The recent launch of change.nhs.uk promises to be ‘the biggest ever conversation about the future of the NHS’.  But don’t be fooled – big conversations are not entirely new, in-fact “thebigconversation.org” conducted an 18-month consultation for the NHS back in 2001 (it also allowed you to ‘text’ in opinions).

There have been plenty of critics of this latest initiative – some jibed at the government for their lack of leadership and others are dubious about if the exercise has honest intent.  While the latter is (for now, at least) an unknown, we applaud the government on being brave enough to do it.  After all, Ministers must have known that opening up a conversation so widely would have generated some heat.  More to the point, people who moan about being ignored would also moan if they weren’t asked!

Look a little closer and you will see this is clearly labelled as an engagement exercise, not a consultation.  And while conversational elements are limited to the ‘ideas for change’, conversation threads are forming nicely. This takes big doses of courage – particularly as a conscious decision was made not to ‘pre-screen’ contributions and instead rely on machine detection of toxic content.  Moderation would have been the safer bet but this would have also stifled the user experience.

In-fact, memes submitted by the public as genuine ideas may have been devious but they actually worked to accelerate awareness and engagement (the best ones collected by https://x.com/floschechter).  Even the Health Minister chipped in with some hunour, thanking people for submitting the idea of a Wetherspoons in every hospital and to fire him out of a cannon to raise money for the NHS.

 

 

So what is the true value of this exercise?  Well, if you’re wondering about the potential of crowdsourcing to come up with some genuinely new or helpful ideas, this research will help . To summarise, ‘crowdsourcing has viable potential to reduce the gap between political elites and citizens through co-decision-making by bringing the citizens’ perspectives who are the experts of everyday life and can help align government’s resources with citizens’ priorities thus increasing both the legitimacy of the decisions taken and their ownership by citizens.’  In other words, it’s not just about the ingenuity of the ideas submitted by the public – it’s also a warming up exercise.  That said, some of the top ideas coming through seem genuinely novel.

In terms of the platform, there are other subtle designs.  For example, an attempt to reduce the friction and frustration associated with registration by removing email verification.   Actually, registration is more about enabling re-engagement. Machine translation is at work in two alternative languages (one using right-to-left text) and some good practices are embedded, such as publishing a full set of questions outside the body of the questionnaire.

With 8,000 ideas submitted in the first week it’s also a bit of a technological marvel.  There were no outages (despite massive traffic peaks) due to clever caching and optimisation.  At the other end, built-in AI on the GoVocal platform will more than likely assist the NHS in understanding what has been said.

To conclude, imperfection is in the eye of the beholder.  While we can’t get too excited about the impact of this particular exercise quite yet, we are plenty excited about the technology which has enabled such freedom of debate.

When combined with emerging mediation technology (such as the Hamermas Machine) we’ll see even more potential in this – for example, influencing people to challenge and change their own opinions rather than simply forming them.  While a citizens’ assembly might also have been a tempting optoin, it is way too expensive in what is otherwise a system that has been plunged into chaos by a lack of funding.