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Engaging local support has allowed St John’s Hospice to reverse its fortunes

Originally published August 2018

The relationship between a local charity and the community it serves is a symbiotic one, as Sue McGraw, chief executive of St John’s Hospice in Lancaster, in the north west of England, knows well. “We’re very lucky to have a hospice in our community and any community that has a hospice is lucky to have one,” she says. “But I think that often when people have that on their patch, they don’t realise what it’s like not to.”

Which is the situation that those who rely on the care and support of St John’s were in danger of facing back in 2013, when McGraw joined the charity. “We were in a serious deficit position — half a million pounds year on year — and were at a point where we were thinking about which services should close,” she says.

Five years later, the organisation has a surplus of £1.7 million and a thriving culture of that crucial community support. So how did they turn things around?

Good governance is key

This point might seem obvious, but many smaller charities in particular struggle with leadership issues, and with putting in place a professional support system. McGraw points out that your local community is a rich resource when it comes to building a strong board, but that you must use it wisely.

“You’ve got to have underpinning support from an engaged board who understand what running a charity means. It’s not just wandering around your community and saying, ‘Oh I’m on the board of the hospice’. We want people for their professional expertise.”

So the charity set about recruiting new board members, and the first 18 months of McGraw’s time there saw a 50 per cent turnover. The first step was recruiting a new chair. It was important to find the right person as the relationship between the chief exec and the chair of the board is crucial, says McGraw.

“Good board leadership is what leads good, strong management. Our new chair, [an ex-director of nursing] trusted me to get on with it, and I trusted her to sort out her board. If that relationship isn’t functioning, I don’t think the organisation functions.”

Applying a proper recruitment process, “none of this tapping people on the shoulder, a friend of a friend of a friend”, McGraw and her chair set about interviewing potential board members, with specific needs in mind.

“We targeted people for the skills that we couldn’t afford in-house and that we knew were gaps in our knowledge. People like the executive lead nurse of a hospital trust, the chief exec of the city council and a great HR director.”

What you’re looking for in a board member is an informed eye that can offer critical support, says McGraw: “The problem in hospices is everyone tells you you’re angels and that everything is perfect. You need people who are going to be your critical friends. I wanted them to have the skills to interrogate and scrutinize the work that we do. Their role is to feel assured that we’re running things properly.”

Perfect your process

Once you have a strong support structure in place, the next challenge is to find ways of working that make the best use of these carefully chosen resources. For St John’s Hospice this has meant spreading the expertise of its board members across the organisation, so that they can get things done in their specific areas then feed back to the board.

“Full board is once a quarter, but in advance of that we’ve done a whole round of our sub committees,” says McGraw. “We have a care, quality and service committee, a fundraising and communications committee and a finance and estates committee. And all the work is done in those. We don’t have four-hour board meetings because we delegate the work to the sub-committee chairs, who are trustees, and the board accept that it has been done.”

Communicate with your internal community

A central part of any charity’s community is of course its staff, and McGraw points out the importance of making sure they feel involved. “The year I arrived we did a staff survey and it would have made you cry. People were proud to work here and of what they did, but were feeling unloved.” She believes it’s important that the board is visible and approachable, so that staff and volunteers can understand how the charity is run.

With this in mind, she’s instituted staff and volunteer forums with representatives from each group, to facilitate a two-way flow of information and ideas.

“We talk about what’s the noise on the radar, what’s going well, what’s not. And I feed that into the board. Then after the board has met we go back to the team and volunteers and talk about what was discussed. So we have a cycle of communication.”

Offer various routes for support

Another piece of advice from McGraw is to vary your charity’s sources of income, and not to become reliant on what at first might seem a bottomless well but can in fact all too quickly run dry.

“We took our eye off the ball,” she says. “We’d had years and years of great legacy income, but this little hospice opened in 1986 and if you haven’t continued to engage with your community, then the legacy income dries up. So the first year I was here we had less than £400,000 in legacies, and we’d set a budget based on having £1 million a year from them.”

She suggests taking stock of where your money is coming from, and watching out for underlying trends. And she stresses the importance of providing opportunities for all those who want to show their support: “If you’re looking at a market you’ve got to segment it, and you need avenues for everyone to join in.”

Collecting small, regular amounts of donations, that people don’t notice, is a top tip. She has found that support for a local charity can often come from the poorest parts of a community, and has made sure their input is valued and incorporated.

“We have a shed in the car park where people can drop off donations for the hospice shop, because you can’t always give money, but you can give something. We’ve got a fabulous café run by our volunteer army, where people can give their time. We have a lottery — some people couldn’t donate £100 today, but they could probably spare £1 a week.”

Invest in fundraising

Fundraising needs sustained innovation, investment and review, says McGraw, and sometimes you need to balance immediate operational needs with planning for the future.

“It’s a dilemma. When you’ve got little money, people are wary of investing in fundraising — they say ‘oh why can’t we just have another nurse?’ But we think it’s very important. We have a three to one ratio: if we’re employing you as a fundraiser, you’ve got to earn your salary back three times over. We don’t work to individual targets, but we know that as a team that is what we have to aim for.”

And the charity monitors these figures carefully: “We analyse — we look at our management accounts every quarter with the trustees, and we scrutinize where we are.”

Make time to tell stories

Storytelling is well known to be a powerful driver for support and donations, so it’s important to develop a good communications strategy to get these voices heard.

“We’ve really upped our communications so that we are front of mind in our community,” says McGraw. “When I arrived here five years ago we had about 1,000 followers on Facebook and now we’ve got more than 10,000. We get people to tell their stories, and the minute you start the ball rolling everybody wants to tell their tale too.”

When everyday commitments are demanding, it can be a battle to find the time to trumpet your achievements, but carving out that space pays dividends, and can raise morale too: “We’ve just recruited someone to collect some patient stories for us, because that’s the bit that we don’t do as well as the national charities. We have great things to shout about, but we’re just getting on with the work and sometimes we forget to stop and reflect on what wonderful stuff we’re doing.”

Keep talking to your community

Ultimately, it’s the community that uses St John’s Hospice that provides the support to keep it going, so McGraw has been sure to build upon this relationship — and she’s not been afraid to tell a few home truths!

“We really spoke to this community. We didn’t just focus on the money, we focused on the message and what this place means to local people. We worked to raise the profile of the charity with some strong campaigns, along the lines of ‘save our hospice for future generations’. We said to people if you don’t help us now, we can’t help you in the future.”

St John’s Hospice was among the nominees for the Managing Turnaround category of the Charity Governance Awards 2018, which was organized by The Clothworkers’ Company.

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