An unusual Christmas gift

In the early hours of this morning (Wednesday 9 December), away from all the Christmas merriment, when all was quiet about, something stirred on the internet. This something was the launch of the Government’s new ‘One Place’ website and although no mince pies or sherry were needed to encourage a visit to every household in the UK, each still received a sack full of presents from our auditing Santa.

Now just to be clear, these ‘presents’ that each and every household has access to via the website, don’t look that exciting on first glance. In fact they mainly consist of a lot of reports about how people’s local statutory bodies are performing and how this contributes to improvements in their local communities, but on further inspection these gifts could become surprisingly useful – just like those boring socks we unwrapped last year and later found to be unexpectedly warm, even practical and a welcome comfort as the year progressed. The same could be true about the information on the website, sort of.

If you were to punch in ‘One Place’ into any search engine you will be transported to a portal where every local authority’s Comprehensive Area Assessment (CAA) had been placed. These reports detail performance indicators by themes in a local area so a community’s prevailing narrative is painted. This picture includes all aspects of what is important to people: schools, health care, local services and police to name a few. This means you and I can see what all the important issues are all in one place. Full details are available on the website for all to see.

This is an exercise in simplicity and transparency: an attempt to create a narrative to describe a local area being on a quest to maintain certain standards or improve them, and everyone’s along for the ride. Sounds all very well, but there are two concerns. Firstly what happens if the narrative that is created is not recognised by those people living in the community? The place that is being described to them from performance indicators is not the place that they know.  This could automatically disillusion them from changing their behaviours to improve that narrative.

The second issue and the more important of the two: are the ‘right’ local residents going to be engaging with the One Place website, start to become more empowered, contribute to the narrative and change their behaviour. By the ‘right’ sort of people, I mean will this system of reporting start to engage with the hard-to-engage people and therefore invite them into the narrative?

From our understanding and work with local authorities on community cohesion and engagement the answer is probably not, but that is the challenge for local authorities to savour; the work begins with the launch of the new website – interpreting is the easier exercise, changing behaviour is more difficult. Local authorities have the challenge to bring this narrative to people in their communities so it is passed on from peer to peer. The auditors have written an understandable story, now local authorities need to deliver that story to local residents, ask them to read it to others and in some cases train them to do so effectively. Only then can the development of this narrative be considered.

This is where TCC has experience in developing these community champions to work alongside local authorities to champion their work locally, not just explaining their successes but working with community groups to understand the issues that may affect the development of this narrative. And during these times local authorities can’t afford to get it wrong, every pond spent on trying to improve this narrative needs to actual improve it, otherwise the way local residents think about their community will not change and future CAA reports will reflect this.

So what about current reports – all throughout these CAAs local authorities are praised for their community work. From Bexley to Barking and Dagenham and from Lewisham to North Tyneside each of these local authorities narratives have been developed through the work that has been done on Community Communicators and the Young Mayor scheme. We believe it’s schemes like these that help create ‘community sprit’ and demonstrate that the right steps are being taken to ‘build trust in the community’.

The audit commission and its partners should be praised for trying to achieve something different and TCC is there at the sharp end working with local authorities to show others how it should be done. If local authorities wish to pull up their comfortable socks and start developing this narrative in time for 2011 they should begin to think a little about Community Spirit as well as Christmas Spirit.

Is tackling inequality of ability enough?

In recent weeks there has been a debate about equality and diversity. Many would argue that the case for diversity has been won. Mainstream politicians now apologise for past opposition to many aspects of diversity such as past opposition to equal rights for minority groups. However in achieving such advances for greater diversity, does that mean that equality is being left out of the equation?

This point was articulated well by Deborah Orr, who recently in the Guardian explained that equality and diversity were different. That a diverse society could tolerate wide degrees of inequality whilst allowing a range of notionally equal personal and social rights. It could be argued that where we now are is arguably the most modern version of equality of opportunity. At the same time formal equality of outcome is seen as unrealistic in a complex, modern, liberal democracy, which accepts a very wide range of lifestyles.

Perhaps the problem is that the frame in which people view equality is increasingly too narrow, based as it was on the struggle to abolish absolute poverty, achieve formal equality of opportunity, provide a minimum standard of living and then widen rights that in the end also allowed for much wider access and diversity. All these are laudable aims where work still continues, but are they the only aspects of opportunity that count?

This is an active debate within TCC and in response we have drawn from our social marketing methodology for a broader answer.

An underestimated issue within inequality is one of changing behaviour and providing support to help people with their motivations as much as helping people improve their ability. This requires an activist but focused approach to identifying what are the vital behaviour or behaviours that facilitate the most change. This may be a minority good behaviour that needs reinforcement or a specifically bad behaviour that requires intervention.

In seeking to change behaviour one needs to understand the two core elements that enable us to address the challenges faced by every individual:

• Ability – This includes the services that enable people to receive a hand-up as well as life skills that people develop at various points
• Motivation – This is about the willingness of the individual to commit to an action and stick with it over a period of time

Much is being done to provide support to enhance people’s ability. Sure Start, Educational services, Job centres. This is very positive and needs to be continued over the long run. However it does little to tackle either communities or people’s motivations in life. From an early point there are many demotivators that mean that for all the resources poured in to improve ability, little change is likely to occur.

The success in providing a minimum standard of living, whilst providing a starting block for many to aspire further, can provide little incentive for some within those communities. They may see themselves unable to succeed effectively in the complex society that we have created and are likely to feel they have little formal status within it, “so why bother”. In recent years some incentives have been created to assist people with a hand up, however these incentives are often too small in relation to the effort required to be rewarded with them, to make any significant difference.

The challenge for those involved in public policy is to develop the tools that enable us to gain greater understanding of peoples motivations in order to provide a similar level of support to that which is given to improve their ability. TCC believes the opportunity exists to use behaviour change techniques of in-depth segmentation and insight to more fully understand the motivations of individuals and use that to assist in the difficult task of narrowing inequalities in a complex modern society.

The above article was posted by Charlie Mansell, the Research and Development Officer of the Campaign Company

“A crisis is just part of the challenge!”: maintaining or rebuilding reputation when patient experience is what now counts.

Andy Burnham’s speech to the King’s Fund yesterday made it clear that the money will follow the results of patient experience.

Whoever is elected to government next May is unlikely to make a significant change to that.

The direction of travel is therefore clear and NHS Trusts will need to prepare for that.

Reports from the King’s Fund and evidence from the United States, where competition is much fiercer, show that non-clinical experience will be at least as important to patients as clinical competence and effectiveness.

Overall Trust reputation will thus be increasingly important and NHS Trusts need a reputation management strategy that not only deals with the occasional crisis management that they are already used to operating, but also a longer-term approach to addressing all the issues that contribute to reputation.

Jonathan Upton, Chairman of the Campaign Company, is well aware of these challenges having led on reputation campaigns in health and other sectors. He is speaking at a Conference on NHS Marketing in Cambridge today. As a contribution to the conference and the wider debate, Jonathan and the team at TCC have produced a guide on reputation management that is available online here

The guide works from the starting point that NHS Trusts are by their very nature in the public eye.  This is because of the sensitive and responsible nature of the work they do and the money they administer on behalf of the taxpayer.

As well as the constant service pressures, there is now the current recession and the consequent pressure on the NHS to achieve savings to contribute to its own future growth to meet health demand. This will put additional pressures on NHS Trusts that most will not have experienced for more than a decade. In addition, many public services are recording higher levels of public mistrust.  An environment in which this is the main narrative may weaken the ability of NHS Trusts to influence the political agenda when big decisions on public spending priorities are required. At the same time crises occur that can set back years of work and poor patient perceptions may now lead to a significant loss of income.

The TCC guide may assist NHS Trusts who find themselves in this situation. It draws from the wide experience of TCC in tackling reputation management issues in the NHS and in the wider public sector.

As well as being online here it is also downloadable in PDF format here.

This posting was written by Charlie Mansell who is Research and Development Officer at TCC

Volunteering: the making of communities

As someone who volunteers with a number of different organisations I felt compelled to write something on the subject of volunteering and the positive results it has on the individual and his/her place in society.

Much research has been done to understand what motivates people to volunteer, but do these motives change over the course of the volunteering experience; what does it take for someone to continue volunteering and can these reasons be captured and articulated when creating new volunteering opportunities: in short can we formally structure volunteering activities to ensure a sense of community is felt by those participating in them? My initial thoughts on this start with a conference that I had been invited to speak at last month:

“Does volunteering include looking after my children?” The speedy response from the back of the seminar room took me slightly aback. My presentation was on the subject of ‘Volunteering: the making of communities’ and I had opened with a question, ‘what was the single most popular volunteering activity in the UK?’ It was a mild concern to me that in a room of social policy professionals, one generally considered that an activity involving the generic nurture, parental love and legal duty of care associated with looking after his children could be recognised as volunteering.

Needless to say I wasn’t quite sure how to respond; I could see the man’s logic, there were similarities: both activities – child care and volunteering – involved self sacrifice, community benefit and evening commitments, but some how this father figure was slightly off the mark.

Volunteering involves an altruistic desire to improve human quality of life by choice not necessity; indeed the context, as well as the motivation, of the volunteering activity can influence the creditability of the action. Volunteers are not just unpaid labourers, but have a purpose to their activities and responsibilities. They can also opt to walk away at any time, making their staying power even more valuable.

The answer I had down for the most popular ‘formal’ volunteering activity was donating blood; over 1.3 million people in this country, that’s 5% of the eligibly population donated their time to donate their blood to save a life. A simple message: save a life in your community, a simple action: lie on your back for 20 minutes and a simple reward: cup of tea and a packet of crisps. This was a volunteering activity that not only made communities, it kept them alive and kicking.

My presentation was on how these same principles could be adopted in local community projects to develop responsibility through structured and flexible volunteering roles that are relied upon by others in the community. Our research has shown that if a successful council-run volunteering project can create a sense of community in those people who participant in the activity then this sense of community was infectious; with volunteers feeling a place and purpose in their wider community. Not only this, but an hour given to volunteer for one’s community is a more valuable one than someone doing it for alternative ends.

This is highlighted through the work Richard Titmuss did in the 1970s where he compared the UK voluntary blood donations with its counterpart in the America, where blood donations were run as an enterprising activity. In America donors were paid for their blood, but Titmuss discovered that the blood they gave had more problems with it; the quality was not as good when compared with the British donated blood. Titmuss coined the phrase ‘gift relationship’ and comparisons can still be drawn with how a community resident and the local authority interact with each other.

Maybe if my vocal father friend had followed through the logic of my presentation he might consider fostering as his gift to the community. A father does not volunteer to look after his children as there is a legal requirement to do so. However a neighbour may babysit them on occasion and not be paid, which could be classed as volunteering – if only defined as informal. Formal volunteering moves past these ‘favours’ to create a role for a member of the community in a public setting. As one speaker remarked at the conference: we ‘need to formalise informal volunteering’, and in doing so brought into question the very ontology of ‘informal volunteering’.

Whichever way community volunteering goes (formal public sector ‘gifts’ vs informal one-off ‘favours’) there is one near certainty – you can normally encourage anyone to contribute their time to an activity with a promise of a cup of tea and a possible packet of crisps.

Alex Bone

alex@thecampaigncompany.co.uk
0144 282 3530

Saucy Postcards?

As we near the anniversary of the once controversial, now revered, postcard artist Donald McGill – The Campaign Company (TCC) send a nod his way with our new promotional postcards!

Working with one of our creative associates,  Sheffield artist and architect in the making, Cecily Chua, we have produced a range of retro seaside postcards.  The nationwide campaign heightens awareness of the services that The Campaign Company (TCC) offers to the public sector throughout the country.

A total of 1250 postcards were sent between Wednesday 19^th and Friday 21^stof August, each featuring an individually hand written message tailored to the recipient.  We at The Campaign Company (TCC) targeted directors, chief executives and communications officers, with postcards sent to every hospital trust in England, including primary care, ambulance, mental health and foundation trusts.

As well as this, every major council in the country has received a postcard in a countrywide campaign to demonstrate creative flair with a light hearted summer theme.

A total of five designs were commissioned to be painted by Sheffield artist Cecily Chua, depicting traditional English seaside postcards with a retro twist in a similar vein to the work of Donald McGill.  The postcards feature bikini clad ladies, muscular lifeguards, ice cream vans and courting couples, much like McGill’s classic originals.

Each picture conveys a different message appropriate to its destination:  “The postcards have been designed especially to illustrate some of the services we offer,” says company chairman Jonathan Upton. “This ranges from member recruitment for hospital foundation trusts through to how we can help organisations build trust with communities.”

For more information about our creative side or our services contact:

Christopher Hill

christopher@thecampaigncompany.co.uk
0114 282 3530

How many people does it take to run a Community Noticeboard?

No, I’m not about to start recounting a traditional joke I heard in the pub, but this story could easily become one, an illustration of how well-meaning bureaucracy can disempower and crush the initiative and spontaneity out of staff as well as alienate their customers.

I board my train at Preston Park station in Brighton to head up to the TCC office in Croydon. Travelling to meet clients all over the country, I often buy extra tickets at Southern’s ticket office.

Bob is one of those great railway staff who become a fixture in commuters daily lives. He posts a regular “thought for the week” on the ticket office screen so all commuters can read it. The sort of harmless common sense folk wisdom that you get in magazines like Reader’s Digest and which often makes you smile as you start a long day.

Things like: “What you say means nothing, how you say it means everything” and “Its nice to be important, but more important to be nice”.

Two years ago there was a local uproar when a new manager made him take it down. A campaign by articulate Brighton to London commuters secured a reinstatement – a local victory for people power.

But clearly bureaucracy does not give up, for today I asked Bob why his sign on his perspex screen had gone again. He explained that he had been asked to transfer it to a “Community Noticeboard” elsewhere in the station.

I am all in favour of there being a community noticeboard. The more the merrier for community groups to promote their activities and keep us informed. However I do not think that taking a piece of individual initiative and shoe-horning it into a more formal space is the right approach.

So now we have a situation where an uplifting message, best placed in to cheer up a commuter at the start of the day is lost amongst the perfectly proper notices for events that a commuter is probably more likely to read on their way out of the station in the evening. In other words the right message is now going through the wrong communications channel. A little common sense, as is often set out in Bob’s thoughts for the week, is what is really required here.

Clearly there should be overall guidelines for any member of staff in a large organisation, but what any large impersonal organisation most needs is front-line staff who are human and who demonstrate to the public every day that it is made up of real people who are just like them. The trick for any forward looking organisation that wishes to show genuine empathy with its customers is to create a framework and tools and then let go. This is important not just for front-line staff, but also for campaigns involving health and environmental champions or advocates in the community. Feedback mechanisms are also important to staff who communicate with customers, but this should not be proscriptive, but instead should be helpful.

“Thought for the week” was the personal relationship building process between the Bob and his customers. This is exactly what staff should be trained to do. The hand-written message and the fact it belonged to the member of staff demonstrates authenticity and just a little individuality.

Organisations in future will need more of that, not less!

This Blog posting was written by Jonathan Upton, Chairman of  The Campaign Company

Values First?

When we first came across Values Modes it chimed with all our learning from our social marketing and community cohesion work. Why are some people so receptive to certain messages and others not? Why are polling organisations still using occupation as the only way of segmenting the populations, when two C1s don’t necessarily think alike? Why do so many organisations believe that two people who buy the same car have the same values when real life experience tells us otherwise? Values Modes gives us the answers and we wanted to find out more.

Jonathan picked up the phone and a week later in walks Pat Dade from Cultural Dynamics. Pat is not your average guy. He grew up in Oregon but has spent much of his life living in the east end of London. Pat and his colleague, Les Higgins, have spent around 30 years asking thousands of questions of tens of thousands of people. They have worked for FTSE 100 companies, leading charities, and government departments.

Pat and Les have built their Value Modes methodology on a strong theoretical framework based on recognized and evidenced theories of motivation within modern psychology and translate that through programme design into effective communications, thus recognizing the importance of evidenced evaluation and an increasing requirement for social return on investment and value for money in these difficult times.

We listened to Pat intently, nodding periodically as his methodology and insight crystallised our thinking. Pat confessed that he was equally inspired by our work and a short time later a new partnership began.

The simple insight of Cultural Dynamics is that if you want to change or reinforce behaviour you have to start by understanding values. These values can change slowly over time, but more importantly once you understand values you can understand current motivations and that is the gold dust of all behaviour change work. Two people who exhibit the same behaviour may do so for very different reasons. Thus understanding these different values and motivations enables one to communicate in a much more effective way that is resonant with the emotions of the various groups you might be aiming at.

So what are these values? At its simplest the Cultural Dynamics model breaks the population down in to three distinct groups. These are pioneers, prospectors, and settlers.

• Pioneers are inner directed. For them the world is about self actualisation, learning, growing, and experiencing new things. They embrace change and have large social networks.

• Prospectors are outer directed, thinking more about their status and finance. They want to be seen in the right places and buy in to the latest trends.

• Settlers on the other hand are nostalgic about the past, fearful of change and pessimistic about the future. Their home is their castle and they have the smallest social networks, often existing of very little beyond family.

This helps us understand why people might exhibit the same behaviour but have different motivations. Take the example of someone buying a Toyota Prius. A pioneer might by motivated by the environmental benefits, a prospector by the association with the many Hollywood celebrities that have bought one, and a settler may want to buy one for the fuel economy.

Of course it gets more complicated, it always does! Each of the three groups divides in to four segments, making a total of 12 segments. We are now working with Pat and Les to adapt their insight to the different environments we work in. We are now working with a number of local government clients utilizing this form of segmentation system to fine tune community cohesion work and it is also being used on behalf of a local NHS client and enabling us to make sure their website properly engages their local population.

Value Modes provides an opportunity to develop deeper insight than traditional demographic segmentation and even standard psychographic measurement tools that are based only on purchasing behaviour rather than underlying values. In a future posting we will discuss the implications of this in more detail.

Defining Social Marketing for Sexual Health

Setting the standard for social marketing campaigns nationwide.

whatdoyouknow.org.uk is an initiative produced on behalf of NHS Barnsley offering support and advice on sexual health for young people, aged 13 to 25, local to Barnsley.  An involving website offers interactive maps, to direct users to the sexual health services, while a variety of ‘on the ground’ activity provides a real presence to the resource.  Look out for our upcoming blogs which will showcasing our highly acclaimed virtual tour of sexual health services.

A recent event, orchestrated by TCC employees Amy Richards and Christopher Hill, relaunched the website and it’s new intuitive design.

Amy stated “The event was really enjoyable and I felt we genuinely made an impact and a difference to the young of Barnsley“.

Christopher commented “It’s always great to get involved at a grass roots level.  Seeing the real life results after months of intensive research, design and hard graft is more than rewarding”.

A variety of tools were used in order to maximise the value of the events.

• TCC VideoQube
  - captured opinions and questions from local young people on video
• TCC Writing on the Wall
  - captured viewpoints anonymously providing a greater depth
• TCC Partnerships
  - bringing our local associates along allowed our team to offer health advice
• Pee in a Pot!
  - the Terrence Higgins Trust were invited to do on the spot Chlamydia testing
• Support Materials
  - signposting young people to useful information and services
• Behavioural Survey
  - examining behaviour and awareness on sex, drugs and alcohol

The event covered it all from, Youth Engagement and Youth Representation to Health Advice and Free Condoms!

The young people can’t wait to grab our exclusive T-shirts!

Richard Hart, Teenage Pregnancy and Sexual Health Co-ordinator of NHS Barnsley was able to comment on the event:
“The event has been a fantastic vehicle to help promote and raise the awareness of the new website amongst younger people locally. Over 2,000 leaflets were handed out and many people stopped to talk about sexual health issues.”

Richard continues:
“The more information we can gather about young people’s sexual health in Barnsley, the better services and support we will be able to provide in the future. Another opportunity to enter the survey competition can be found by logging onto the whatdoyouknow.org.uk website.”

Our popular, eye-catching and informative materials

Our event was noted by Jon Harvey Associates on their Creative Ideas blog
http://tinyurl.com/WDYKjonharveyassociates

The project has also been acknowledged by a host of professional websites:

NHS Barnsley
http://tinyurl.com/wdykNHSBarnsley,

Healthy Schools, Barnsley
http://tinyurl.com/wdykHealthySchools,

Kendray Hospital
http://tinyurl.com/wdykKendray,

Studio DM
http://tinyurl.com/wdykStudioDM,

Safeguarding Children, Barnsley
http://tinyurl.com/safeguardingchildrenBarnsley

If you would like more information about the whatdoyouknow.org.uk campaign, or how we can help you please get in touch.

Christopher Hill
e. christopher@thecampaigncompany.co.uk
t.  0114 282 3530

PROMs: number crunching or patient insight?

The High Quality Care Progress Report was issued a few weeks ago (June 2009). The report updates the public on the original report that came out in June 2008 and we at the Campaign Company were especially interested in what it had to say.

The original 2008 report stated that “we will make payments to hospitals conditional on the quality of care given to patients as well as the volume. A range of quality measures covering safety, clinical outcomes, patient experience and patient’s views about the success of their treatment – known as patient reported outcome measures or PROMs – will be used.”

The 2009 progress report attributes a whole chapter on ‘patient experience’ that talks about good practice, but does not specfically mention PROMs by name. However professionals are not worried as today (Wednesday 8 July 2009) sees a national conference being held on PROMs. It will explain that previous outcome measures have focused on indicators of failure such as mortality, complications and re-admissions. However PROMs are designed to take into account the physical and mental benefits of treatment as perceived by the patients themselves.

From 1 April 2009 the NHS will be the first health care provider in the world to routinely collect patient reported outcome measures, but many organisations are keen to find out how this can be done, which is why today’s conference will be packed, and what will they be told? The Campaign Company hopes it will be along the lines of the below:

‘PROMs are a good starting point for collecting data with regards to patient satisfaction, however there are a number of limitations to the scope of PROMs for example how do you measure the health –related quality of life for patients with long-term chronic illnesses?

Is patient satisfaction not based on patient experience? If so then surely we should be exploring the patient’s experience through the health care system as this will ultimately determine whether or not the patient is satisfied with the level of care provided/received. Patient experience needs to be at the heart of outcomes – an ‘end’ in itself not achieved through the ‘means’ of other measurements such as: ‘waiting times’ and ‘membership involvement’.

How we measure true, real time patient experiences is the challenge! We need to get under the skin of patient experience, explore the real issues, ask the questions that they don’t know how to ask, engage with patients on a micro-level i.e. follow and explore their care journeys only then will we be in a position to fulfil the true needs of patients.’

If this is indeed the right view being delivered at the conference then it is good for patients. It is only through empowering patients and following them through the care journey that effective changes can be made to the overall experience. The Campaign Company has a strong record in facilitating these exercises and driving through change based on systematic public participation in services.

It is only by investing in these activities, and not solely through interval consultations and sometimes impersonal quantitative surveying that PROMs can be implemented; resulting in NHS organisations achieving more positive indicators and a good excuse for Lord Darzi to heap even more praise on the sector come the 2010 review.

Making patient “rights” work

The Government’s announcement of a range of new “rights” for the public to replace targets is welcome. Whilst targets might have been a useful driver in its early years, more recently they have been seen as bureaucratic and top down. However in order to drive this rights agenda forward a number of things need to happen:

• Effective operation of people driven outcomes will require public authorities to gain far greater insight into customer expectations than in the past.
• There is also a need for strong local advocacy to support those communities that can be either hard to reach or nowadays hard to engage. For example white working class communities with a strong perception of unfairness over changes they feel they have had no control over are a group that will need greater empowerment.

Of the new rights, Andy Burnham’s list of “entitlements” for users of NHS services could make the most impact as they have a lot of potential to  increase empowerment. However we all know that some people will be more confident in using their new rights. For this new patient driven process to work there needs to be a strong system of  support and insight into patient experience to ensure there is no newly developed “postcode lottery in entitlement” and those from poorer communities are encouraged to have equal access in utilising their rights.

These announcements also indicate a strong degree of consensus in this area across the main parties. I have previously blogged about Shadow Secretary of State for Health, Andrew Lansley’s vision for the NHS which has a similar focus on patient driven outcomes. What this means to local government and health providers is that no change is not an option! The need for greater local advocacy to secure the rights of the less articulate is something that will not go away and the far sighted in the public sector will be preparing for it in a cost effective way now.

Peter Watt is Chief Executive of The Campaign Company