BACKGROUND With the advent of internet-based communications, face-to-face interactions are becoming increasingly uncommon and inconvenient, including those between the doctor and the patient. Social media (SM) has been recognized as a tool that could potentially help nourish and expand relationships in healthcare; however, much remains to be explored. OBJECTIVE A systematic literature Review (SLR) was conducted to explore the use of SM in the United States (US) healthcare setting, and the characteristics of its use, including barriers and facilitators. METHODS A SLR was conducted using three peer-reviewed databases; PubMed, MEDLINE and EMBASE. EBSCOhost database was included to gain a deeper understanding of companies’ use of SM and any lessons that can be learnt and applied to the healthcare setting. RESULTS Over the last decade there has been a rapid shift in the US towards the uptake of SM technologies, with many hospitals now using platforms such as Twitter and Facebook for communication, health promotion, education and research. SM can also present a competitive and financial advantage to increase a hospital’s reputation and reduce costs. However, despite its many proven or apparent uses, SM also brings with it many challenges, such as ethical considerations, need for clear guidelines and evaluation, perceptions and attitudes of patients and staff, and the possibility of mismatched offer versus patients’ needs. CONCLUSIONS The future of SM lies first of all in developing sound practices, and in its integration into the hospitals’ overall communication strategies, as well as expanding the number of uses and stakeholders involved.

BACKGROUND Engagement strategies used within the NHS, to reach out to the public and internal stakeholders, have continuously changed over time. Communication with each other is happening through more user-generated information being shared through social media (SM). The advent of SM has shifted the information-seeking behaviour of society, including healthcare. The ability of SM to engage people in the community and overcome traditional separation barriers gives SM the invaluable power of helping in the transition towards a more community and prevention focused health care delivery involving multiple stakeholders. OBJECTIVE A systematic literature review (SLR) was conducted to explore how SM is currently being used in the NHS using current literature. This was under the general theme of use of SM in the NHS, and strategies to engage the public in the NHS. METHODS Literature searches were performed in PubMed, MEDLINE and EMBASE between 2004-2017. The relevance of articles were screening using a pre decided inclusion and exclusion criteria. The papers included were critically appraised using the PRISMA Statement. Two separate search strings were created to cover both SM use in the NHS and engagement strategies in the NHS. RESULTS The search string yielded 3145 papers in total. After screening by initial limits, de-duplicating, screening by title, abstract and inclusion/exclusion criteria, a total of 55 papers were reached. These were all critically appraised and were divided based on the theme they covered. The themes found amongst these 55 papers were use of SM in: the NHS, nursing, healthcare research, conferences, gaining insights to patient perspectives and trends, recruitment, patient and medical education, successful Twitter campaigns and engaging patients. CONCLUSIONS Literature has shown two main views apparent on the use of SM in the NHS. The effectiveness of SM use in the NHS is uncertain, but SM specific uses acknowledges the potential of SM in engaging with the public and therefore helping to achieve the ambitious Five Year Forward View. Whilst limited, the literature has shown that SM in NHS has been used in research, conferences, and education of other doctors and patients. Engagement strategies in the NHS have mostly taken the form of awareness campaigns in key areas, such as lung cancer, nutrition and antibiotics use. 22% (12/55 papers) shows that the use of SM in the NHS has still far to go before it achieves full implementation and utilization.

BACKGROUND The number of social media users in the UK is rapidly rising. However, there is a lack on primary research as to how the National Health Service (NHS) is using social media to engage patients and the public. OBJECTIVE To understand the current methodology, implementation and strategy of social media use within NHS Trusts. METHODS A qualitative grounded theory approach was taken through semi-structured interviews with NHS Trusts. Selection was based on the Trusts quality ratings by the Care Quality Commission (CQC) in 2017, selecting the highest 15 and lowest 15 ranked trusts. Telephone interviews were conducted with a member of the communication teams and were audio recorded then transcribed. Three independent researchers thematically analysed the transcripts, to draw themes that emerged from the transcripts. RESULTS Following a pilot study, we conducted interviews with the communications team of 27 NHS trusts across the UK. Six main themes arose from the interviews: 1) The social media and communications teams; 2)The Trust; 3) The Trusts’ use of social media; 4)The Trusts’ management of their social media ; 5)The future of social media; 6)The use of social media within the NHS). These six higher themes consisted of a total of 26 subthemes. CONCLUSIONS The themes allow us to understand how social media is currently used within the NHS, as well as its potential future scope. Recognising the main areas of importance to Trusts and current difficulties they are facing, allow us to explore ways of increasing social media use by NHS Trusts. We have proposed a set of guidelines, known as the ENGAGED framework, which trusts can use to enhance social media use and enagagement. CLINICALTRIAL Nil