wider definition of engagement, based on the consequences of even one-waycommunication. However, that would equate digital engagement with all digital activity, and detract from the

    focus on interaction that is the purpose of this paper.

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    Annex 2: Example initiatives

    Examples from across DH

    Response to pandemic flu, 2009

    A programme of engagement across several digital channels. A Twitter channel provided regular

    updates on breaking news items and other content. A protocol was also developed between the

    major public-facing government websites to use the pandemic flu Twitter account to amplify their

    respective significant messages.

    Monitoring and listening played an important role. By understanding the conversations that were

    happening in digital channels, content could be tailored to meet particular concerns, or to clarify

    points where needed. Although DH decided not to interact directly with the public through digital

    media, its use for listening to conversations, sentiment and concerns demonstrated engagement

    because content was created or changed as a result.

    Other digital engagement took place through the use of video content (NHS Choices posted

    commentable content on its YouTube channel) and some content was also hosted on DHs YouTube

    channel (non commentable at that time). A paid search management strategy was put in place to

    ensure the prominence of appropriate links relevant to pandemic flu search queries.

    NHS Choices also supported commenting on its news articles. Generally these conversations were

    self-moderating; with users directing users to correct information sources if they were in doubt. A

    general policy of not interfering in user commentary was observed. Email subscriptions for updates

    were also supported by NHS Choices.

    HPV Vaccination, 2009/10

    The HPV vaccination campaign used a mixture of traditional and digital media. Traditional

    promotional media and paid web search were supported by web content giving further information

    on the vaccination programme. A notable engagement feature was the ability to register for

    reminders (sent by text message) to help make sure that vaccinations occurred at the right time. This

    was a novel use of a digital channel (the mobile phone) to reach an audience group for whom this

    was particularly appropriate.

    The HPV use of social media (Facebook: http://facebook.com/hpvtogether) to support other

    channels has also shown some excellent practice. The theme of the page is not: become a fan of

    HPV vaccination it has instead featured attractive content for girls and young women on lifestyleand leisure interests. By sharing content that has value to this community, the community engages,

    develops and almost as a by-product becomes conducive to receiving, sharing and discussing

    messages about the vaccination programme. The Facebook group has over 2,500 fans, and has been

    used to organise events such as the Girls Night in which was signed up to by nearly 8,000 people.

    Big Care Debate, 2009/10

    One of the largest, multi-channel digital engagement exercises, this included an email list that could

    be signed-up to, a Facebook page, a Twitter account and latterly, an exercise to encourage the public

    to submit photos related to care, for display and potential inclusion in the forthcoming White Paper.

    Supporting web content for the engagement channels was created as a subdomain of Directgov.

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    The Facebook page attracted informed and active contributors, and built up a following.

    Contribution from DH to discussions on the page was relatively limited in volume and frequency

    compared to that generated by the public, with the effect of allowing a small number of vocal

    contributors to dominate discussions.

    Webinars/webchats (various dates)

    DH has conducted several webchats, hosted in different ways: in a government channel (the No10

    web chat platform); via the media (using the Guardians webchat services); and with the third sector

    (using Mumsnet and Carers.org as webchat platforms). Typically the format centres on a prominent

    individual (the Chief Medical Officer, senior official or minister, typically) providing either a briefing,

    with follow-up comments and participation, or a straight question-and-answer format.

    In a recent example (Feb 2010) Phil Hope chaired a web question-and-answer session for around an

    hour taking questions on the topic of care and support. The full transcript of the webchat is available

    at http://www.number10.gov.uk/Page22420. The moderator took direct questions about the

    engagement exercise (in addition to questions for the minister) and provided personal responses viaemail a very positive indication of engagement.

    Examples from across government

    The New Opportunities online consultation

    (www.hmg.gov.uk/newopportunities.aspx) provides access to the New Opportunities White Paper

    and seeks opinion on how the UK can draw on the opportunities offered by the global economy.

    The site is a primary source of information that encourages users to engage in discussions in other

    locations before submitting their comments.

    The Sustainable Development Commission website

    (www.sd-commission.org.uk/pages/sd-panel.html) The Sustainable Development Commission has

    recruited a 500-strong panel of multi-discipline stakeholders to which it can pose regular

    consultation questions.

    Number 10 webchats

    (www.number10.gov.uk/news/webchats) allow the general public to direct questions at the people

    who make decisions that affect their lives. They are a cost-effective and engaging way of involving

    the public in government processes, and embed good content.

    The Communities and Local Government discussion forums

    (http://haveyoursay.communities.gov.uk/ forums/) enable users to debate issues that are relevant

    to their local community through the Departments own social media channels. They are a low-cost

    way of gathering public opinion and placing the views of the public at the heart of policy-making

    processes.

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    The Listening to Students blog

    (http://talk.dius.gov.uk/blogs/studentlistening/) provides the Department for Innovation,

    Universities and Skills (DIUS) with an opportunity to post information that will engage university

    students in government decisions. The Departments dedicated social media unit creates technical

    solutions, policy and communications. The student listening blog is a good example of the way inwhich DIUS creates dedicated spaces for key stakeholders using low-cost social media.

    RAF careers promotion

    (www.bebo.com/theroyalairforce) has benefited from social media activity. Its Bebo page

    successfully exploits the network effect by giving users highly engaging content that they want to

    talk about and share with others. To do this they allowed frontline staff to tell their own stories

    using video and chat.

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    Annex 3: Implementation guidance

    Recommended practice

    More detailed guidance on digital engagement by channel:

    Social networking sites (e.g. Facebook) Consider creating pages related to the targeted topic (as opposed to being based on its

    direct theme); some creativity of approach can help in attracting broader audiences and

    building a more active community. Examples include the Girls Night In events within

    the HPV group, and an approach to social care recruitment which focuses on more

    general issues of career choice not just around social care.

    One of the most sensitive areas is the boundary between personal and business personafor staff participating in the Facebook environment staff should always engage as DH

    officials when participating on official business on social network platforms.

    Web campaigns Give consideration to the need for new content developing existing content on public-

    facing government sites (e.g. NHS Choices or Directgov)

    Look for opportunities to make content available to other platforms (including non-government) in addition to developing content on government sites

    Consultation channels

    Ask for proportionate personal information, indicating how it will be used

    Make it clear what (minimal) information is requiredfrom those engaging, and what isoptional. Barriers to participation should be as low as possible.

    Forums Decide on moderation approach (pre-publication, post-publication or none) based on

    the context of the forum membership, topic area and discussions. Moderation helps

    reduce the risk of off-topic or offensive content being submitted, and can be used to

    prevent on-forum conflict between users, but it can also introduces costs and delays to

    publication, and can be seen by some users as a form of censorship.

    Assess forum usage as proportion of available audience, check for domination by asmall, vocal community, and consider mitigating actions. As an example, if a profession

    has several thousand members, but only a handful are participating in a forum, explore

    ways to broaden the appeal, either by seeding different topics for discussion or by

    publicising the forum to a wider audience.

    Blogs (including microblogging) DH policy is that no officials will blog in a personal capacity. Any channels that are

    operated must respect this; an example of a way to achieve this might be the use of a

    range of external contributors to write posts based on specific topics, as a featured

    theme relevant to a particular policy area. Once begun, blogs should be regularly

    updated.

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    Allow blog comments; decide on moderation approach (pre- post- or none) based oncontext, but a blog with no comment facility represents generally poor practice (and is

    effectively no more than web page publication).

    Cross-promote the blog or microblog in other channels. Use a personal touch, but dont make it all about one persons activities. Exploration of

    related themes, or asking questions of the channels audience, can be useful ways to

    broaden the content and value of posts.

    More detailed guidance is available from the e-Communications and Publishing team.No new blogging or microblogging channels should be set up without the involvement of

    ECP.

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    Annex 4: a Framework for Digital Engagement in DH

    It may be useful to recap this digital engagement framework in a 6 P mnemonic form:

    Purpose

    Is there a clear purpose for digitally engaging?

    Principles

    Have the principles within this document been reviewed before firm plans and commitments are

    made?

    People

    Are the resources in place to support digital engagement? Is the community with whom engagement

    is proposed well-understood? Are other communities that may become engaged also understood

    Place

    Where to engage: on a DH platform, on other platforms (government and non-government), via

    supersites, or using a combination of these?

    Practice

    Are the guidance notes within this paper being applied to the operation of digital engagement? Has

    additional guidance been sought from the eCommunications and Publishing team and from peers

    where necessary?

    Protection

    Has due care been given to risk, reputational protection and potential policy impacts of digitally

    engaging? The eCommunications and Publishing team provide advice and expert guidance in this

    area.

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    Annex 5: Glossary of terms

    Term Definition

    Blog Derived from Web log originally a regularly-updated journal on

    which visitors could leave comments. Now generally used for a site

    (or section of a larger site) where text-based content can be

    created in the form of short articles, almost always open for

    comments to be posted. These comments may be subject to some

    degree ofmoderation.

    Campaign site Website created in association with a specific campaign; usually

    for a defined period of time; may include facilities to receive user

    feedback and present an opportunity for engagement.

    Commentable document A facility for hosting a document under review, usually divided into

    manageable sections, and permitting comments to be left for the

    author and to permit dialogue between commenters. Combines

    some of the features of a wikifor collaborative working, but

    retaining an initial document structure throughout. Has been used

    on a number of government policy documents made available for

    digital consultation. One tool that delivers this functionality

    (implemented on the WordPress platform) is known as

    Commentariat. Example at:

    http://interactive.bis.gov.uk/lowcarbon

    Consultation channel Any channel used as part of the policy formation process whether

    in the gathering of ideas, discussion of concepts with stakeholders,

    or in hosting content as part of a formal consultation process. The

    content may be commentable (see above), hosted as a wikifor

    collaborative editing, or simply be displayed publicly with

    comment invited through email or other direct channels.

    Content-based networking

    sites

    e.g. YouTube, Vimeo, Flickr, TripAdvisor sites based on content of

    a certain type (e.g. video, images, reviews) with a strong element

    of user feedback, user-generated content (UGC) and elements of

    social networking (e.g. ability to create groups, forums, favourites,peer-to-peer relationships etc.)

    Crowdsourcing The use of digital (or other) media to allow the contribution of

    information or ideas from a wide range of people, usually around a

    topic, a question, or a request for innovative suggestions.

    Dashboard Dashboard: a utility that searches and aggregates information

    from many channels across the internet, and displays it all in one

    place, in real time, for management, monitoring or consumption

    purposes. Example: www.netvibes.com/socialcare

    Data feed Automatic generation of content (usually from a website) so that it

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    Term Definition

    can be read elsewhere, or integrated into other channels. A feed

    might be updated, for example, every time a new blog post or

    comment is created, allowing the content to be read elsewhere by

    a subscriber to that feed.

    Feeds are also useful for automating information flows between

    websites, so that a change in one place can be reflected in another

    site without the need for manual intervention. Updated disease

    statistics would be a good example of such a feed.

    Digital communications Communications using digital media (aka digital channels): the

    internet, mobile telephony or digital television technologies

    includingplatforms operating using these technologies.

    Digital engagement The use of interactive techniques to improve service delivery andinformation provision via digital media technology.

    Email subscription Although not social in terms of community formation and peer-

    to-peer interaction, allowing users to register email addresses to

    receive personal(ised) updates represents a form of digital

    engagement. Digital tools build a two-way relationship: the user

    receiving content, and also experiencing some sense of being part

    of a community, even as information recipient.

    Forum Area for registered members to discuss specific topics. Can form

    part of a wider overall site. Characterised by a core user basemaking multiple contributions and often sharing relationships or

    culture. Forum content may or not be moderated.

    Geolocation The tagging of content with attributes relating to a physical place.

    Typically this will be either the place where the content was

    created, or a place to which it refers.

    Group A type of forum generated by users within a social networking or

    similar type of site. Shares many of the characteristics of a forum,

    but can be more volatile. Members (who are a subset of the

    members of a larger form or social network) will typically interactfor a shorter period of time, usually around a specific single issue.

    Creation offan pages (or similar designations) also effectively

    forms a Group.

    Metadata Information about information. Often invisible to the user,

    metadata allows content to be classified, structured and sorted.

    Tags represent a use of metadata.

    Microblogging e.g. Twitter, Identi.ca, Yammer (the latter within corporate

    environments). Member communities sharing short message

    content, openly and by direct peer-to-peer message. Highly

    flexible in their use, and prone to rapid escalation of issues:

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    Term Definition

    creation of a Twittermob.

    Moderation Editorial judgement over user-generated online content.

    Numerous varieties exist, from moderation by peers or by the site

    owner/author, to outsourced arrangements where professional

    moderators assess and process comments on a larger scale.

    Post To publish content to a blog, micro-blog, forum or website, either

    as a new topic or as a comment on existing content. Also, as a

    noun, to describe the content posted (synonymous with blog

    post, forum post etc.).

    Platform Infrastructure within a digital channel allowing content to be

    hosted, applications to be run, or interactions between users

    managed, within an overall structure. An example might includeyoutube.com a platform for video hosting and interaction, or the

    iPhone as a mobile telephony platform capable of running a

    variety of different applications installed at the choice of the user.

    Private social networking site A social network intended for a specific community of interest.

    Offers similar features to an open social networking site, but

    almost always sets conditions and controls over entry and

    participation. E.g. sites set up using Ning.

    User-generated content Any content provided by users, rather than the owners of an

    online environment. May or may not be moderated(see above)

    User feedback A specific type of user-generated content: that created as a

    response to provided informational content. Can take the form of

    freeform text comments, votes, likes/dislikes, or more detailed

    survey-type information.

    Social bookmarking A method by which people can store, organize, search and share

    articles, blog posts and other information. There are many

    different libraries, each with their own bookmark, including Digg,

    de.lici.ous and Reddit. Increasingly, posting content links as tweets

    or to Facebook profiles provides a common form of bookmarking.Eg. the DH website supports the sharing of content through social

    bookmarking:

    http://www.dh.gov.uk/en/MediaCentre/Pressreleases/DH_115988

    Social marketing The use of marketing techniques to achieve desired social

    outcomes (e.g. behaviour change). May or may not involve the use

    of social media. Included here to avoid confusion with social media

    marketing.

    Social media Digital tools that permit people and organisations to interact freely

    with low (or no) barriers to entering a conversation.

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    Social media marketing The use of social media to promote a particular cause or product.

    May or may not have social marketing implications. Included here

    to avoid confusion with social marketing.

    Social networking site A website offering general-purpose networking features to all who

    may want to join. Facebook dominates the adult market; Bebo has

    a focus on a younger/teenage audience; MySpace is now focused

    on music/video content and may be regarded as a content-based

    networking site, albeit one with a high membership.

    Tags Keywords (or similar indexing information) describing online

    content that allow other users to search for relevant material.

    Twitter The best known of the micro-blogging platforms. Users contributeshort messages, either on the twitter.com website, or using a

    number of third-party client applications: whatever the route,

    interaction happens in a consistent and open way. Terms include:

    Tweet: to post content (short messages up to 140 characters long)

    Re-tweet: to republish anothers post. Good for spreading

    messages widely, or adding commentary to them

    Hashtags: words or phrases preceded by #. This allows them to

    be grouped together and easily searched.

    Webchat (or Webinar) A structured discussion using instant messaging

    Example: http://webchat.number10.gov.uk

    Wiki An open collaboration environment in which users may freely (or

    with some controls) create and modify content as a community.

    The best known example is Wikipedia, where an open community

    collaborates to create an encyclopaedia, but wikis can be used for

    tasks as varied as communal creation of a policy document, or

    managing the names and interests of attendees to an event.