Back in 2005 when social media was just getting going I read the Cluetrain Manifesto. It told companies in no uncertain terms about just how different the coming world of informed consumers was going to be. Cluetrain was big, famous and influential. It used this picture to illustrate the way that companies were treating their customers.

Not very Christmassy I grant you but arresting. And if you were being unkind – or had just spent too much time at the Mid Staffs inquiry – you might think that incidental roadkill is exactly how lots of people who have been harmed by the NHS end up feeling.

So our (slightly sombre) Christmas Cracker is a new version of the manifesto re-written for the NHS and updated to take account of social media. (And our thanks, acknowledgements and apologies to the great original.)

A Cluetrain Manifesto for the NHS

People using social media communicate in language that is natural, open, honest, direct, funny and often shocking. Whether explaining or complaining, joking or serious, the human voice is unmistakably genuine. It can't be faked.

On the other hand when the NHS ventures on-line it usually talks in the humourless monotone of a Comms strategy, and the your-call-is-important-to-us busy signal. Same old tone, same old evasions. No wonder people are beginning to lose respect for a health service unable or unwilling to speak as they do.

But learning to speak in a human voice is not some trick. Trusts and Health Boards will not convince us they are human with lip service about "listening to customers." They will only sound human when they empower real human beings to speak on their behalf. This isn’t difficult – some health organisations are already doing it really well.

Twelve Propositions for the NHS in 2012

1. Social media means that the networks surrounding health services are getting smarter, more informed, more organized. Participation in these networks changes people fundamentally.
2. There are no secrets in this new world. Combine open data with democratised voice and whether the news is good or bad, everyone will know it.
3. With a billion people on Face Book the NHS’s attempts at patient engagement and empowerment look increasingly out of touch with reality.
4. The hard-to-reach aren’t 'out there' – they are alive and well and working in the NHS.
5. The NHS is having two conversations. One with itself. The other with everyone else. In most cases, neither conversation is going very well. Almost invariably, the cause of failure can be traced to obsolete notions of command and control.
6. Front-line staff - who make the wheels of the NHS turn each day - want to join these public conversations directly in their own voices, not in platitudes written by the Director of Comms.

Meanwhile what people are thinking online goes something like this:

7. The people we’d really like to talk to on-line are the nurses and doctors who look after us. But you always hide them behind a corporate smokescreen that prevents anyone taking responsibility for the words that come out of their mouths. Don’t you trust them? Or is it us you don’t trust?

8. We already know some people who work for you. They're pretty cool online. Do you have any more like that you're hiding? Can they come out and play? When we have questions we turn to each other for answers. If you didn't have such a tight rein on "your people" maybe they'd be among the people we'd turn to.

9. We’d be delighted if the NHS joined us in this new world of social media. But it's our world. Take your shoes off at the door, start talking human! Even at their worst, our on-line conversations about your services are more interesting than all that corporate flim-flam you’ve been shoving at us since Mrs Thatcher's time.

10. We've got some ideas for you too: some new tools, stuff that will make your services better, and your staff happier. For free, right now. Got a minute?  

11. We'd like it if you got what's going on here. That would be really nice. But it would be a big mistake to think we're holding our breath. We have better things to do than worry about whether you'll change in time to get all this. Health care is important but it’s only a small part of our lives. It seems to be all of yours. Think about it: who needs whom? 

12. To the NHS these networked conversations may appear confused, may sound confusing. But we are organizing faster than you. We have better tools, more new ideas, no rules to slow us down. We are waking up and linking to each other. We are watching.

But we are not waiting.                                                                                                         

                                                                                      Happy Christmas!