‘Recruitment into the project was lower than expected’ was a common theme emerging from many of the Brightlife projects, with almost all of the delivery partners underestimating the time and work involved in establishing and promoting a new brand.
This was partly a result of a lack of understanding of how marketing works: several partners reported that they didn’t think their efforts were successful because most participants heard about the project through word of mouth “instead of through marketing”, failing to take into account that all efforts to position and raise the profile of their offer were ultimately with a view to encouraging exactly this sort of word-of-mouth promotion.
However, for others it was a result of a lack of adequate planning, and a failure to build sufficient promotion and recruitment into project design. This does not necessarily mean that a marketing strategy needs to be complex or expensive: sometimes simple is better.
One of the advantages to having an ‘umbrella brand’ like Brightlife was that even the smallest of its project delivery partners could benefit from its substantial regional profile. Although interestingly, some of the largest delivery partners suggested that this may have been a limitation, as the relatively new branding of their project partnerships did not benefit from the recognition of their existing national brands.
Very few over-50s self-identify as ‘old’, while equally few define themselves as ‘lonely’ – a term that can have negative connotations of sadness, desperation and vulnerability. But how do you market a scheme to combat loneliness and social isolation amongst older people, if your target audience don’t want to be told they are old and don’t want to admit they are lonely?
This is a question that has been explored in great depth by Brightlife over the past five years, including in the development of the Brightlife brand itself. While many of the Ageing Better regional partnerships chose names that referenced their membership of the ‘age’ sector, the name ‘Brightlife’ was chosen for Cheshire West and Chester to reflect an ambition to ‘make age irrelevant’.
This principle has since become a central to all communications at Brightlife, with messaging and imagery being carefully selected to be positive and aspirational while making age implicit. In recognition of the fact that many of the people with whom Brightlife engages are in the darkest times of their lives, Brightlife brand guidelines also emphasise the need for all communications to be thoughtful and compassionate, with a focus on connection rather than on isolation.
This was equally important when it came to project messaging. Participants of many of the projects reported that they valued such inclusivity – one provider received a comment from a participant who was delighted to discover that “they don’t feel like an older person’s group!”
Similarly, individual project messaging should reflect the fact that potential participants may not identify themselves as ‘lonely’, even if they are experiencing negative effects of social isolation. This was acknowledged by the delivery team involved in the Connect Up project (The Neuromuscular Centre), who suggested that participant recruitment had been slower than expected partly because potential participants didn’t identify with the project’s messaging around ‘loneliness’.
Hundreds of volunteers were involved in the Brightlife programme, both as part of commissioned projects and services and as core Brightlife volunteers. It became clear early on in the project that volunteering presented an opportunity to individuals who might not otherwise engage as service users.
While the majority of Brightlife volunteers were over the age of 50, most would not consider themselves as ‘old’, so even if they were to experience feelings of loneliness, they would have been unlikely to seek out any kind of formal provision for ‘older people’. However, many of those who volunteered with Brightlife received significant personal benefit from doing so.
The Brightlife Social Prescribing scheme employed volunteer ‘Community Connectors’ to support the work of its Social Prescribing Coordinators at drop-in sessions. Feedback from many of these Community Connectors emphasised the importance of their role in making them feel more connected, valued and useful.
Similarly, nearly half of those who volunteered with the Brightlife Buddying and Befriending scheme were aged over 50, and many of these reported experiencing loneliness themselves to varying degrees. Feedback from volunteers suggested that the regular social events that were organised as part of the project provided some much-needed social interaction for many.
A 2018 review of the national Ageing Better programme found that this was also the case for many other regional Ageing Better partners – in most regions, “older people want to feel useful and engaged and not just as recipients of services. Often they feel more comfortable contributing than they do receiving and many enjoy opportunities to ‘give something back’ to their community.” The ubiquity of this experience shows that the role of volunteering as ‘help by stealth’ should not be underestimated when considering the format of future interventions.
Some people are not willing to commit as a formal volunteer, but want to ‘help out’ on an ad hoc basis. For example, during delivery of the Share Club project, Community Compass offered informal volunteering opportunities, such as asking people to help with welcoming new members and making sure that everyone was involved, to successfully encourage participation from those who might not otherwise come forward.
“We found that many older people were worried about signing up to volunteer officially: they worried about taking on too much, their own health and letting people down if they didn’t feel up to it. So we decided to be more relaxed with the volunteers within our groups – we didn’t ask them to do the paperwork and kept things very informal and as a result we now have a group of fantastic volunteers without whom we would struggle to run the days. We call them our ‘under-cover’ volunteers.”
Similarly, feedback from participants in the Malpas Cancer Friends project suggests that while many members joined the group expecting to help others, they often gained a lot themselves: they felt less socially isolated and felt more valued within their community. These people were not officially ‘volunteers’, but still joined the project with a view to helping other people.
Older people who are experiencing loneliness and social isolation are, by definition, hard to reach – their social networks are small or non-existent, while perceived stigma can make them reluctant to seek help. To reach the most vulnerable, it is therefore crucial to coordinate with existing agencies and service providers within the community.
The development of informal partnership networks, through which organisations can share opportunities and refer participants into each others’ services, can be a valuable recruitment tool.
For example, in recruiting participants for their ‘Growing Connections’ gardening project, Groundwork Cheshire Lancashire and Merseyside found that many in the target cohort were reluctant to take part in the project without support, so an informal partnership network was established to facilitate referral and participation. This also enabled the project team to establish new and improved business relationships, including links with Cheshire West Voluntary Action to support future funding applications and volunteer recruitment efforts.
Recruitment and engagement of participants can also be facilitated by employing an individual from within the target community in a project leadership role, as they are likely to have existing connections within relevant communities – this was a model used successfully by The Neuromuscular Centre in their delivery of the Connect Up project.
Many of the projects that were delivered with Brightlife funding were designed using a medical referral model for recruitment, with most providers anticipating that their (free) service would be used to alleviate some of the heavy demand on the NHS, particularly mental health services.
However, a common theme emerging from these projects was that they had ended up receiving far fewer referrals than expected through this route. This was the result of several factors, the first of which is simply that establishing and maintaining any kind of formal referral network takes a significant amount of time.
This is particularly the case when setting up a free-to-access service in a new area, as discovered by the project team for FAB Cheshire West, who had planned to use this model to recruit participants into their bereavement support service. They acknowledged that a rigorous mobilisation phase is required for such projects, and that there had been insufficient time allocated to this in the project plan.
Another factor is that practice staff within primary healthcare settings can be reluctant to engage with external agencies, with reception staff often acting as informal ‘gatekeepers’ to GPs and other health professionals.
It was found that providers of existing services can also be protective of what they consider to be ‘their patients’, and can be reluctant to refer them elsewhere. This resistance to engagement was a problem encountered even by the delivery partners of projects offering to ease pressure on some of the most oversubscribed health services, such as the Men’s Mental Health Project (Listening Ear).
Even where practice staff are willing to engage, formal referral pathways from GPs can be challenging to establish due to time pressures faced by those working within the health service.
It is clear that careful design of messaging and approach is required to facilitate referrals: something that the Brightlife Social Prescribing team have developed extremely successfully over the course of their project, having faced many of the same issues as the individual project delivery teams – including encountering practice managers acting as gatekeepers.
To facilitate referrals, the Social Prescribing team took a two-pronged approach. Having initially developed and produced a paper referral form and relatively formal referral procedure that was designed exclusively for health professionals, it was soon realised that simplification (and diversification) of the referral pathway would facilitate its use. Consequently, other options were introduced to create a faster and less rigid referral pathway.
At the same time, the team realised the value of clarity in promoting their service offer. This was found to be particularly important for mitigating the risk of Social Prescribing staff having to fulfil more complex unmet needs for participants in the scheme: being clear about the scope of their services has led to more appropriate referrals being received from health professionals.
Even once a referral is made, many of the most vulnerable older people will need support to engage with a project or service. This support does not need to be formalised, but what it does need to do is to build trust.
Several Brightlife delivery partners successfully used drop-in sessions as a recruitment tool for projects and services. The neutral, ‘no-strings’ nature of these sessions allows people to try out existing activities – or to find out what opportunities are available – without having to commit long-term, enabling them to gradually build trust and engage at their own pace. Drop-in sessions were also introduced to the Social Prescribing scheme and soon became an integral part of the offer, when it became apparent how highly participants valued them.
Such drop-in sessions or other less formal/structured activities can also act as a pathway for participants into other activities. This was acknowledged in the Great Outdoors Malpas project (Cheshire Wildlife Trust), where it was found that drop-in birdwatching sessions often attracted more new participants, who subsequently went on to take part in other, more regular activities within the project.
Choosing a suitable venue and location can also help to build trust. The most successful projects tended to be those held in venues where the staff were welcoming, and where participants felt valued and safe.
In cases where the venue is owned or managed by the delivery partner, it can be useful to invite participants to visit before they are required to make a commitment to join in. This system was operated with great success by Bridge Wellness Gardens, delivery partner for the Better Lives Club project.
Trust can be a particularly important factor in attracting and recruiting older men into projects and services. Delivery partners for some of the Brightlife projects that were aimed primarily at men, for example the Winsford Super Shed project (Age UK Cheshire), found that the majority of older men were reluctant to attend new events or initiatives without a significant amount of extra encouragement.
Recruitment and ongoing engagement of men and other less confident participants can be facilitated by introducing informal ‘buddy’ systems, whereby an existing participant acts as a friend and mentor to the newcomer, often building a trusting relationship outside of the project environment before the first attendance.
Interestingly, men may also be more likely to take part in group activities when there is already an equal gender balance of participants. To address the fact that the majority of participants in their weekly ‘Compass Club’ in Malpas were female, Community Compass used what they had learned from delivering the same project in Winsford – that men were more likely to take part in activities which involved both exercise and socialising – and introduced two additional activity taster blocks specifically aimed at men.
Several of the men recruited for these taster activities went on to join the weekly Compass Club in Malpas, which improved the gender balance of the group, and in turn, encouraged more men to join.
Something that can get in the way of building trust is requiring the completion of too much paperwork. Social Prescribing coordinators found that unstructured questions were more effective (and less intimidating) than formal questionnaires for evaluating new clients.
Conversely, persevering with formal evaluation, even where challenges are encountered, can sometimes damage trust – something that was acknowledged by the delivery partners of the Meet and Eat project (Cheshire Agricultural Chaplaincy).
The question of how to balance this with the need for standardised assessment is addressed further in the ‘Capturing impact’ section.
It is important to remember that the process of building trust cannot be rushed or forced – it can require a great deal of sensitivity and patience. By offering gentle, encouraging support at a level appropriate to individual needs, providers can successfully build lasting, mutually-trusting relationships with all those they seek to engage.
Tuesday morning’s are a hoot at Sue’s drop in club at a church in Chester. Yet many of the participants say they’re just grateful to have a reason to get up and out for the day.
Nothing surprises Yvonne Boyle and Simone Cobbold anymore. They started Community Compass, which receives funding from Brightlife, walking the streets of Winsford asking those over 50 what services they felt were missing in their area.
Our connections with people are at the core of everything we do… Even a smile, a good morning or a nod of the head from a stranger can lift our spirits on a grey and dreary day.
The Brightlife Team is working closely with our lead body Age UK Cheshire on an integrated approach to responding to Covid-19.
Together we have set up a Community Response Team that covers four geographical areas across Cheshire. The Community Response Team has established a single point of contact telephone line to provide support for older people with: