Starter for 10: What online tools & social media should be accessible in the NHS?

I’ve written previously about the problems of accessing elearning in the NHS and how this affects teaching and learning.  Back in November my colleague Andrew Howe and I gave a presentation to the NHS-HE Forum on accessing University teaching and learning from the NHS.  Our presentattion  gave an overview of some of the problems our clinical teachers and students face accessing University resources on their NHS PCs.  We also highlighted the frustrations concerning the inability

  • to access the growing amount of open learning content available  on sites such as YouTube, Vimeo and blogs and
  • to make use  of Web 2.0 and social media tools.

These sites, tools and technologies  make it easier for teachers to produce and remix online learning content.  They also offer many opportunities to support collaborative work, research and to share information with patients and colleagues. The reality, however, for those involved in teaching in the NHS and for our students on clinical placements is that access to many of these sites and tools are blocked by NHS firewalls. In some cases health boards have made them accessible but only to those clinical staff using them for research.

The outcome of our presentation and the following discussion at the November NHS-HE Forum meeting is that a short life working group has been set up to look at NHS-HE connectivity best practice.  The group includes IT managers, librarians, medical educators with responsibility for elearning and  we’ll be putting together our work plan when we meet later this week.

One of the things I’ve been tasked with doing is coming up with a starter for 10 list of tools/sites that should be accessible from the NHS.  I know the sorts of sites that my colleagues are keen to be able to access for example

  • YouTube
  • Vimeo
  • WordPress sites
  • Blogspot sites
  • Posterous
  • Social bookmarking sites like Delicious and Diigo
  • Google docs
  • Slideshare
  • Ning
  • Twitter

I’m also interested to hear what the wider NHS community involved in teaching and research would like to access.  Which tools would you like to access that are currently blocked in your health board or trust and why would you like to have access them, what benefits would they bring to your work?


  1. Screenr would be a massive help. Viewing images on PACS, then we can do a quick Screenr, and share it. It can be kept confidential, as the identifying tags can be removed, and we can scroll through CTs in real time, etc. That would be a really nice wee tool to have.

  2. All of the above sounds about right, although I would also add LinkedIn, for those who cannot already access it.
    In addition I think there are probably some wider issues to tackle:
    This should be less about seeking permission for individual tools, and more about a change of perception from the IT community.
    Let’s start at ‘everything is accessible’, then work back from there, rather than the other way around, which seems to be what we have now.
    It’s also important to make sure that content publishers and audiences understand the tools; their strengths and weaknesses. This will help everyone get the most out of them.

    1. Thanks for suggesting LinkedIn, I’ll add this to my list.
      From what I’ve heard it seems at a national level there is no policy to block sites that we’d like to be able to access, it’s individual trusts, boards and health authorities that choose to block things for one reason or another, bandwidth being the most common for sites with streaming video. Our experience even within one board is that some sites are accessible in one location and then in another building they are not. I think we need some consistency in approach. The challenge is how do we change the perception of the IT community. Are there examples of good practice in trusts that we can share to highlight how some start from a point of making everything accessible and explaining what the various tools have to offer?

      1. I think we should raise this again at #nhssm. We’ve discussed it before and it always generates an interesting conversation.
        I have personal experience of the benefits that something like Yammer can bring to disparate teams within an organisation, but Colin Wren at St Georges Tooting has insight into patients making use of their Facebook channel and other tools, none of which would be possible if he hadn’t been allowed access in the first place.
        Worth noting too that the people who manage these channels are often doing so outside of their core job description, driven by enthusiasm.

        1. That would be good, I’d be happy to pass on the #nhssm conversation to the working group. In relation to teaching many are using these sites outside of work hours. There are some though that refuse to look at them out of work hours on principle.

  3. Going to reply more fully but re Screenr, is it blocked? Or is an issue with Java? Also just to clarify, do you mean the identifying tags from the CT can be removed? No way of making screenr itself not public, but you can download viseo and then upload to somewhere else that is private. In any case, if the pt could be identified there would be consent issues whether private or public.

    1. Think the problem re Screenr is not being allowed to play the video on an NHS PC. If we embed video from YouTube, Vimeo etc into Blackboard or our WordPress sites you can’t see them on an NHS PC. Also I don’t know whether Screenr works on IE6.

  4. Have you given any thought to the accessibility of these tools to NHS in-patients?

    As I am a service user governor for a mental health trust I am thinking specifically of psychiatric patients. We can be in hospital for some time and there can be little to do bar watch television.

    It is hard for someone in my position as a governor to see what is on offer in the wards as I am not allowed access as a governor. I am on a committee that discusses use of internet technology but we had no data on accessibility.

    Inadvertantly I was admitted to an acute ward as a patient. I discovered there was one computer for patient use but it was pretty well unusable as it had NetNanny installed on it. None of us could check our emails. The strangest sites were blocked. Most news sites were inaccessible.

    I know there are issues with regard to unsuitable sites but surely the majority of adults ought to be able to access regular email sites , social networking sites and mainstream sites. Other popular destinations include sites with information on medication and illnesses and government information eg on social security. If funds were available I am sure it would be possible to create an internet for special categories of patients such as those in secure units.

    I would also suggest that elearning might be a popular occupation for people stuck in hospital for a long time.

    In my view the NHS needs to get away from the view that the internet is always a hazard to the health of psychiatric patients. There are benefits as well.

    1. @Beatrice – I hadn’t thought of this aspect, so thanks for raising it. I’m not surprised to hear you couldn’t access your email as generally webmail services like hotmail, google etc are blocked, our students are unable to access their University email when they are on attachments. These sites are blocked for security reasons and I understand that NHS policy states that only NHS email can be accessed on the NHS networks. I’ll raise the patient accessibility issues at the working group.

  5. One thing that should come with access to these site is training of some sort. A quick and simple guide that will help those who do access these sites a quick overview of ways that they can avoid issues (i.e. negative comments and how to reply to them) and how to effectively use tagging, hashtags etc.

    As highlighted in a #nhssm chat a while ago though it’s not only an IT issue it is also an Information Governance issue. Once these two hurdles are cleared then the gates will be open.

    Good post though, be good to see what other services people are using

    1. I agree Colin, there needs to be staff development and resources to support their use. Again this an area where we can share best practice and perhaps training resources so that we’re not all re-inventing the wheel.

      1. I’m currently working on some basic ‘how-to’ posts for nhssm, simple stuff like using and managing Facebook and Twitter. Once these are done they should be able to provide a template for training resources.

        Of course there is still a need to open up conversation about best practise and the most efficient ways to do things.

  6. I agree with all of the above, there are a number of very useful resources that we either cannot access or don’t have the privileges to install. I’d find it much easier to use my own laptop, however this would be in breach of the local policies around data security.
    There seem to be too many blanket policies regarding web content, although I have found people to make exceptions around particular sites if you have a good reason for needing access. The ones you’ve listed at the top are good examples where more access would definitely benefit teachers.
    I also think Colin’s points about training are crucial if teachers are going to be able to make use of these new technologies in a coherent and useful way. Twitter could have many useful applications, as could quick podcast creation software like Audioboo, but unless senior staff are a) aware of them, and b) can use them then we are unlikely to be able to take advantage of them. I guess the other key point (given today’s ruling about tweets being classed as public material) is how to use these resources professionally and safely. I still see so many doctors who fail to protect the information they share on social media sites.

    1. Chris thanks for your comments and for mentioning Audioboo, this came up in another conversation recently so will add this to the list. The points you raise about digital professionalism are also important, I think we need to address these issues with students too.

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