We can never hope to win the public over to our side by staying in our offices and tweeting – we must get out there and meet the people, says Mike Wedgeworth

A powerful community reaction to the closure of the accident and emergency department in Chorley, Lancashire, saw hundreds of protesters on the streets, at the hospital and in the town. It shows little sign of abating.

Social media was key to bringing out the crowds, and keeping the protest going.

Karen Partington, chief executive of the Lancashire Teaching Hospitals Trust, updated the Lancashire Health and Well-Board on the latest state of play at its most recent meeting.

She showed, to everyone’s satisfaction, that everything is being done to re-open the department in the context of a national shortage of accident and emergency specialists and their unfair distribution nationally and regionally.

The passion and commitment of the Chorley protesters is a powerful expression of Lancashire localness.

Changes, however necessary for the wider benefit of patients, are likely to be opposed from day one, and attempts to put the facts before an emotionally charged audience will rarely be heard

But when I suggested to them it may be unfair to make the trust the target of their complaint, rather than seeing the closure as a local manifestation of a national shortage of trained staff, its leaders promptly called for my resignation as chair of Healthwatch Lancashire.

Later they mobilised supporters to hold their banners aloft outside our offices. Cannily, our staff invited them in for a cup of tea, had a good talk with them, and, as they left, all confirmed a better understanding.

Some days later, a Chorley councillor persuaded Lancashire County Council to pass a resolution, which described the problems at Chorley Hospital as an “early symptom of an emerging national problem in the NHS” about lack of adequate resources.

Emotionally charged

This seemed to me to hit the nail more fairly on the head.

But none of this prevented further hostile reaction or press publicity about pressures on other A&Es, babies dying, ambulances bypassing Preston Hospital etc.

Although it is possible to detect some signs of a shift in the focus of the campaign towards a national perspective, the events at Chorley demonstrate yet again the enormous difficulty of winning public support for any attempt to change the status quo of any hospital, anywhere.

None of us can afford to be slouches in using social media to get our messages across. But the very ease of doing so can open us to its worst features: vitriol and abuse

Changes, however necessary for the wider benefit of patients, are likely to be opposed from day one, and attempts to put the facts before an emotionally charged audience will rarely be heard.

This experience has prompted many of us who are involved in “system change” to ask some fundamental questions about how we go about what is blithely called “communication and engagement”.

None of us can afford to be slouches in using social media to get our messages across. But the very ease of doing so can open us to its worst features: vitriol and abuse. Language used on the internet is more aggressive and irrational than the same people would ever contemplate when they meet face to face.

Although it would be foolhardy to propose a single panacea, it does appear to be the case that when people meet together, and share in discussion, debate and controversy, there is a better prospect of changing hearts and minds.

Whilst it is very obvious that much discussion on the future of the health service already rages, in academia, among the professionals intimately involved, journalists and elected persons, there seems little breakthrough beyond those unkindly called the chattering classes.

And, from the perspective especially of members of Parliament and local councillors, it would simply be electoral suicide to argue for radical change if the electorate is hostile.

Comms army

Yet, there are thousands of groups in our communities who are open to hearing the messages we need to convey. Churches, mosques, Rotary clubs, women’s institutes, Young Farmers Clubs, representatives of business, voluntary and community organisations of every size and interest. We should meet with them; we should talk with them. We must step out of our offices and truly engage with people.

 The experience of Healthwatch Lancashire, in holding what we call “care circles”, is a good illustration of how “meeting”, in this case with people who respond simply because they have a very general though connected interest, works well: it does not “talk to” but “talks out” of their existing understanding.

The professionals who work in communications and engagement in the NHS and local government constitute a veritable army, and between them spend a substantial budget.

But questions must be asked about how much of their time and money is devoted to helping the citizen to understand, and then even to welcome the changes ahead.

Healthwatch advocates that all concerned should “get out more”. We should aim, collectively, for in-depth conversation with the public through “community intermediaries”, which seems as relevant to the self-interest of individual NHS and local government entities as to our collective interest in changing the way we work.

Mike Wedgeworth MBE is chair of Healthwatch Lancashire.