If you are setting up a healthcare website, the trick is to let users shape the content, says Bill Douglas

You can earn great credibility in computing circles these days by talking assuredly about Web 2.0. These new technologies in web development have seen the role of publisher start to move away from companies and organisations and firmly towards all of us who use the internet with YouTube, Facebook, blogs and so on.

All of which should make for better online facilities for networks and communities of practice. The NHS has plenty of those and a look through networks.nhs.uk shows just how many of them are online with their own sites. Should they build the new technologies into their sites? And should a network merely provide a 'shell' site and leave it to members to populate it?

In most cases, the answer is surely yes, as one of the raisons d'etre of any network must be knowledge-sharing and no network co-ordinator can know it all. I have had the privilege of leading an online community of practice for NHS web developers. The site, webteam.nhs.uk (accessible from NHS connections only), is basic, even old-fashioned, but revolves around a heavily used discussion board and areas where members share documents, plans and techniques.

These sites achieve some success by being practical, punchy and no-nonsense. Members should know that they can go to their network's site, ask a question and get the answer from peers. Without this Web 2.0-style democracy, an online network can in some cases be little more than a corporate brochure and that really would be missing out on something.

Can the same rules apply to online networks for our patients and public, such as websites aimed at people with a particular illness? A potential barrier to the success of such sites is the perception among visitors that they are being marginalised.

Some sites still provide a text-only version of their material, ostensibly to assist people with visual impairments. However, many within that audience have good computer skills and clever software to cope with correctly programmed 'standard' websites and refer disparagingly to those stripped-down versions (no photos, no videos, no sound) as 'blind ghettos'.

In a similar vein, my team of programmers and editors was proud of a new site we created for people with a particular condition in our region. Expectations of a busy discussion board were dashed, though. 'Prompter' topics about good places to shop or go on holiday brought replies to the effect that sufferers shop and holiday exactly where everyone else does, thank you very much. Since then, the site has been very quiet and we have learned our lesson about treating everyone equally.

That is not to deny the value of modern internet facilities for patient groups. Rather, it reinforces the idea that such facilities are best used to allow the members themselves to provide practical questions and answers, with as little interference from above as possible.