Making Connections

These recommendations are based on what Brightlife has learned about how to best reach older people who are in need of support.

‘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.

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.

Working with healthcare agencies and professionals

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.

The value of the ‘drop-in’ model

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.