Patient Opinion's mission is to carry the experiences of patients and carers into the heart of health services, where they can make a real difference both to how staff feel about their work, and to the services they provide every day.

Sometimes our progress feels painfully slow, but this week two things really lifted my spirits - and then something else brought me straight back down to earth.

The first lift came from Devon, where the Royal Devon and Exeter Foundation Trust is just getting underway with Patient Opinion. Instead of just setting up one or two staff to receive all our email alerts, they've decided to set the ball rolling right across the surgical directorate.

So that's 80 senior members of staff at the trust, new to Patient Opinion, and all standing by and waiting to hear from their patients and carers. Impressive commitment to the new world of social media!

The second lift was from the other end of the country, where we saw this exchange follow feedback about the Scottish Ambulance Service.

After an unhappy experience in the ambulance and A&E, the patient posted their concerns on Patient Opinion. The service was able to respond online, reassuring the patient that raising these issues would not compromise their care - which is, of course, one of the most important barriers to honest feedback.

The patient was reassured, and has since met with the service face to face, posting on Patient Opinion that: "I felt comfortable and free to say what I needed to and I feel very validated and understood."

I love this story not just for the happy ending, but because it shows how conversations which can't begin in person can begin online, continue face-to-face, and finish up online again.

So what brought me down? A call to Patient Opinion from someone with a serious long-term condition, a longstanding user of services at a well known teaching hospital. The patient had had a poor experience at one of the hospital's clinics. They sent in a written complaint, but received no response, so after a month they posted their story on Patient Opinion.

It wasn't long before the phone rang. It was a member of staff at the hospital, who refused to give their name. The patient was told: "Withdraw your complaint, or we will withdraw care."

We still have some way to go, it seems, before some health service staff see patient experience as a gift from which they can learn.

Today we saw a lovely example of how quickly and efficiently someone can take patient feedback, and use it to make things better.

A few days ago a patient with coeliac disease posted a story about how they were taken aback to be charged over £40 at the pharmacy for items "prescribed" by the community dietician.

Today, Helen Wyatt from NHS Rotherham responded on the site to say that this might have been an error, and for the author to get in touch to sort things out.

An hour or so later, Helen posted again to report that the primary care trust had updated the voucher form used by dieticians, to avoid a similar mistake happening in the future - making the service better and clearer for everyone, just like that!

Hey, you think I'm going to let myself be outdone on video? No way!

So here's me speaking at Nick Marsh's excellent recent Service Design Thinks evening.

Ten times as long, but only twice as embarrassing (to me, anyway).

James Munro, Patient Opinion - Service Design Thinks 3 from Nick Marsh on Vimeo.

Where's Paul been the past few days? We had to turn to YouTube to find out.

Turns out he's been at the OxfordJam unconference all the time - and here he is, caught on camera:

Next week I'm off to talk to commissioners of maternity services about online feedback from users of the services they commission.

Maternity care is one of those parts of health care where "clinical outcomes" are vital but usually OK, and "experiential outcomes" sometimes forgotten. I've blogged before on what women have said on Patient Opinion about their care.

So I thought it might be interesting to construct a quick Wordle of the 1,000 odd comments on maternity care that we can find on both Patient Opinion and NHS Choices. And here it is.