Social media

Version 1.1, 16 February 2023.

This guidance is part of the Working in a digitally transformed NHS section of the Good practice guidelines for GP electronic patient records.

Social media is an online medium that allows people, groups, and organisations to communicate with each other. The term describes a range of online platforms that make communication interactive and engaging. Social media users can use its channels to provide information, give their opinions, and engage in conversations.

Information and communication on social media channels can also be re-shared with others within and across different social media platforms. Popular sites such as Facebook, Twitter, LinkedIn, Tik Tok and Instagram are now widely used means of communication.  Other examples include forums, blogs, and dedicated support groups and communities. 

Communication mediums on these platforms include written text, videos, sound recordings, and images.

Social media in primary care

Social media tools are increasingly being used in primary care in innovative ways to benefit healthcare professionals, patients, and communities.  Health professionals can represent themselves as individuals, and practices can represent their organisation on social media platforms.  Even when practices do not manage a social media channel for their organisation, patients can still discuss and ‘tag’ the organisation on platforms like Facebook.

The next generation of staff and patients will not know a world without social media. The presence and influence of social media will continue to grow.

Benefits of social media to primary care

Organisations that choose to use social media in the right way can experience many benefits.

The COVID-19 pandemic highlighted the benefits of a virtual presence and making best use of the various communication channels available to patients.  Through meaningful engagement with patients, social media bridges the gap between people and the organisations delivering their care.

While certain demographic groups represent the greater proportion of social media users, the fastest-growing demographic on Facebook are those aged over 55. Statistics report at least 66% of the UK population are social media users.

The benefits of a successful social media strategy for organisations and their patients can include the following:

  • raising the profile of general practice within the community
  • raising the profile of the organisation in the community by developing a virtual presence
  • broadcasting health promotion campaigns to patients and the wider community
  • posting information about new or changing services within the area
  • targeting and engaging specific groups of patients
  • improving the speed and breadth of information sharing with patient populations
  • gathering feedback and suggestions from patients quickly and instantly
  • building relationships with patients and populations in the local area
  • targeting previously under-represented groups within the community such as teenagers or patients suffering from mental health issues
  • creating a fast, effective two-way communication channel for patients
  • greater patient engagement in health and policy discussions
  • compared to postal services, social media is relatively cheap, and it is not limited by the character limits of SMS text messaging.

Benefits within the practice

Practices with a social media presence can use this to drive engagement within their own organisation.  Staff can be encouraged to see health promotional campaigns the organisation is delivering, or how patients respond to vaccination efforts. Individuals can feel part of that communication at an organisational level, encouraging collaborative thinking across the practice.

Discussions on social media about educational topics can also benefit healthcare professionals’ continuous learning and development.

Healthcare professionals also use social media for a variety of personal reasons. Examples include, but are not limited to:

  • developing their own individual social media presence
  • accessing professional and peer support
  • engaging in networking communities to maintain professional relationships or connect with other professionals.

Developing a social media strategy in general practice

An agreed strategy supported by meaningful plans is needed to use social media correctly and effectively.

Organisations choosing to create a social media account should do so as part of a blended communication approach. Social media should not wholly replace traditional communication methods to reduce the risk of excluding certain groups or individuals.

Creating a social media account should form part of a purposeful engagement strategy to maximise its benefits.

Before starting a social media account, practices need to choose the platform to suit their population and the organisation. The social enterprise organisation Primary Care Commissioning has created a smart guide to engagement, describing the different platforms, with some great case studies.

Once live, an account will need active management to succeed.  Creating a social media champion and nominating individuals with protected time to tend to social media activity is very important.

Top tips include the following:

  • publish a social media policy for the practice to guide employees
  • train nominated individuals on using social media tools and norms such as tagging or using the ‘#’ function
  • activate the proper privacy and security settings on the account
  • create a content strategy and approach, for example, will the content be written, graphical or video-based? (Awareness days has a great calendar function to coordinate with national campaigns)
  • ensure written communication is easy to understand – the Plain English Campaign has resources to help with this
  • have a clear complaints policy to deal with complaints arriving via social media
  • publish user guidance and a ‘code of conduct’ on your surgery website, to tell patients what they can, and should not, use the platform for, e.g. patients must be aware they cannot cancel or make appointments via social media

Using multiple platforms

Practices embracing multiple social media platforms and accounts can use tools to streamline their workflows and improve efficiency. These tools can help post across multiple platforms, schedule postings, and monitor activity. 

Regardless of your social media strategy, be clear on the outcomes you want to achieve.  While social media is relatively cheap to use, it takes time to manage and moderate.  

Be clear on what you want to say, how you want to deliver the message, who your target audience is, and want you want to the audience to learn.

Responding to posts and comments on social media

Social media is a powerful two-way communication tool.  Organisations will inevitably receive posts and comments back from patients. These posts or comments can be used to engage in valuable discussions or represent learning opportunities.

Organisations may be able to disable comments, depending on the social media platform being used.

From time-to-time, organisations will need to deal with negative comments or complaints on their social media accounts. Before acting, consider the following:

  • Where are the comments being posted?
  • What is the nature of the comments?
  • Are the comments founded on truth? Review objectively.
  • What is your organisational policy on dealing with negative reviews or posts?
  • How could these comments affect team morale or individuals within the organisation?

In general, practices should follow the same principles for reviews posted about their practice on existing forums like the NHS.UK website.  This may include acknowledging the comment and encouraging the patient to contact the practice directly to discuss further.

Your defence union can provide advice if you are unsure what to do next. The Medical Defence Union and Medical Protection Society have created valuable guidelines for managing these situations. The BMA also has guidance on dealing with abusive comments on social media platforms.

Risks and pitfalls | professional conduct

Social media can be a powerful engagement tool, but it can have serious consequences when used inappropriately.

Organisations and healthcare professionals must act responsibly when using social media platforms. This also holds true for professionals using social media accounts in a personal, non-professional capacity. Appropriate conduct by healthcare professionals and organisations on social media upholds the trust of the public in the professions.

The boundary between public and professional behaviour can be unclear on social media, and the principles established by professional conduct need to be maintained.

Communication on social media can be shared widely and may impact professional standing. Falling foul of these recommendations could result in disciplinary action.

The professional councils all have clear guidance on the use of social media (General Medical Council, Nursing and Midwifery Council, Health and Care Professions Council).

Healthcare professionals and organisations must be mindful of the following:

  • the standards expected of healthcare professionals and organisations do not change on social media channels
  • clinicians should refrain from accepting friendship requests from current or former patients on their private or personal accounts
  • writing posts whilst identifying yourself as an organisation or health professional is likely to be received as trustworthy by the public and represent views of the profession
  • healthcare professionals posting in a professional capacity should use their identity and avoid posting or commenting on areas beyond their remit or competence
  • organisations and professionals are responsible for information or advice posted on social media in their professional capacity and should ensure it is evidence-based and correct at the time of posting
  • it is inappropriate to post informal, personal derogatory comments about patients and colleagues
  • social media should not be used to harass or victimise someone so before posting anything, consider whether the intended content can be deemed offensive

Patient confidentiality

Professional conversations between healthcare workers are more commonly occurring online or within dedicated messaging platforms.

Not all the information within the social media environment can be protected.  Patient and service-user information must be treated as confidential when using social media. Although some information posted online may not directly breach patient confidentiality, it may still contain identifiable content.  

The information posted on social media can be re-shared across multiple platforms and simultaneously linked across multiple social media accounts. This can increase the risk of unintentional breaches of confidential patient information.

At all times, remember your duty to maintain patient confidentiality.

Security and privacy

Healthcare professionals must be aware that even without engaging with patients on social media, their private accounts or personal information online may still be accessible. Organisations and professionals should adopt conservative privacy settings on their social media accounts. Examples include using strong password combinations, turning on two-factor authentication, and enabling email/text alerts for accounts changes.

Healthcare professionals should disassociate personal and professional online profiles wherever possible.

Defamation laws apply to claims made online that may affect the reputation of individuals or organisations.  Social media content may be regarded as public property. Posting inaccurate information about products or services may be subject to legal proceedings and can result in sanctions applied by professional bodies. It is important to have a clear understanding of personal information, images and material that can be copied, uploaded, or shared on social media and stored under copyright, privacy, and data protection laws.

General guidance referring to medico-legal and privacy risks recommends that healthcare professionals avoid giving personal medical advice through social media have been published by the General Medical Council (GMC).

Summary

  • Use of social media platforms for communication and engagement can bring a wide range of benefits for patients, professionals, and organisations.
  • Organisations should develop a clear strategy for the use of social media if it is to be used securely and effectively.
  • Social media should be integrated into a wider organisational communication and engagement strategy to avoid digital exclusion.
  • Be clear on what you want to say, how you want to deliver the message, who your target audience is, and want you want to the audience to learn.
  • Patient confidentiality must always be observed.
  • The boundaries between public and professional behaviour can be unclear when using social media and standards of professional conduct be maintained always.
  • Make sure all staff know how to use social media and what to do in the event of personal or professional criticism or complaints online.
  • Guidance on the safe use of social media is published by the professional bodies.

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