Get the outcomes right and the rest will fall into place

By Pamela Muir 11 January 2013

Funders rightly expect us to show them how effective we are at changing people’s lives for the better. The pot of money is shrinking so bidding for funds and getting it right is more important than it’s ever been. Without question, if we can demonstrate outcomes in simple terms, and make the measurement meaningful, we’re going to enjoy more success in winning bids and retaining contracts.

Outcomes frameworks may seem like a ‘buzz’ phrase at the moment, but they are definitely here to stay. To prepare for the NPC conference I asked people—both inside and outside my world at Action on Hearing Loss—how can we use outcomes effectively when every funder and every bid will be different?

The best advice started at home, where we’re developing our new five year strategy. A major feature of this will be to reinforce that Action on Hearing Loss is very much an evidence-based organisation. This works both ways—we’re thinking about evidence in terms of the reasons why we do things, and then evidence to demonstrate how we’ve changed lives for the better.

In our centenary year, the same year we changed our name from RNID to Action on Hearing Loss, we launched our Hearing Matters report which essentially drew on everything we, and others, knew about hearing loss and tinnitus in the UK. As well as some startling statistics, it also explored attitudes to, and impacts of, hearing loss and tinnitus in the workplace, social life, education, within the biomedical research environment, and in public health—and set out what changes were needed to improve the lives of people with hearing loss.

In addition to this, our newly-formed research panel—comprising a diverse mix of people with hearing loss and tinnitus—has already this year given us huge insight into communication barriers facing deaf people when they access health services. This gives us the evidence we need to know that improvements need to be made, but also helps us to focus on what the outcome of a campaign or other activity may be.

Also featuring strongly in our new strategy will be to achieve nine outcomes based on consultation with a wide range of stakeholders, including funders and people who use our services. Now we need to work out the “theory of change” for these: the journey we’ll go on to deliver the outcomes and how we’re going to monitor progress against them.

Keeping with internal advice, people at Action on Hearing Loss also told me that our quarterly ‘Plan, Do, Review’ process, which is all about detailed planning to achieve outcomes, has made their working lives much more efficient, enabling easy measurement of progress against plans. We’ve also recently introduced a new outcomes system in our specialist care and support environment, which very much centres on the people we serve and is measured by how we impact on the quality of their lives.

Looking further afield, we’ve found that the way we’ve structured our processes and outcomes internally at Action on Hearing Loss has put us in a much better position to adapt to different funders’ requirements. It’s often the case that we need to introduce different measurements that we’ve not used before; but we find that when we set out to base our plans on outcomes from the start, then adapting delivery or measurement is easier to do.

Hear to Help—our support service available in communities throughout the UK for people who wear hearing aids—is one area of our work which relies on funders, whether corporate or public. While there’s no doubt funders do have an increased focus on hard outcomes measures, people still matter, and using real life stories to back up the hard evidence is as important as ever.

Beryl Nattrass from Gateshead is typical of many people who have struggled to get used to wearing a hearing aid. Here is what she said:  ‘I’m a receptionist in a law firm. I started to worry about my hearing when I couldn’t quite hear properly when I was dealing with clients. My worry was whether I would be able to continue doing my job if I had a hearing loss. When I went to visit my GP I discovered I had severe hearing loss in my right ear and a slight hearing loss in my left ear. Wearing the hearing aids was difficult at first; it put me off balance and they stayed in a bottom drawer for a long time. Eventually, I visited a Hear to Help project, and found that the moulds had not been fitted properly, which is why I was experiencing the discomfort. I knew then to go back to the audiologist and to get them adjusted. I’m glad I found out what the problem was. If I’m going to lose my hearing through age I want to get used to wearing hearing aids so I don’t have to give up work and the social activities I enjoy.’

Ultimately, people care about people: we all want sustainable and positive change in people’s lives. We need to be able to demonstrate this in the most appropriate way to funders; it won’t always be the same and it won’t always be simple. But if we start with outcomes, it will be easier for us to get there. At the Impact Leadership conference next Wednesday 16th I’ll be talking more about how we demonstrate our impact to funders and policy makers, our successes and challenges, and what we need to do next.

Pamela Muir is Head of Corporate Planning and Business Analysis at Action on hearing Loss, where she is leading on the development of an evidence-based, outcomes-focussed strategy.