How to close down a service or programme well

A recent seminar hosted by NPC, in partnership with The Clothworkers’ Company, explored the often-overlooked matter of organisations closing down their services or programmes and sought to provide guidance to trustees who may be considering taking such measures. The event was chaired by Katie Boswell, NPC’s Associate Director for Strategy & Leadership, and our speakers were Iona Lawrence and Louise Armstrong from Stewarding Loss; Don Burford and Dominic Parkinson from BLG (Bromley, Lewisham and Greenwich) Mind; and Mark Perry from SignHealth.

Endings are never easy, and yet we face them all the time in life. In relation to the non-profit sector, the ending of services or programmes has always been a taboo subject, that was until the Covid-19 pandemic. Since the beginning of the pandemic, it is estimated that two in five charities have relied on reserves to help them get through the crisis, with many charities having to suspend services or programmes due to strained incomes and fundraising difficulties. The pandemic has meant having to focus not only on the practicalities of endings, but to engage with the emotional and relational aspects of endings too. After all, the ending of services and programmes can have a negative impact on those who an organisation serves.

When planning an ending, an organisation has to consider numerous factors, such as the needs of those who rely on the service or programme and the impact their work has on them. The organisation must weigh up these factors against the costs of delivery before deciding whether to end a service or programme.

However, if endings are done well, then they will lay the foundations and sow the seeds for what comes next. So how do we end things well? And what can we learn and take forward from these endings?

Recognising the early signs and applying best practice

The seminar was kicked off by speakers Iona and Louise from Stewarding Loss, an organisation which seeks to support and influence civil society to embrace endings and to view them as ‘new beginnings’.

During the discussion, Iona acknowledged that whilst it’s true that ‘if things ended well, then civil society would be healthier overall’, currently there exists little support for those who may be thinking about ending services, programmes, or organisations. This can therefore make knowing when to bring things to an end a challenging ordeal. As Louise noted: ‘it’s the messy decision-making before you decide to close or end something that is really difficult and where a lot of trustees and leadership teams can get stuck’. However, she went on to mention a few early signs that suggest a conversation about an ending may be worthwhile, whether it be of a service, programme, or organisation. These are:

• Finding it difficult to recruit or retain staff and volunteers, particularly in senior or leadership roles
• A shift in engagement within your staff group, stakeholders, or the people you work with could be an indicator that something is not right
• Doing more fundraising than work. Chasing the funds rather than applying them to what you want
• If staff are feeling anxious
• Going through times of significant change, for example the ends of strategies and the beginnings of new strategies might be a good time to question what need there is for the service or programme and what impact or contribution this service or programme can make

In addition to this, Louise highlighted two toolkits designed by Stewarding Loss to provide guidance on best practice for those who may be considering bringing things to an end within their organisations.

The Sensing an ending toolkit provides a step by step guide for those anticipating or undertaking a non-profit organisation closure or merger, and the Staying close to loss toolkit is for those organisations who may not necessarily be considering bringing their services or programmes to an end but are nevertheless looking to embed a healthy culture of thinking about this topic on an ongoing basis.

Deciding what is best for your organisation

Endings involve tough decisions which need to be made for the welfare of the organisation and its core mission. For example, where there is not enough funding for a particular service or programme, it may be in the organisation’s best interest to bring that service or programme to an end, so as not to jeopardise the quality or viability of the organisation and its other services or programmes. This was the situation faced by BLG Mind, a charity that provides support for people struggling with their mental health alongside support for individuals with dementia. Sadly, after forty years, the charity had to make the difficult decision to close down their MindCare Dementia Support Centres.

BLG Mind Trustee, Don Burford, and Director of Services, Dominic Parkinson, explained that the MindCare Dementia Support Centres had for several years prior to their closure been operating at a significant financial loss. This was made worse by the onset of the Covid-19 pandemic, and its associated regulations and requirements. The charity was unable to find a way of correcting this loss without jeopardising the quality of its MindCare Dementia Support Centres and consequently the services had to be ended in March 2020.

BLG Mind conducted a 30-day staff consultation during the process of closing down its Dementia Support Centres, which sought to mitigate the effect of the proposed closure on staff, volunteers and, above all, service users and their families. From this process, the charity took away the following key learnings that are important to bear in mind when thinking about bringing your services or programmes to an end:

• Establish your key principles and rationale for running or closing down a service with your board and other key stakeholders
• Maintain good communication with staff and service users and have a clear strategic plan
• Frequently review the plan an re-evaluate your course of action accordingly
• Don’t be afraid to ask difficult questions
• Execute mechanisms for closure, including consultation with stakeholders
• Review, consolidate and manage outcomes from closure

Finding the positives in an ending

During the seminar, Mark Perry, a Trustee of SignHealth, a charity that seeks to improve the health and well-being of Deaf people, told us about the closure of SignHealth’s BSL Health Access service. This service was set up in March 2020 specifically in response to the pandemic, when many services switched to virtual consultations or due to strict coronavirus protocols made it impossible for a sign language interpreter to join a patient in a hospital or GP setting. The pandemic created a new communication barrier for Deaf people accessing healthcare, so a solution was needed fast.

In response to this challenge, SignHealth launched a free, 24/7 remote interpreting service named BSL Health Access, in partnership with the company InterpreterNow, to enable Deaf people to access medical services with the support of an online interpreter. The service proved to be incredibly popular with over 44,000 calls placed through the service, in some cases saving lives. It was a vital resource for Deaf people accessing healthcare across England throughout the lockdowns.

SignHealth acted quickly with the full support of the board and invested £800k from its own reserves to provide funding for the BSL Health Access service, to ensure Deaf people were not left without support. In late 2020, following much lobbying and putting forward the evidence, NHS England provided SignHealth with a grant to cover the cost of the service from December 2020 to March 2021. However, without further funding from NHS England after this period, SignHealth’s board, following a detailed options appraisal prepared by the leadership team, took the sad decision to prepare for a planned closure of the service in March 2021, one year since it became operational.

Mark noted that ‘to not gain formal recognition or traction for such a clearly useful service was depressing’.  This is especially important when linked to the rights of Deaf people to have equal access to health care services.

However, the closing down of the BSL Health Access service did lead to some positive developments, with NHS England commissioning a rapid review of BSL (British Sign Language) interpreting across all NHS England services and a review of the Accessible Information Standard used by NHS England. The ending of the BSL Health Access service was something of a ‘new beginning’ for the charity, enabling SignHealth to strengthen its relationship with NHS England and demonstrate the ‘proof of concept’ to influence future change. Going forward, the charity now has a stronger voice at the heart of public sector decision-making on real issues and health challenges affecting the Deaf community.