We believe that all citizens should have a say in the Sustainability and Transformation Plans. We also realise how difficult it can be for organisations to engage with people about this complex subject.

Healthwatch chapters around the country are being commissioned by Clinical Commissioning Groups to conduct this important engagement locally. We can help, and we suggest this approach for hearing from more people, especially from those who are seldom heard.

In order to get the most out of this exercise it is important to remember that many more people than you may realise do not access the internet, have a smartphone, or interact with social media. In fact, the latest Ofcom statistics show that in the UK, 29% of people don’t have a smartphone, and 34% of those don’t use their handset devices to access the internet. What’s more, 19% of adults don’t have either a landline or mobile internet connection. But, 93% of people have at least a dumb phone.

The people who fall into these statistics will be the seldom heard voices you most need to hear from. When you provide an SMS text method for people to be able to have their say in any engagement process, you open up the voice of the response you will get.

Using this free-to-the-user, anonymous comment recording method, you also overcome people’s reluctance to try and write or verbally express themselves if they lack confidence due to low literacy, English as a second language, or fear of being identifiable.

These days most consultations and surveys are internet-based. You must go online to access a link, or questionnaire, or download an app. At best you may have a paper questionnaire requiring good English literacy, or get invited to an intimidating or inconvenient community meeting as an alternative chance to have your say.

Many people find filling in surveys tedious or difficult, and those who struggle may not wish to acknowledge their need for assistance.

Textocracy can be used in any situation, so even if you are running a focus group or community meeting, people attending can still immediately and easily text in what they are thinking in response to your prompts, without fear of embarrassment or identification.

This anonymous way to have a voice that is usable by 93% of the population can appeal to those least likely to be reached through mainstream initiatives, less likely to interact with public sector professionals, or pay attention to mainstream public information campaigns.

There are two main powerful places to start to get access to those hidden voices:

1.Go to those places where people from demographics that are not often engaged may listen to their peer leaders. It is important to remember that many people do not have access to the internet or smartphones, and social media and any online surveys or websites are likely to miss the groups you are most interested in engaging.

Providing those least likely to engage with conversations or surveys the option of texting in makes commenting particularly accessible for those who may usually be invisible due to smaller numbers, minorities with substantial communications barriers and/or hidden voices.

Some good places to start include: housing associations, neighbourhood associations, Working Men’s Clubs, local religious groups, anglers’ or fishermen’s clubs, hairdressers associations, neighbourhood and community shops.

Using messaging through these forums, especially using natural peer leaders, you can encourage commenting from people who would never normally engage.

Showing the peer leaders how a Textocracy number works, showing them live comments appearing on the dashboard, can provide a powerful catalyst for getting their help in encouraging their groups to use the service. They are able to say, “The number works, they are listening, I’ve seen it myself!”. This means more comments and more data from a wider range of people.

2. Work with existing local and national activist groups that are vocal about the NHS- both pro and con.

They have active listening groups who care passionately about what is happening in the NHS. Many have local as well as national groups, such as:

Approach them as potential partners, acknowledging that they have the ear of thousands of people who have strong views about the NHS. Let them know that you would love to hear from those people, too. Of course there could be strong negative views about changes to the NHS. It is important to hear those along with positive and constructive ones. All comments add to the data and information that you can get to feed back to your local NHS commissioners as part of the duty to consult.

Perhaps most importantly, opening up this channel of communication will offer the opportunity to get accurate information out to these groups about the STPs and what they mean for the NHS. Let them know that you want to hear from their members.

You can also ask them to get their members to get the people they know who don’t usually speak up or for some reason find it difficult to be heard. Friends, family members, people in their community can all take this new opportunity to have a voice. Their passion about the NHS attract engagement with their communities.

How an SMS service makes it easy

You can do this easily with little burden on your Healthwatch teams. Give groups locally a Textocracy number to be able to speak openly and anonymously about their views of the NHS and their responses to the STPs. It will be free for them, and anyone with even the oldest simple mobile phone will be able to have their say.

I believe these two methods will, with little burden on existing staff and stretched teams, increase many times over the number of comments Healthwatches will get in to their service about the important issue of the STPs. But perhaps more importantly, because the service uses SMS, anyone with the simplest mobile phone, with low literacy or on low income, with English as a second language, who is not tech savvy or who has limited access to the internet can easily and anonymously have their say.

All Healthwatch chapters need to do is put out their unique Textocracy number through their existing communication channels, display it during focus groups or community meetings, and always provide it as one option as a way for anyone to have their say.

For those Healthwatches who are particularly stretched for resources and staffing, using Textocracy for this purpose could prove a straightforward and effective way to get the conversation started locally with their constituents, with little burden on small teams.