pills and medicine

NHS & VCS at 70: NHS charities—towards an understanding of impact

17 August 2018

There are over 250 dedicated NHS charities across the UK. Even though that number includes a few big names, like Great Ormond Street Hospital Charity, most of the time their contributions go unnoticed by the general public. This is a shame because without the wide range of programmes they fund, many users-of and workers-in the NHS would have a far worse experience. Recently, NPC has been working with the Maddox Group of CEOs of NHS charities and our work points towards both the value that these charities have in themselves and lessons for others in the voluntary sector who want to work with the NHS and understand their impact.

Primarily made up of grant-giving charities, the sector supports a wide range of causes including: financial aid for patients, cutting-edge research, equipment for NHS facilities and NHS staff wellbeing. Undoubtedly it provides backing for projects that would not have been possible otherwise.

But understanding the full scope and impact of these efforts is a challenge because data on what projects NHS charities fund, who benefits and how, has historically not been collected in a standardised way across the sector.

The Maddox Group are seeking to change that. Formed in 2013, the group’s aim is to build a shared vision, evidence base and understanding of the vital role NHS charities play in the health system. As part of this mission, NPC are supporting them to explore how to better capture, define, measure and demonstrate impact—both individually and across the NHS Charity sector.

In the last year, the Maddox Group embarked on the first phase of a shared measurement pilot, across seven participating charities, coordinated by Imperial Health Charity and Royal Free Charity. Charities submitted data on the grants they funded, and trialled patient and staff questionnaires, developed collaboratively. Although it’s still early days, there are a few important learnings for the sector, and other funders interested in shared measurement.

Shared measurement is a balancing act. Though there’s substantial overlap in the types of projects NHS charities fund, there’s great variety in what they look like on the ground. Activities dubbed ‘patient support’ could entail anything from gardening centres for people with PTSD to music programmes for the elderly. Given this variety, which is often the case within sectors, it’s important to strike a delicate balance—choosing outcomes that are both meaningful and relevant across charities, yet worthwhile and reasonable to collect locally.

We found that bringing charity reps together to develop pilot materials and, later, to feed-back on the pilot was crucial to this. As we’ve reported elsewhere, being flexible about what gets measured locally can facilitate buy-in, something we’re exploring for the next phase of the pilot.

Targeting funder impact introduces complexity. Shared measurement is complex in and of itself but for funders, who are one step removed from activities, there are added practical and analytical challenges, which we’ve written about. Many NHS charities sit separately from hospitals and the strength of relationship with hospital contacts will vary by project. This was a significant barrier to data collection in the pilot, and a priority of wider roll-out will be thinking about how to support NHS charities to bridge this gap effectively.

Attributing outcomes to activities. This issue is not unique to grant-makers, but it’s especially relevant where projects have multiple funders or funding only goes to a component of an intervention. Although we’re limited in the rigour of our methodology when it comes to understanding funders’ impact on things like staff and patient outcomes, capturing this data still allows us to begin to query how responses differ across projects to inform decision-making.

It’s also important to remember that even more straightforward data collected as part of shared measurement can be informative: charities participating in the pilot said what they found most useful about the pilot data was getting an overview of what projects they are funding and who the beneficiaries are. This alone goes a long way towards helping the sector understand its impact and contribution to enhancing patient care.

The health service is facing challenges and needs innovative models, of the kind pioneered by charities, if it is to survive. However, it can’t commission this work without a body of evidence to support it. Collecting this data and demonstrating impact will help the unsung charity heroes working in the NHS and inform the evaluation practice of other charities working with the health service.