So, there’s been a lot of activity around the NHS Constitution this week.

The group reviewing this document, led by Dr Steve Field, held a twitter discussion one lunchtime and you can read the extracts of this on the Department of Health website here.  Then, yesterday, Jeremy Taylor from National Voices and a member of the review group wrote a rather good blog about the challenges of arriving at a Constitution that is both based on rights and values and has teeth .

This is all a very sensible bit of sounding out of people’s views ahead of the full public consultation on the Constitution towards the end of this year.

One of the immediate issues as noted both by the tweeters and Jeremy is the document’s lack of visibility.  So, in answer to my own question posed in today’s blog headline, while you of course can’t write the whole document in 140 characters it would be a noble aspiration and one fit for our ‘social media’ orientated culture to try and sum up it’s key pledge to citizens in 140 characters.  The statement then might be a footnote to many documents and communications received by patients, with it gradually seeping into society’s psyche.

I seem to remember that in the days of ‘Clause 4,’ the Labour Party did the very same thing by putting the wording of this on the back of membership cards.  To great effect given the numbers of people who were able to recite it.  Those were the days he says almost as if it is a confessional.  Anyway, I am going to have a go at my 140 characters version over the weekend.

I’ve also been pondering what has made the US Constitution such a successful document – and the one that springs to mind immediately when we think of constitutional matters – over many hundreds of years.  There is something about its clarity of language, its vivid nature, the fact that it is concise,  its ability to enshrine checks and balances between institutions but also between the individual and these organs of power, and the way it future proofs itself by building in an acceptance that not only do things change and providing mechanims for dealing with this.  Plus, finally, you can’t consider its resonance through time without also dwelling on the notable characters behind its compilation.  They were about as far removed from the pen of the modern policy-maker as you can be without the whole thing becoming fiction.

Perhaps that’s the real challenge for the future NHS Constitution as Jeremy sort of implies – whether it becomes fact or fiction.