Addressing Loneliness in Rural North Yorkshire
The project and my experience as a Pro Bono volunteer
By Sarah Culkin, UK Department of Health
An organisation in the North of England took over a rural visiting service for the elderly and was very keen to ensure that as much benefit as possible could be provided for recipients of the service. It therefore requested a pro bono study from the UK OR Society to help a project team understand how a strategy for improving the service could be constructed.
I was assigned to the task by The OR Society and started work by collecting information and evidence through interviews with stakeholders, accompanying the project team on visits to clients, reviewing survey feedback and finance information. This information was used to produce an initial system diagram. I then facilitated a workshop with key stakeholders to present, discuss, amend and build on the system diagram (see figure 1).
Figure 1. Part of the System Diagram
The system diagram allowed a birds-eye view of the service, helping to see how people flow through the service and how it interacts with other neighbouring services and stakeholder groups.
Back at the office I reviewed the map and conducted thematic analysis on all of the interview notes and other textual information. This analysis allowed clarification and quantification of major themes and topics occurring in the information and led to a list of clear recommendations. For example, it showed that volunteers were not being used to good effect, instead visits were mostly performed by the three staff members, and links and communications with other organisations were also underdeveloped, leading to a confusion and sometimes duplication of work. By refocussing the work of the permanent members of staff to these areas, meant that the service could grow and also be more targeted and efficient.
These recommendations were assembled into a strategy map, showing how they link together and lead from inputs to desired outcomes. From this a balanced scorecard of measures can monitor progress and outcomes of the service to ensure maximum benefit (see figure 2).
Figure 2. Strategy mapping of recommendations
My experience as a volunteer
I was made to feel very welcome by rural visiting team, right from the beginning. There could have been some suspicion about my role, as the review had been arranged through the chair of the umbrella organisation that the service sat under. The service had only recently been taken over by that organisation, and was based remotely, so it was seen as a good opportunity.
The service team in Ripon was small, but they were very dedicated to their elderly clients, this was easily seen as I accompanied them on home visits. In my role it was important that I ingratiated myself, made the team feel at ease, and explained clearly what I was and wasn't there to do. At the same time it was important to remain impartial and analytical, and be prepared to deliver recommendations that may rock the status quo. This balance was something I also felt quite keenly when writing up the final conclusions and recommendations in my report.
The experience was so rich, like nothing I have experienced in my day job at the Department of Health. For example, at the end of the stakeholder workshop where we reviewed and refined the system map, the service team leader hugged me because she was so pleased with the results - definitely not something that has happened in a civil service meeting before!
Because I was getting experience of a sector directly related to the work of the Department of Health, I was fortunate to be able to do this project as part of my CPD hours. As a result I have brought back so much that informs my day-to-day work, my understanding of the realities of care and the challenges the front-line face. In many ways it has been far more valuable than a training course, and without the cost. And the thought that I may have influenced decisions about this valuable service for the better is incredibly rewarding.
The benefits of the study
· As a result of the analysis the client, project team and analyst all gained a thorough understanding of the service and the wider system it is part of ;
· A Strategy map for reducing loneliness was identified and evidenced. This would be used in future, for example, to track numbers of volunteers used, how they contribute to the numbers of visits made, and how well the service works in partnership with neighbouring organisations;
· The client was ‘taken on the journey’, so now understands where strategies come from;
· The work produced a solid foundation from which to re-model the service and apply for associated funding.
At the end of the study the client said: “I’m really pleased with the report and it will be very useful indeed for forward planning and to support our Big Lottery bid “