Hang out where your Audience hangs out: Targeting GPs through Doctors.net.uk

Since it's launch in 1998, Doctors.net.uk has become the UK’s largest network of medical professionals. The organisation now has a membership comprising 90% of the UK's practising doctors, with one in five logging in every day. Twice during September, the website received record amounts of traffic, with 40,000 unique visitors during a single day.

In it's own words, the website, "... is available to UK-registered doctors in primary and secondary care. It is a secure service offering a professional e-mail facility, clinical and non-clinical forums, the very latest medical news and free accredited education allowing doctors to maintain Continuing Professional Development (CPD)."

This doctor community regularly makes a direct contribution to patient outcomes, with many examples of rare conditions being diagnosed and treated, thanks to doctors being able to share their knowledge and opinions. It’s become an indispensable resource across primary and secondary care, with 97% saying the site is their most trusted source of information.

The phenomenally high percentage of take up  and the regularity of  engagement makes Doctors.net.uk THE Social Network in which to reach GP’s and secondary care clinicians. Forget facebook and twitter; this is the place to be. Whether it's market research or spreading a message, there's no other place to be found online with the sheers numbers of active members, representing virtually the entire populace of doctors in the UK.

But it is a private network, so  not a free for all, where service providers looking to exploit GP's new found powers in commissioning, can go around selling their wares. Instead, Doctors.net.uk offers option for Private and Public organisations to purchase access to their membership, whether to conduct market research or run communication and educational campaigns. It's not clear from the website exactly what this entails or if it's open for all companies, such as Social Marketing providers, but what is clear is the results. Doctors.net.uk offers extremely detailed and accurate metrics to demonstrate return on investment. Boehringer Ingelheim, for instance, engaged 27,000 doctors in a year-long campaign that was equivalent to having 45 sales representatives on the road for the same period of time.

The Third Sector has also taken advantage of this. Cancer Research UK appointed Doctors.net.uk to launch a three month campaign targeting general practitioners. This involved a dedicated Cancer Research UK microsite within Doctors.net.uk, providing GPs with authoritative evidence-based information to improve patient consultations and earlier diagnosis.

The Department of Health and NHS make extensive use of the opportunities for engagement that Doctors.net.uk has to offer. The NHS Institute for Innovation and Improvement conducted a year long programme through the network, aimed at improving the quality and efficiency of high volume care. They reported great success, with 20,000 doctors assessing their clinical practices and 8.000 changing their working methods, all as a direct result of the campaign.

This engagement between GP's and the Government will be of increasing importance as NHS reforms take place. Doctors.net.uk have already started to react to the changes, with the launch of a commissioning microsite and joint research projects with influential think tank, the King’s Fund. This aims to help GP's with the new process, providing clear information and forums for discussion, help and advice. This comes after research conducted by Doctors.net.uk revealed that 83% of doctors don't feel equipped to implement the reforms. Hopefully, the microsite will go some way to addressing that.

As mentioned above, I'm not clear whether companies such as ours, who offer Social Marketing services, can use Doctors.net.uk to target those GP's looking to commission what we offer. If this isn't already a possibility, I would hope that with their growing responsibility for commissioning, it soon will be. Throwing open the doors may well be too much, potentially diluting the prime purpose of Doctors.net.uk and putting off GP's, but if it's controlled, it should be mutually beneficial to both provider and GP.

NHS Choices Sharing User's Data with facebook and other Third Parties; Is this Actually so Bad?

A new article by blogger Mischa Tuffield has raised concerns over privacy on the NHS Choices website.  After conducting in depth research, Mischa identified four third-party companies, including facebook, who can track a user's movements through the NHS site. He suggests that this would be fine for a website that rates pubs, for example, but not when people are seeking advice for potentially sensitive and private matters, as they may do on the Choices website. The article even goes so far as to suggest that this may contravene the NHS's Data Protection Policy, as the data would be sent outside of Europe, which the policy forbids.

This has the potential to cause a major headache for the NHS's flagship website, which has established itself as the foremost destination for health advice in the UK. As with visiting a local GP, confidentiality is a priority for people when it comes to their health and if this isn't guaranteed on NHS Choices, that could effect their willingness to use the service.

Though the story has been reported via several online news outlets, the mainstream media has yet to pick up on it. If they do, these few spots of rain may develop into a full blown storm.

After reading the blog himself,  Tom Watson, Labour MP for West Bromwich East, certainly believes it warrants more attention. He wrote directly to Secretary of State for Health, Andrew Lansley, strongly urging that the tracking code be removed.

The Department of Health has responded to concerns, stating;

""Facebook capturing data from sites like NHS Choices is a result of Facebook’s own system. When users sign up to Facebook they agree Facebook can gather information on their web use. NHS Choices privacy policy, which is on the homepage of the site, makes this clear.

"We advise that people log out of Facebook properly, not just close the window, to ensure no inadvertent data transfer."

I tend to agree with this. Facebook has long been criticised for it's management of privacy, but a user does have the option to log out if they don't want their web movements tracked. The way facebook does this has been massively well reported during it's history, so it's highly unlikely that many of it's users are ignorant to how it works. If they stay connected, then surely that's their responsibility?

The real question for me is, what happens to the data once it's collected? For a start, it's not going to be made Public. I would imagine that this would be the main worry for those hearing about this story; that their embarassing illnesses could appear in their friends news feeds. This isn't going to happen, unless of course it's actively shared by a user, in which case, again, it's their responsibility.

Mischa states in his article that the DH's Privacy Policy doesn't make it explicit that data is not shared for third party advertising. Although facebook's interconnectivity with other sites aims to improve the user experience, it's difficult to argue that the main aim is anything but to improve the targeting of it's own advertising. This is likely to be the outcome of the shared data; it influencing the adverts an individual user, and only that user, sees on facebook.

There are still arguments against this, especially from an ethical standpoint, but I'd argue that there would be no actual negative effects for a user from having their data shared. Compare this to the positives of having facebook integrated into NHS Choices, where a single user can easily raise awareness of a health issue or story amongst their peer group of several hundred people, as well as the services which the website and NHS provides, with the potential for that information to spread virally to many, many more. There's many other benefits as well, but that alone should make facebook an indispensable part of NHS Choices.

Souper fundraisers for November

The eskimosoup team went head-to-head with St Stephen’s as part of the Devil’s Kitchen programme run by the Smile Foundation whose charities for 2010 are Hull and East Yorkshire based House of Light and DownRight Special.

The day went extremely well and both teams had enormous fun getting everything prepared and ready for their guests arriving on the evening. Not only did the eskimosoup team put in a magnificent performance and WIN Devil’s Kitchen, we managed to raise £2995.50 for the Smile Foundation – well done team!

On Friday 19th November eskimosoup organised a 10-hour Keepy Uppy challenge for Children In Need on behalf of St Stephen’s. Richard Quelch and Nathan Ledger took it in turns every 30 minutes to keep the ball off the ground – Congratulations to Rich and Nathan for all your hard work and determination!

Alongside this challenge, there were jugglers from Magic Carpet Theatre, Round the Block, and local performer Calum Tomeny. Members of the public also took part in a mascot penalty shoot-out against Hull FC’s Airlie Bird, Pudsey, and mascots from St Stephen’s retailers including Build a Bear and Health Central.

We would like to thank everybody for their kind donations and helping us raise £1,372.00 for Children In Need.

NHS Choices: A Flagship Big Society Website?

NHS Choices, the self described "digital gateway for the public to access NHS information and advice" has published it's annual report. The document details the website's achievements and development over the past year, as well as it's plans for the coming year. The website has undoubtedly been a success for the NHS, with over 100 million visits over twelve months, becoming firmly established as the most popular health related site in the UK.

This success has been reinforced with the assertion that the website has actually saved the NHS an estimated £44 million a year.  This is based on the reduced need for GP call-outs and appointments, due to people finding the answers they need on the site. In the current economic climate, where the NHS is expected to tighten it's belt, such estimates highlight the immense value that the Internet can provide.

However, that does exclude the 15 million people in the UK, who currently have no access to the Internet. Rather than just dismiss these as an inevitably unreachable element, the report shows how NHS Choices have looked to how they can still benefit. In the main, this has involved working with intermediaries, such as libraries and health teams, who can provide access and support. There is also the NHS Choices Mobile service, which allows access to the website's directories via text message.

With great amounts of traffic, demonstrable savings, and a reach that even extends to those without internet access, where next for NHS Choices?

The plan that the report sets out for the year ahead lists new features to be introduced. These include allowing healthcare providers to edit the details of what they offer, extending user comments to all NHS services and making the homepage customisable, so that a user can personalise what is displayed to their own needs.

To a certain extent, it's already there, but with these changes, NHS Choices will move more and more towards being almost a perfect example of a national Public Sector website within the ethos of the Big Society. Co-production, where an informed Public works in conjunction with a decentralized Public Sector to provide a highly personalised service for it's individuals.

The one thing all but missing from the report, which you'd be hard pushed to omit from any modern internet strategy, is Social Media. There's mention of improving Social Network linking, but little else. Of course, this is a report on the website itself, so you might expect few mentions of outside media and there may be a separate strategy in place, but everything is so integrated in the modern internet that it's surprising that Social Media is barely mentioned.

The NHS Choices facebook page only has about 1,000 subscribers and although the twitter profile fares better with about 10,000 followers, this is still a relatively small number for such an organisation on that platform.  Neither have prominent links on the NHS Choices website, which along with the small numbers on the respective profiles, may indicate that Social Media isn't seen as a particularly important part of the overall strategy.

This could be because the powers that be see Social Media as unnecessary.  NHS Choices is an exhaustive resource, which attracts great numbers and already has in place many elements to gain the interaction and engagement that Social Media is famous for. But just because it already does well, that doesn't mean it couldn't do better.

The benefits of Social Media have been well documented, so there's no need to go into detail on that again, but it's capacity for attaining that engagement on such a deep level, along with it's vast, sometimes viral, reach make it a tool that could bring a great deal to NHS Choices.  Not only that, but the unprecedented level of user supplied lifestyle information on such platforms as facebook, offers an opportunity for targeting specific demographics at a level that's absolutely impossible to attain elsewhere.

A Human Face for the Department of Health: Blogging and Transparency

Following on from our last article, Does the Department of Health make the most of Social Media?, we were grateful to receive a comment from a spokesman for the Department, Tim Lloyd. It was great to gain feedback on our thoughts from the DH and hopefully there'll be more to come, helping us offer greater insight.

One point Tim raised was uncertainty at what purpose the hypothetical DH facebook page would serve, which we recommended in the original article.  I responded with the following;

"I think what I’d see as a facebook page for the Department would be how I’d envisage any Government page; giving an approachable, human face, focusing on transparency so as to help demystify the workings of Government and to provide a Public forum around those workings."

I stand by this and certainly believe facebook is a great platform for this purpose. However, giving a human face and personality is more often the role of the blog and the DH have recently launched one that does just that. Written by the head of digital communication for the Department of Health, Stephen Hale, it aims to provide information on how they're using the medium and promises everything from "... the big strategic stuff to the daily delights and frustrations of working in government digital communication".

So far Stephen's only published two articles, but they're already really great, being very obviously from a real person and having just the right mix of informality with professionality and knowledge. In my opinion a perfect example of what a Government blog should be. Stephen himself mentions what an asset official blogging can be and has the intention of advocating the platform with Ministers and staff. I wish him all the success in this, as bringing that inherent transparency and personality can only help strengthen the Public's relationship with Government.

I'm champing at the bit to read more from Stephen's blog and to gain further insight into how the Department utilizes digital communication. Stephens latest article mentions developing metrics for measuring their success and I'll be very interested to see what he comes up with. It's a notoriously difficult discipline, especially within the Public sector, where the usual measure of  'sales made' has little relevance, so I'll look forward to Stephen publishing more details.

Read Stephen's blog here.

Does the Department of Health make the most of Social Media?

The Department of Health (DH) has just published the traffic statistics for it's website during September, as well as it's overall numbers on it's various Social Media profiles.  It currently uses Twitter, Flickr and YouTube, but has no facebook page. More on that later.

The website itself has had 3,438,908 page impressions, 755,359 unique visitors,  and 1,074,474 visits during the month. These figures alone don't tell much of a story, except to say that the site does get a healthy amount of traffic. It would be interesting to see these numbers broken down further, to show for instance, what proportion of those visitors were Health Professionals or members of the General Public.  This can be difficult to measure, but would give a better impression of the website's reach. Perhaps, integrating a short survey could help.

The most popular pages are unsurprisingly those concerning the recent white paper, Equity and excellence: liberating the NHS. There's been a large amount of discussion around the reorganisation of the NHS, detailed in this paper and publishing the document online gives people the option to easily access and read it themselves, rather than rely on third party reporting.

The DH's Twitter profile had  5369  followers and had tweeted 607 times in total by the end of September. The tweets comprise in the main of links to official announcements, health news and the activities of high ranking personnel, such as site visits and interviews.

Perhaps the primary function of Twitter is to disseminate information, so it could be a great tool to raise awareness of the Department's activities within the country's population, helping achieve the transparency that the Government states as one of it's aims. To that end, it may be an idea for the profile to include more tweets directly related to the Department. More calls to 'retweet' would also help spread the message and increase the numbers of followers, which though currently at a respectable figure, would need to be a lot higher if the aim is, as you would imagine, to address as much of the populace as possible.

If engagement is also an aim, then having tweets direct to a platform with more versatility, like facebook, would also be an idea. A facebook page is conspicuous by it's absence in the DH's portfolio of Social Media profiles. I've been unable to find any official strategy or rationale for the Department's use of Social Media, but engagement is the overriding reason why organisations use it. It's therefore somewhat odd that facebook, the undisputed king of  engagement, has been neglected.

A reason for their existence is also missing from all three of the profiles.  It's generally good practice in a Social Media profile to actually state what it's for, but many companies and organisations instead just describe themselves, like they would in an 'about us' on a website. Yes, say who you are, but also tell users what they can expect on the profile, the benefits to them for subscribing and how they should interact.

The Flickr page provides a good example of this, as it's not immediately obvious what it's for. The majority of the first page is taken up with photos of visits by the Minister of State for the DH, Simon Burns. The profile (essentially the 'about us') for the page is empty, so that sheds no light. Navigating to 'sets' actually gives the best impression, as this displays a thumbnail for each set of photos on the page. It shows that indeed the main function for the page is to display photos of various public appearances by Ministers at events and launches.

The page had been viewed 59,445 times in total, so again, gets a reasonable amount of traffic, but no comments have been left by visitors. It's therefore a one-way communication, missing out on the interactive nature of Social Media. A little more variety in the sorts of photos posted and some calls to action within the comments could help this, taking the page from merely a way to distribute photos, to another gateway to engagement.

The DH's YouTube channel does have that variety, with a large number of videos ranging in subject from Social Marketing ad campaigns to case studies from health professionals.  The quality of content is really strong and the stats show 197,904 views, which appears to be a good number. However, looking a little deeper, the channel is almost three years old, so over that time scale the views are relatively low. The videos individually average in the low hundreds for views, though a noticeable exception is the Change4Life campaign, produced by Aardman. This series of adverts are way up, in the tens of thousands, which could possibly be down to the popularity of the production company, whose other credits include the Wallace & Gromit films. Should this be the case, the higher number of views would most likely be down to users finding the videos in searches. The difference implies that the profile relies on searches for views, rather than the videos being pro-actively promoted.

To maximise the effective reach and levels of engagement from Social Media, content and the profile itself needs promoting and interaction encouraged. The various platforms should be used in a coordinated manner, cross pollinating each other, so for example, tweets should regularly link to new videos and images on Youtube and Flickr respectively, where visitors are encouraged to leave comments and share. They should all then feed back to a central hub profile, where the deepest engagement takes place. We would usually recommend a facebook page for this hub and I would recommend the same for the Department of Health.

Does the NHS need to get to know their Audience, when Business already does?

A new Social Media campaign has been launched to help raise awareness of the Health4Work Adviceline. The service, provided by NHS Plus, aims to reduce the £100 million a year cost to business incurred by sickness and absence, by offering free and confidential advice to employers from occupational health experts. Clear Thought, a marketing agency based in Bristol, have been commissioned to conduct the campaign.

The specific targets for the campaign are small business owners, hence Clear Thought's involvement, as these are their main client base. The company therefore has extensive experience and knowledge of communicating throughout this demographic. This show's great forward thinking on the part of NHS Plus in their commissioning. Knowing your audience is the foundation of any Social Media campaign and it would be difficult to argue that the NHS has the necessary familiarity with small business. So they go to a company that does.

Moving forward with the Public and Private sector partnership in the Big Society, perhaps other companies could offer similar. If a national brand in the UK mainly markets it's products to children, then it's reasonable to assume they've done their research and know the market. They know how to sell to that demographic. Should the NHS have a Social Marketing campaign aimed at children, such as combating child obesity, then that research and knowledge already in place with the large brand, could be extremely useful in delivering that message. Perhaps even a combined message would be feasible.

Whether it's the marketing agencies who specialise in working with companies that target a specific demographic, or the companies themselves, sharing their insight would be a great contribution to the Big Society. Why should the NHS, or indeed any other area of the Public sector involved in Social Marketing, spend time and money getting to know their audience, when Business already does?

Follow the Health4Work Social Media Campaign at;

http://www.facebook.com/Health4Work

http://twitter.com/health4work

http://blog.health4work.nhs.uk/

November to Remember

November is a busy month for eskimosoup’s events team as we support our client St Stephen’s with two major fundraising activities.

On the 19th November eskimosoup are doing a “keep it up for Children in Need” day, where the aim is to keep a ball in the air for 10 hours, yes 10 whole hours! Participants range from skilled footballers, jugglers and members of the general public.

Alongside this challenge, you have the chance to score a penalty past some of the well-known mascots of Hull, in our ‘Mascot Penalty Shootout’. Why not come down to St Stephen’s and try your luck, you might even be the next Jimmy Bullard?!

In addition to these challenges we will also have a face painter, where children can have their faces painted like Pudsey. So come down to St Stephen’s on the 29th November and help us ‘show those spots and let’s raise lots’.

Then, on the 28th November the famous Santa Run is back! The route 5km has been planned, the Santa suits are ready and waiting, all we are missing is the reindeer!

If you want to be one of up to 500 running Santas and help us raise thousands of pounds for Cash for Kids and help children from our region who need it the most, sign up here or call 01482 593193 for your registration form.

Your £10 entry fee gets you your santa suit and a medal. Then its up to you to get as much sponsorship as you can to make this year’s Santa Run the most successful yet!

The Big Society in Action?

Following on from our recent article taking a look at the NHS Organ Donation Social Media Camapaign, it was great to read that a further 500 people have signed up, thanks to the efforts of Kidney Research UK. This came about as a result of a unique project ran in North West London, aiming to raise awareness of the greater need for organs by those of a black or South Asian origin, due to a higher risk of contracting diabetes.

The project was funded by the Big Lottery Fund (BIG), a non-departmental public body which is responsible for delivering about half of all funds raised by the National Lottery for good causes. According to Sir Clive Booth, Chair of the Big Lottery Fund, “BIG has invested over £80 million into medical and social research to enable organisations to produce and disseminate evidence-based knowledge, to influence local and national policy and practice, and develop better services and interventions."

Despite the sign ups not being the goal of the project and actually being an unforeseen benefit, this is a great example of how interconnected public health is. An intervention in one aspect can lead to positives elsewhere, highlighting how cohesion and coordination between the Third Sector and the NHS, not to mention business and the Public, could be so important in maximising outcomes. Whether or not the Coalitions Governments Big Society agenda is sincere or entirely achievable, this is the main reasoning behind it and no matter your opinion of the agenda, does seem to make sense.

The project is going to be rolled out beyond North West London via government funding, though the article doesn't say how far a field this will be. It would be good to see collaboration between Kidney Research UK and the NHS Organ Donation campaign to exploit and adapt the project for their Social Media platforms, as well as other media. Although the project has a basis in 'face to face' communications, Social Media perhaps provides the next best thing and can have a national reach with very little cost.

As mentioned in the previous article on the Donor campaign, good causes can work extremely well with the viral nature of Social Media. With about 14% of all those needing kidney donations in the UK being from a black or South Asian background, it's a big problem that needs as much support as possible. Looking to utilise how effectively a message can be spread on such platforms would be a great help and would be all the  more effective should pages work together. Cross pollination, as it were, between organisation's profiles would not only allow their fan-bases to be targeted en masse, but also give greater scope to segment future fan targets, delivering each other's or joint messages where appropriate.

There could also be another benefit. If sectors are to have a greater partnership in the future, the cost effective and social nature or facebook, twitter, et al, could make Social Media a very useful platform in which to get to know each other and to start testing the waters in working more closely together. It is obviously already established as a place to make friends, but has also made business practices more visible, with it's credo of honesty, openness and transparency, so could even assist in reducing the impact of the traditional cultural differences between sectors, by offering insight into those cultures.

Consumers want Business to take up it's responsibility in the Big Society

The 4th Annual Goodpurpose Study by Edelman has just been published, examining global consumers attitudes towards the social purpose of business. Conducted over 13 countries, the survey looks at expectations of how brands and corporations should conduct themselves, especially in relation to supporting social issues.

For the fourth year running the study has found an increase in the role business is expected to play. Token donations to charities or latching on to a good cause for no other reason than to help PR is seen for what it is and viewed in a negative light, with people now wanting a more fundamental contribution to the improvement of society and it's environment. This should be a prime consideration in all activities that a business might pursue, including it's general day-to-day practice.

This attitude is one that business cannot afford to ignore, as the study shows that in the UK at least, it's a more powerful trigger to purchase than design, innovation or brand loyalty. It also indicates that the majority of people believe business and the Public working together can have more of an impact than they would individually. They would also be likely to share positive feeling about a company, which would obviously be extremely useful in the Social Media age.

Looking at this as a whole, it could almost be taken straight from the Big Society agenda. It shows that whether the Public actually buys in to that particular moniker, they're certainly all for the thinking behind it. As mentioned in our previous article, Can Business help the NHS in Social Marketing?, companies are already realising and acting on this emerging Public opinion. To make the circle complete, the Third and Public sectors need to seize on this, capitalizing on the resources and funding that business can supply, to tackle Social Issues in a collective and coordinated way.

Wahey... Fancy a dance-off?

Last weekend saw eskimosoup have their hands full with bags of comedy. On the 29th we prepared a comedy dance-off in connection with St Stephen’s and hosted a Charity Game Show with Keith Chegwin on the evening.

Vampires vs. Zombies? Cowboy’s vs. Indians? Cops vs. Robbers? Hull College provided a group of 10 dancers who performed two different routines with three costume changes.

Routines performed to tracks suck as Ice Ice Baby, Run DMC and Thriller contained comedy moves such as body ripples, the snake and the splits. To view these dances please go to www.facebook.com/hullcomedy.

We would like to take this opportunity to say a BIG THANKS to David Danville and his dance group for taking part – you did a great job!

WAHEY!! Keith Chegwin returned to Hull for a 3rd year running to host his Charity Game show as part of the Hull Comedy Festival, supported by First Hull Trains. The fun packed night consisted of comedy, quizzes and games that delighted, surprised and gave members of the audience chance to challenge Cheggers!

The eskimosoup team had a great evening with Keith, and we hope the audience did too. Hull Comedy Festival is almost over for another year…though there are still plenty of top shows to get your final fixes, go to www.hullcomedy.co.uk.

Twitterers react to the Spending Review

Since last Wednesday's spending review, the Internet have been buzzing with reaction and commentary.  Twitter has been no exception, providing great insight into how the Public feel about the cuts. Given their severity, it's perhaps unsurprising that the overall response has been far from positive.

Perhaps trying to keep their heads down, the Conservative's Official profile (http://twitter.com/Conservatives) only referenced the cuts in a couple of Tweets. These highlighted the fact that the review wasn't their sole responsibility, being a collaborative effort via their "Spending Challenge" initiative and that it was a necessary measure due to a decade of debt built up by Labour.

The rest of the 'twittersphere'  weren't so quick to shift responsibility, but took a pragmatic view of the difficulties inherent in the review.

http://twitter.com/jmedcasereports commented that cuts would effect the availability of hospital beds, linking to a Telegraph article on the subject. The NHS budget may rise by £10 bn over the next four years (though factoring in inflation and considering they're expected to make £20bn in savings, this is hardly a rise in real terms), but council cuts will impair social services for the elderly, meaning their need for hospital beds could rise. The Big Society agenda states that the Third Sector will have a bigger involvement in health care, but as their funding through councils is reduced, can they realistically be expected to provide further help for the elderly, as well as other elements of Society where care is needed? If support for charities and social care departments dealing with problems such as mental health and alcoholism is reduced, there may be a higher uptake of hospital beds from there as well.

An article over at the Observer really resonated, with many Twitterers (http://twitter.com/virginiamoffatt,  http://twitter.com/adanylkiw, and http://twitter.com/instituteforgov, to name but a few) linking to it. Written  by a Civil Servant, giving the view from within Whitehall, it's main thrust is a shared feeling in the corridors of power that an almost utopian efficiency will be needed throughout the Big Society in order to make the projected and needed savings in coming years. Few believe this will take place and the country will instead be facing massive job cuts throughout the Public Sector. If this is the belief of those actually working in government, one does start to doubt the sincerity of the whole Big Society agenda. Is it not so much us all taking our part in creating a better tomorrow, as sharing the blame for harsh times, when we can't live up to the Governments deliberately unrealistic benchmarks for efficiency?

Guardian Journalist, Patrick Butler (http://twitter.com/patrickjbutler) posted links to various reaction pieces at his newspaper. A particularly interesting article gave doctors' views from a survey that the King's Fund health thinktank commissioned from Doctors.net.uk to gauge feeling on the cuts and recent proposals for the NHS.

Part of the justification for decentralising decision making to GP consortia was that they know how best to deliver health services and where to spend money. Somewhat ironically, the survey reveals that only one in four doctors believe the Coalition Governments proposals will actually lead to a better standard of care. The general consensus is that asking the NHS to make £2bn of savings, while undertaking the largest reorganisation in it's history is a virtually impossible task. If that's their opinion and they know best, then shouldn't that have an impact on the Governments plans for reform?

These are just a few of many who've tweeted on the subject, offering a fascinating real-time perspective from a genuine cross section of the UK's population.  To see more, visit the search results page for "spending review" here.