Digital Engagement

Department of Health April 2010

E-Communications & Publishing Communications Directorate Skipton House

Digital engagement

Table of contents
1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. Executive Summary..................................................................................................................3 Digital engagement: opportunities and tools..........................................................................3 The context of digital engagement for DH ..............................................................................5 Digital engagement: DH’s strategic objectives ........................................................................6 Why engage digitally at all? .....................................................................................................6 How to make the decision to engage in digital channels ........................................................6 Why is a Departmental approach to digital engagement necessary?.....................................7 Relationship to other initiatives...............................................................................................9 Defining a digital engagement approach.................................................................................9 When and where to engage ..................................................................................................11 Implementation considerations.............................................................................................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 Summary
1.1. 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 for the 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. 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. In addition, the outside world is engaging with DH (and topics relevant to DH) in digital channels in any case, using blogs2, comments on media sites, social networks and more. Having an approach and supporting materials to respond to this is important. The document presents criteria that can be used to assess whether, and how, DE may deliver 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. A simple set of strategic priorities forms the heart of the document. The relationship other relevant strategies and initiatives across government, and within DH, is described in this paper. The document focuses on engagement in the context of digital communications. The term ‘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. This document is owned by the e-Communications and Publishing team (ECP) within the Communications Directorate, and is hosted online, via a Quickr (“Digital Engagement”). It forms the Department’s 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 tools
2.1. 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.

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The relationship between these terms is discussed in more detail at Annex 1. This and other terms are described in the Glossary at Annex 5.


Digital engagement
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. DH has a range of its own channels available to support digital engagement, including: § an external ‘corporate’ website: § a public-facing website, NHS Choices: § Delphi, the Department’s intranet: § Commslink, an internet-based network restricted to communications professionals across the NHS: § a YouTube channel for video content: (as does NHS Choices: – each channel having a different content focus § a Flickr stream: § several Twitter accounts: one for the Department as a whole; others with specific objectives, styles and content § its own presence within other public-facing sites, such as the Care and Support content within Directgov § Facebook pages for relating to different policy areas and campaigns § a Civil Wiki page: § 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 Marketers’ network, sponsored by DH ( 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 metrics associated with them. Channel DH website ( NHS Choices website ( Delphi, the DH intranet Commslink YouTube Example metric 850k visitors/month 9m visitors/month 170 pages updated/month 3,700 users DH channel: 322 subscribers ; 156,000 views 189,903 views




Digital engagement

Channel Facebook Twitter

Example metric Example: HPV page has 2,500+ fans @dhgovuk – 2364 followers

3. The context of digital engagement for DH
3.1. Before considering digital engagement in more detail, the characteristics of DH’s communications context are worth noting: Widespread general interest: health matters are of interest and relevance to a wide audience, with many individuals ready to engage. This differs from, for example, international trade, science or agricultural policy matters. Everyone is a healthcare stakeholder. Diverse audiences: DH audiences include managers, medical professionals, other government 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. Overlaps between health practitioner and patient interest: whilst the principal focus of some 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 are intentionally targeted at mixed lay and specialist audiences, and where they are delivered through intermediaries. Existing areas of interest: from healthcare consumers to healthcare professional groups to 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. Fast-moving, unpredictable and high-impact content areas: issues ranging from new diseases (such as pandemic flu), to treatment concerns, to health scares (real or perceived), 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.







Digital engagement

4. Digital engagement: DH’s strategic objectives
4.1. 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. We will ensure, through evaluation, that our digital communications are effective and maximise the use of DH communications resources. We expect a consistent set of operational principles (described in detail in this document) 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. We expect digital engagement (and the use of digital communications generally) to become 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: 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 engagement opportunities are continuing to increase over time. 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. An approach to digital engagement does not start from the presumption that “more openness 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 channels
6.1. Digital engagement is not currently a standard part of communication planning in DH. Current DH practice, experience and expertise vary widely across directorates. Nor, for reasons set out in this paper, should it necessarily feature in all communications 6

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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 the platforms that are being used – do they have a particular culture or pre-existing user community? A recent government crowdsourcing of images used Flickr; falling foul of Flickr’s active professional photography community who reacted to the seeming ‘amateurisation’ of their market. § An opportunity to co-create. Is the subject being communicated one where representation, creation and amendment can genuinely be offered? § A need for openness and scrutiny. Is the historical or broader context of the topic such that openness and engagement may be particularly appropriate? (A non-DH example 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 aren’t under direct control always have the potential to be used for purposes that weren’t predicted. § Ability to think laterally: some of the most successful digital engagement has come about 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 more general 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 the work 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 that proceeding with digital engagement will have value.

7. Why is a Departmental approach to digital engagement necessary?
7.1. Digital engagement, particularly that involving social media, changes the way we communicate. It is: § Far more widely distributed: all those involved, whether as public service providers or as users, have the potential to publish on a very wide scale § Direct: digital engagement has the potential (for better or worse) to redefine intermediation 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 7

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§ Unpredictable: events and conversations frequently cross between channels in unexpected 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 passenger’s 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 in association with traditional media § New: not yet embedded into ways of thinking or working; meaning that some mistakes 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. As an example of this, Eurostar service failures in December 2009 exposed the lack of a digital 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. Any long-term digital engagement approach carries a significant caveat – the technologies 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 few significant forums and blogs, and having an understanding of the most popular social networks, was achievable without a large commitment of resources. At the start of 2010 this landscape is showing signs of change. As ever, the ‘popular’ networks 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 initiatives
8.1. 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 Department’s priorities and role. This document covers the business use of social media for digital engagement – not the use 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. The overall cross-government engagement strategy, as set out by Cabinet Office and documented 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 go Create better user experiences for government services § Enable people to find the information and online services they require by having fewer communication channels and focusing them around audience needs § Bring relevant information together into one place on government sites rather than across several sites, saving users time and effort § Create a consistent high-quality experience through a dedicated set of standards Enable non-governmental bodies to reuse information § Help non-governmental bodies to build new services by structuring information so that they can combine public data with private data § Avoid replicating what is already being undertaken by non-governmental bodies These 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 approach
An identifiable relationship to overall organisational strategy 9.1. For Department of Health, this means an alignment of DE to the overall strategic objectives of: § Better health and well-being for all: helping people stay healthy and well; empowering people to live independently; and tackling health inequalities.
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§ Better care for all: the best possible health and social care that offers safe and effective 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 the heart 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 support all engagement in practice, strategic and tactical: a. Set objectives for all planned engagement activities, and be clear in the desired outcomes from unplanned, responsive activities. b. Build a business case quickly and adjust it in the light of experience – it may not be right first time. Build in agility to the process of developing the business case – quick turnaround 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 when a community’s character and needs are understood, and particularly if it has been preengaged 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 aren’t taken by surprise. Above all, don’t abandon a channel and leave it publicly visible and unattended. h. Similarly, co-production sets a tone for future activity. Once audiences have experienced co-production in a particular policy area, it may be hard to revert to previous approaches.


Digital engagement
i. Remember the effectiveness of DE as complementary to traditional media – plan digital activities as part of an overall approach. j. Follow the code for civil service online participation. k. Don’t 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 could happen 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 DH’s 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 fail s. 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 lacking u. Don’t ignore digital engagement, whether planned or not – it won’t go away

10. When and where to engage
10.1. 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; approaches which can be used in combination: § On one’s 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 for engagement 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 web content 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 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 11

Digital engagement
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 considerations
11.1. 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 may be 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 worked with 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 QIPP’s objectives. This led to a balanced choice for each story on whether engagement was appropriate, and if so, in what channel. 11.3. The use of social media is becoming better understood. More is known about the nature of 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 smarter resourcing 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 clear engagement 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) and the 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 clearly we must bear in mind the realities of access when planning for digital engagement.

12. Evaluation
12.1. 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.


Digital engagement
12.2. Tools fit for the evaluation of digital engagement are required: this may mean the design of ‘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 of DE 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 audience reach, and volumes of content generated; § sentiment analysis (some degree of sampling is inevitable) as evidence of audience perceptions of engagement; and § assessment of overall achievement of campaign or policy goals, where engagement has 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. There is arguably a wider definition of engagement, based on the consequences of even one-way communication. 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 DH’s 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: 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 lifestyle and 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 Guardian’s webchat services); and with the third sector (using Mumsnet and 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 The moderator took direct questions about the engagement exercise (in addition to questions for the minister) and provided personal responses via email – a very positive indication of engagement.

Examples from across government The New Opportunities online consultation ( 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 ( 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 ( 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 ( forums/) enable users to debate issues that are relevant to their local community through the Department’s 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 ( provides the Department for Innovation, Universities and Skills (DIUS) with an opportunity to post information that will engage university students in government decisions. The Department’s dedicated social media unit creates technical solutions, policy and communications. The student listening blog is a good example of the way in which DIUS creates dedicated spaces for key stakeholders using low-cost social media. RAF careers promotion ( 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 persona for 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 publicfacing government sites (e.g. NHS Choices or Directgov) – Look for opportunities to make content available to other platforms (including nongovernment) 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 required from those engaging, and what is optional. 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 a small, 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 on context, 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 don’t make it all about one person’s activities. Exploration of related themes, or asking questions of the channel’s 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:

Is there a clear purpose for digitally engaging?

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

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

Where to engage: on a DH platform, on other platforms (government and non-government), via supersites, or using a combination of these?

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?

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.


Digital engagement

Annex 5: Glossary of terms

Term Blog

Definition 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 of moderation. 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. 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 wiki for 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: 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 wiki for collaborative editing, or simply be displayed publicly with comment invited through email or other direct channels. 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.) 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: 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: Automatic generation of content (usually from a website) so that it 21

Campaign site

Commentable document

Consultation channel

Content-based networking sites



Data feed

Digital engagement


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 – including platforms operating using these technologies. The use of interactive techniques to improve service delivery and information provision via digital media technology. Although not ‘social’ in terms of community formation and peerto-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. Area for registered members to discuss specific topics. Can form part of a wider overall site. Characterised by a core user base making multiple contributions and often sharing relationships or culture. Forum content may or not be moderated. 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. 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 interact for a shorter period of time, usually around a specific single issue. Creation of fan pages (or similar designations) also effectively forms a Group. Information about information. Often invisible to the user, metadata allows content to be classified, structured and sorted. Tags represent a use of metadata. e.g. Twitter,, 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:

Digital engagement

Email subscription







Digital engagement


Definition creation of “a Twittermob”. 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. 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.). 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 include – 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. 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. Any content provided by users, rather than the owners of an online environment. May or may not be moderated (see above) 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. 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: 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. Digital tools that permit people and organisations to interact freely with low (or no) barriers to entering a conversation.




Private social networking site

User-generated content

User feedback

Social bookmarking

Social marketing

Social media


Digital engagement

Term Social media marketing

Definition 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. 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. Keywords (or similar indexing information) describing online content that allow other users to search for relevant material. The best known of the micro-blogging platforms. Users contribute short messages, either on the 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 another’s 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. A structured discussion using instant messaging Example:

Social networking site



Webchat (or Webinar)


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.


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