This year has been momentous so far… We have launched our new brand We are celebrating 20 years of making a difference And we are half way through our 2010-2015 strategy
Trustees and Directors met in September to review progress The following slides are the major issues covered, and the consequences that flow from that
In 2003 we were a £10 million charity People said we were punching above our weight The truth was we weren’t of sufficient weight We needed to grow, to increase our capability
First phase, 2005 to 2010 Established stroke as a major health priority Established fundraising growth: better infrastructure, a major donor team, donor cultivation, legacy marketing, charity of the year capability, better data about our doors and potential donors. Established ourselves as UK wide Established greater public awareness of stroke Established more service contracts Established all the basics of a voluntary sector organisation Established better relationships with stakeholders
Second Phase Established the Stroke Association as a ”major” charity player: with increased influence, a solid constituency of stakeholders, quality assurance and a stable financial basis Continued to push growth in fundraising and improved our infrastructure Built on public awareness of stroke to make sure people understood stroke and the necessity of more and better services and treatments Established more services, and made sure service contracts covered most of our infrastructure costs
Third Phase We need to consolidate the Stroke Association as a ”major” charity player and brand We need to bring in enough income to meet all of our infrastructure expectations, and want to create substantial surpluses for research and enhanced services. (£50m mark? We want to engage with the public to demonstrate success in research, service improvement and treatments and to accelerate giving as a result We need to grow our service provision meeting more of the needs of more people, with the added bonus that service contracts will more than cover infrastructure costs
Written before change in Government, and dramatic changes in Health, Welfare Benefits, and Social Care policies and structures Written with assumptions on donor behaviours following previous trends Did not factor in the impact of our new brand Agreed more prioritisation to prevention work Key driver to continue growth and improvement curve
We’re going to look at: Prevention Research Services Infrastructure
Events organised by staff and through our partnerships (with Rotary, St Andrew’s First Aid and the Ambulance Trust) enable us to reach a wide audience with the message of high blood pressure and stroke. At these events we are able to capitalise on our relationship with organisations such as Change4Life, who produce useful information to pass on to people who visit our events to encourage healthy lifestyles.
340 Commissioned Services – up from 300 in 2010 289 contracts – up from 250 in 2010 £12.3m (£11m) Contract income from Health and Social Care – up from £11m in 2010 586 staff of whom 211 full time and the majority are professionally qualified in health or social care – up from 500 in 2010 2,791 volunteers of whom 13% are stroke survivors – up from 2530 25% clients of working age and 7% BME
This review is about building on and adjusting in the light of circumstances the 2010 to 2015 strategy document, not a complete rewrite Next few years about sustainability and consolidation, meeting need for £1million extra net per annum just to stand still Need to become more market able, capable of effectively reaching and relating to key audiences/customers, and conversion to supporters Beyond incremental growth is needed in fundraising, this will need support from communications to happen
We need to look at our structures to make sure we can overcome threats and weaknesses We need to better understand and meet the needs of our audiences – our beneficiaries, our volunteers, our campaign supporters, our donors and, crucially, our potential donors So we will be redirecting resources and investing in better data analysis and audience insight and in our marketing
We will move our business support team to be part of the CEO’s office - This will help us to drive improvements across the Stroke Association and to improve our planning Our Partnerships team will move into Communications `– so we can really develop our work with stroke survivors, stroke clubs and other partners and so that work can improve our external communications And we want to shift the emphasis of our regional fundraising This emphasis on community fundraising fits with the challenge of localism that we face and our need to develop the stroke community through more volunteering, through our community development pilots and through the building of our campaign supporter base
But let’s move away from strategy to look at the impact we have had with our research over the last twenty years… 20 Years of Stroke Association Research Funding Between 1991 and 2011, the Stroke Association awarded more than £40million to support vital stroke research. This research has had a big impact on our understanding of stroke, on the way stroke is treated in the UK, and ultimately on the lives of stroke survivors and their families. Our funding has provided a lifeline for stroke researchers and clinicians at a time when funding for stroke research was notoriously low. Our priority has been to fund clinical research that makes the maximum possible difference to the lives of people affected by stroke.
shown that one in ten people who experience a ‘transient ischaemic attack (TIA)’ will go on to have a major stroke within a week shown that treating TIA patients in an emergency TIA clinic can prevent 80% of them going on to have a major stroke within 3 months developed the ABCD score to help doctors predict who is most at risk of a major stroke after experiencing a TIA improved the quality of carotid artery surgery so that more strokes are prevented
We’ve shown that paramedics can use the FAST test to accurately identify stroke patients . This research formed the basis of the FAST stroke recognition campaign. We’ve contributed to the evidence to show that stroke units save lives (Nottingham Stroke Unit study). We’ve promoted the more widespread use of thrombolytic drugs to dissolve blood clots during an ischaemic stroke (International Stroke Trial-3 feasibility study). shown that giving aspirin immediately after stroke can prevent a second stroke (co-funding of the International Stroke Trial-1).
developed a programme of ‘ early supported discharge ’ so that stroke survivors can leave hospital earlier after their stroke increased the amount of occupational therapy available to stroke survivors living at home or in care homes developed Functional Electrical Stimulation (FES) to improve hand and arm function in stroke survivors with arm paralysis.
Our rehabilitation research has: improved our understanding and consideration of communication difficulties after stroke led to new speech and language therapies for patients with communication difficulties developed a web-based tool to improve reading in stroke survivors with loss of vision in one eye (Read-Right) created a screening tool to better identify stroke survivors with psychological problems (BCoS screen)
Between 1991 and 2011, we awarded more than £12million to build stroke research capacity Awarded 30 Clinical Fellowships to talented doctors to become stroke specialists, many of whom are now leading stroke units and services around the country or are actively involved in clinical stroke research. Awarded 46 Junior Research Fellowships/Bursaries to allied health professionals to study for a PhD and embark on a career in stroke research. Awarded 5 Senior Research Fellowships to allied health professional to built up their own stroke research group. Awarded 3 Clinical Research Fellowships in collaboration with the Medical Research Council to allow doctors to pursue a career in stroke research and develop a research group. New for 2012: Princess Margaret Research Development Fellowships Flexible award for supervisors to build research capacity. “ When I started, in 1992, stroke was an area of research that the Medical Research Council would barely entertain. In the early 1990s only three people [in the UK] were interested in stroke; about seven years later nearly 100 people were training to be stroke physicians and now 20 years later we have the NIHR Stroke Research Network and all the major research funders investing in stroke. ” . Professor Marion Walker MBE - PhD and first lectureship post at Nottingham were both funded through the Stroke Association chair. Professor Walker was one of the first occupational therapists to receive a PhD. She is now an international leader in stroke rehabilitation.
Plans to rapidly grow services by 2015 have had to be re-thought No growth next year, then gradual return to growth the year after and continuing slowly Unless a new service type were to “take off” again
Immediate future Recent count, 5 out of every 6 services have contracts with end dates of next March or earlier But we expect the vast majority to be renewed
Social Services (1/3 of our contracts) no change, we continue to argue our case – and it’s a good case NHS Commissioning Managers, those who manage our contracts remain unchanged GPs will be making many decisions, working in Clinical Commissioning Groups (CCGs) Many influencers too!
We meet mainstream policy e.g. 6/12 reviews, supporting self management, control through information In every service we can demonstrate outstanding outcomes Our audits show that we can save the NHS and social care money
Our managers face an enormous task in converting our contracts to new CCGs And we have to promote better what we do e.g. our Communication Support publicity over the winter and spring
Piloting services that help “transfer of care” (discharge) and prevent readmission Self-management support, including new technology Supporting volunteers and communities to extend and enrich services into the long-term
This is prompted awareness by total marketing spend – mostly fundraising marketing e.g. Direct marketing… as you can see, there is a direct link between what you spend and how well known you are
BUT…..1% yet this is still 500,000 people!!!
This is demonstrated by sector-wide evidence
And by what we know about people who do events for us
And by what people who donate to us tell us
And by yet more sector wide evidence
Our light bulb moment… whoops, forgetting our carbon footprint here
That’s better…. So, our light bulb moment here is that we need to re-focus our efforts on reaching out to people that have some affinity to stroke, some understanding of the devastating , effects of stroke either personally or professionally.
… I hear you ask
Well. Lets look at an example from another charity – Macmillan Cancer Support. Long held up as a good example of a successfully function organisation, a successful brand and mature fundraising operation. Some clever people at Macmillan realised that for every person they supported through their Cancer Support work…
… There was a network of 17 people that were ‘touched’ in some way by the cancer the Macmillan beneficiary was experiencing. This was therefore the size of their potential support – the beneficiary and the 17 people surrounding them.
Now…. Lets apply the same logic to the Stroke Association. Every year, we directly reach around 35,000 people through our Life After Stroke Services…
I’m sure you’re all familiar with your 35,000 times table, so you can do the sum… Using the Macmillan model (which may or may not be correct), that’s 595,000 each and every year that we could view as potential supporters
And imagine what that is over the next ten year period? The answer?
In a nutshell, that’s a lot of people that should be warm to us….
A huge amount of people that should have a reason to support us
A gigantecimal amount of people who should be choosing us above any other cause
A whopping great big number of people that represents the size of the opportunity facing us. Our challenge is to work out how best to get our messages to them and through them to others
Currently the Stroke Association helps many thousands of stroke survivors and their families each and every year. We’ve already seen that’s TRUE – it’s currently at least 35,000 each year and you can double that figure if you take into account calls to the hotline for example Survivors and their families feel grateful for the help they receive, and are likely to feel empathy with the situation of other people who will have strokes in the future. We know that’s TRUE because, our latest collated national impact survey results showed that 87% of respondents said that they would recommend the Stroke Association’s services and we’ve already demonstrated that personal experience is more likely to result in support Furthermore, many of them will already be charity-minded and actively give to or support other causes they care about. Well, that’s probably also TRUE… Giving is good. We love to give. We are a giving nation. Giving makes us feel good about ourselves. Giving is what makes Britain Great.
Although many stroke survivors will go on to support us through volunteering, currently very few of them or their friends and family, following their experience of benefiting from our services, become active donors or supporters of the charity. This is the tantalising gap we are deciding to fill.
We are embarking on a staff engagement programme that will help create and maintain a culture of the whole organisation supporting the Stroke Association to be successful by increasing support from those closest to our cause.
We need to win at least one major charity of the year partnership We need together to build the stroke community in very locality to help us in our work to campaign for better stroke services or to defend those under threat; to volunteer with us to provide more support to stroke survivors; and to help us to raise the funds that make all of our successes possible.
What this talk covers • Mid-term strategy review • Our 20 year impact on stroke research • Contracted services update • Promoting our need for voluntary incomeStroke Helpline 0303 3033 100stroke.org.uk
2010 to 2015Mid term strategyreviewStroke Helpline 0303 3033 100stroke.org.uk
Background• Our charity – the Stroke Association - is not about just “surviving” year to year• Stroke is a big cause and a big responsibility• Our aim is nothing less than making a fundamental contribution to lessening human misery• We have to be a big enough charity to make that difference: we have to grow…Stroke Helpline 0303 3033 100stroke.org.uk
The story so far…Stroke Helpline 0303 3033 100stroke.org.uk
First phase 2005 to 2010 2005 to 2010 2010 to 2015 2010 to 2015 2015 onwards 2015 onwards Establishing stroke as a major Establishing stroke as a major health concern and developing health concern and developing our infrastructure our infrastructureStroke Helpline 0303 3033 100stroke.org.uk
Second phase 2005 to 2010 2005 to 2010 2010 to 2015 2010 to 2015 2015 onwards 2015 onwards Establishing the Stroke Establishing the Stroke Association as a major charity Association as a major charity player playerStroke Helpline 0303 3033 100stroke.org.uk
Third phase 2005 to 2010 2005 to 2010 2010 to 2015 2010 to 2015 2015 onwards 2015 onwards Consolidation and growth Consolidation and growthStroke Helpline 0303 3033 100stroke.org.uk
Our current strategyStroke Helpline 0303 3033 100stroke.org.uk
Prevention • Know Your Blood Pressure reaches 30,000 people a year • We refer over 4,000 people a year for follow up with their GP • 50% of people know that high blood pressure is the biggest risk factor for stroke, and awareness of high blood pressure far outweighs other risk factors • Partnerships with Rotary, St Andrew’s First Aid, Ambulance trusts, Change4lifeStroke Helpline 0303 3033 100stroke.org.uk
Research • Increased our annual spend on research through collaborations with other funders and the Princess Margaret Research FundStroke Helpline 0303 3033 100stroke.org.uk
Research • UK Stroke Forum going strong with 1382 Delegates at the 6th Conference in 2011 • Expanded UK Stroke Forum activities to include an annual Northern Ireland conference in collaboration with ACPIN • Performing the role of hosting the endorsement programme for the Stroke Specific Educational Framework from Department of Health • Secured funding from Skills for Care to become an accredited provider of QCF training in Stroke Awareness. • Achieved and retained NHS Information Standard (IS) accreditation for all our information productsStroke Helpline 0303 3033 100stroke.org.uk
Services • 340 Commissioned Services • 289 contracts • £12.3m Contract income from Health and Social Care • 586 staff of whom 211 full time and the majority are professionally qualified in health or social care • 2,791 volunteers of whom 13% are stroke survivors • 25% clients of working age and 7% BMEStroke Helpline 0303 3033 100stroke.org.uk
Services • Moved helpline team from London to Bromsgrove • Formed Children’s Committee, and secured funding for pilot children and stroke service development in London • Developed and integrated electronic client relationship, management and data system into our work enabling impact reporting and capacity for research activity in futureStroke Helpline 0303 3033 100stroke.org.uk
Infrastructure • Increased accommodation away from London with Bromsgrove and Cardiff • Integration of datasets across organisation nearly complete, providing platform for marketing analytics • First Capital Appeal success: the Life After Stroke Centre fundraising appeal exceeded target by 11% • We now have more than 2000 legacy pledgers • Quality goals being achievedStroke Helpline 0303 3033 100stroke.org.uk
But also… • A hugely successful Action on Stroke Month (thanks to you for your participation) • Our new brand, website, intranet, and ever increasing social media activity • Doubling of the number of campaign supporters in the last year alone • Listening to stroke survivors, leading to our high profile Life After Stroke and benefits campaigningStroke Helpline 0303 3033 100stroke.org.uk
What has changed…Stroke Helpline 0303 3033 100stroke.org.uk
Financial changes Double dip recession Reduced commitment to give from some donors Turmoil in the health service in England UK-wide cuts in health and social care fundingStroke Helpline 0303 3033 100stroke.org.uk
Political changes Localism agenda in England Increased nationalism in devolved nations Demands from beneficiaries for support against withdrawal of benefits and rightsStroke Helpline 0303 3033 100stroke.org.uk
Where are we now…Stroke Helpline 0303 3033 100stroke.org.uk
Opportunities • New brand is proving its potential to attract more people and companies to us • Recession has, at least, had positive impact on ease of quality recruitment • New services developments: Stroke Companion; 6 month,12 month reviews • Recession creating more partnership opportunities • Getting closer to large Charity of the Year winStroke Helpline 0303 3033 100stroke.org.uk
Threats and Weaknesses • Some small scale competition for contracts • “Tesco-isation” of voluntary sector continues, making it harder to get profile • Concerns about de-prioritisation of stroke due to knowledge deficit in new structures and closure of stroke networks • Demand from stroke survivors for support on welfare rights, we have no objective on thisStroke Helpline 0303 3033 100stroke.org.uk
Threats and Weaknesses • The cuts of £1.8 million last year have tested and restricted our abilities as an organisation • The volunteer support infrastructure we want and need is not in place • Staff training budget very restrained, despite new demands as we gain new servicesStroke Helpline 0303 3033 100stroke.org.uk
Threats and Weaknesses • No cost of living or increment pay rises for two years; threat of losing good staff increasing • Graduate recruitment programme closed down • Business development possibilities suspended • Marketing and promotion budgets inadequate and internal organisation needs reviewStroke Helpline 0303 3033 100stroke.org.uk
Shared understandings • Next few years about sustainability and consolidation, meeting need for £1million extra net per annum • Need to become more market able, capable of effectively reaching and relating to key audiences/customers, and conversion to supporters • Beyond incremental growth is needed in fundraising, this will need support from communications to happenStroke Helpline 0303 3033 100stroke.org.uk
Our structures • We need to look at our structures to make sure we can overcome threats and weaknesses… • We need to better understand and meet the needs of our audiences… • …So we will be redirecting resources and investing in better data analysis and audience insight and in our marketingStroke Helpline 0303 3033 100stroke.org.uk
Our structures • We will move our Business Support team to be part of the CEO’s office • Our Partnerships team will move into Communications • We are shifting the emphasis of our Regional Fundraising team by making all of our events activity come under one team and by promoting much more community fundraisingStroke Helpline 0303 3033 100stroke.org.uk
Between 1991 and 2011, the Stroke Association awarded more than £28 million as project and project grants addressing issues all along the care pathway for stroke. Project and Programme grants awarded broken down by research area (1991-2011 )Stroke Helpline 0303 3033 100stroke.org.uk
Our prevention research • one in ten people who experience a TIA will go on to have a major stroke within a week • treating TIA patients in an emergency TIA clinic can prevent 80% of them going on to have a major stroke • the ABCD score to help doctors predict who is most at risk of a major stroke after a TIA • improved the quality of carotid artery surgery to prevent more strokesStroke Helpline 0303 3033 100stroke.org.uk
Our research has saved lives • paramedics can use the FAST test to accurately identify stroke patients • evidence shows that stroke units save lives • more widespread use of thrombolytic drugs to dissolve blood clots • giving aspirin immediately after stroke can prevent a second strokeStroke Helpline 0303 3033 100stroke.org.uk
Our rehabilitation researchhas improved lives • ‘early supported discharge’ so survivors can leave hospital earlier • increase in occupational therapy available to stroke survivors • Functional Electrical Stimulation (FES) to improve hand and arm function in stroke survivors with arm paralysisStroke Helpline 0303 3033 100stroke.org.uk
Our rehabilitation researchhas improved lives • improved our understanding and consideration of communication difficulties • led to new speech and language therapies • web-based tool to improve reading for those with loss of vision in one eye (Read-Right) • screening tool to better identify stroke survivors with psychological problems (BCoS screen)Stroke Helpline 0303 3033 100stroke.org.uk
Research Capacity Building30 Clinical Fellowships: 46 Junior Research Fellowships/Bursaries: 5 Senior Research Fellowships: 3 Clinical Research Fellowships: New for 2012: Princess Margaret Research Development FellowshipsStroke Helpline 0303 3033 100stroke.org.uk
Context • Major restructure in England has led to planning “blight” • NHS in England to save £20bn • Cuts to LA funding of 28% • So far, we have suffered the loss of some services, and valued colleagues, and had some with reduced funding… • …But we have made gains too • Overall at standstill, a remarkable achievement compared with some other charitiesStroke Helpline 0303 3033 100stroke.org.uk
Looking forward • Recent count, 5 out of every 6 services have contracts with end dates of next March or earlier… • …But we expect the vast majority to be renewedStroke Helpline 0303 3033 100stroke.org.uk
Commissioners as customers • Social Services (1/3 of our contracts) no change, we continue to argue our case – and it’s a good case • NHS Commissioning Managers, those who manage our contracts remain unchanged • GPs will be making many decisions, working in Clinical Commissioning Groups (CCGs)Stroke Helpline 0303 3033 100stroke.org.uk
CCGs: what do we know? • Like many, we know relatively little • We have interviewed just under 1 in 10 across the summer • No indication that they won’t support stroke, or the voluntary sector, or that they plan cuts to community servicesStroke Helpline 0303 3033 100stroke.org.uk
We have a strong case…Stroke Helpline 0303 3033 100stroke.org.uk
And we have a lotof work to do…Stroke Helpline 0303 3033 100stroke.org.uk
And we continueto develop newservices.Stroke Helpline 0303 3033 100stroke.org.uk
Pay attention!Here comes thescience bit…Stroke Helpline 0303 3033 100stroke.org.uk
Cancer is the most popular cause to donate to, followed by children and young peopleStroke Helpline 0303 3033 100stroke.org.uk
“Please indicate which types of charities you have givenmoney to in the last 3 months, and which you havevolunteered for.” Prompted 44% Cancer 42% 35% Children and young people 31% 24% Hospices 21% 23% Veterans/ armed forces 17% 21% Animals 20% 17%Health & medical (excluding cancer) 15% Nov-11 16% Older people 12% 13% Overseas aid and development 24% 13% Sep-11 Rescue services 13% 13% Homelessness and social welfare 11% 11% Mar-11 Disability 7% Environment and conservation 6% Dementia 5% Mar-10 Religious 7% 7% Sensory I mpairment 3% Not sure 5% 17% None of these 19% 0% 10% 20% 30% 40% 50% Base: 1,000 adults 16+, Britain.Stroke Helpline 0303 3033 100 Source: Charity Awareness Monitor, Nov 2011, nfpSynergystroke.org.uk
Competing against these charities is not possible, we need to take a different approachStroke Helpline 0303 3033 100stroke.org.uk
Sure enough this is shown in the ‘spontaneous awareness’ figures of charities working in the health sectorStroke Helpline 0303 3033 100stroke.org.uk
“Please can you name the first charity, voluntaryorganisation or pressure group that comes to mind” / “Andwhich other charities, voluntary organisations, pressuregroups can you think of?” 1% of people name Stroke Association as a charity working in the health field ie c 500,000 people. Base: 1,000 adults 16+, BritainStroke Helpline 0303 3033 100stroke.org.uk Source: Charity Awareness Monitor, May 12 (Online), nfpSynergy
Personal situation and a person’s tastes are key reasons to donate to charityStroke Helpline 0303 3033 100stroke.org.uk
Tastes, preferences and passions, Charities… “that I admire”… “am comfortable giving to” “Things that happen to appeal to me” Personal and Professional backgrounds, “Touch a chord” “Close to my heart” CGAP report (2010) “How Donors choose Charities”Stroke Helpline 0303 3033 100stroke.org.uk
Personal links are demonstrated time and again by people fundraising for usStroke Helpline 0303 3033 100stroke.org.uk
Most of our supporters have strong, often personal ties to strokeStroke Helpline 0303 3033 100stroke.org.uk
Q= What is your link to stroke?****this was a survey monkey (online) survey, 3 quarters of respondents were over the age of 46Stroke Helpline 0303 3033 100stroke.org.uk
And here’s yet more research that shows these are key reasons for people donating to charityStroke Helpline 0303 3033 100stroke.org.uk
A lot!Stroke Helpline 0303 3033 100stroke.org.uk
A huge amount!Stroke Helpline 0303 3033 100stroke.org.uk
A gigantecimalamount!Stroke Helpline 0303 3033 100stroke.org.uk
A whoppinggreat bignumber ofpeople…Stroke Helpline 0303 3033 100stroke.org.uk
True or false? • Stroke Association helps many thousands of stroke survivors and their families each and every year… • Survivors and their families feel grateful for the help they receive, and are likely to feel empathy with the situation of other people who will have strokes in the future… • Many stroke survivors and their families will already be charity-minded and actively give to or support other causes they care about…Stroke Helpline 0303 3033 100stroke.org.uk
But… • Although many stroke survivors will go on to support us through volunteering, currently very few of them or their friends and family, following their experience of benefiting from our services, become active donors or supportersStroke Helpline 0303 3033 100stroke.org.uk
Therefore• We are embarking on a staff engagement programme to: • Help fundraisers to build strong, mutually beneficial relationships with their colleagues from other departments • Support all staff to help their colleagues, at appropriate times and in an appropriate way • Increase understanding of what voluntary income provides for the association and how we wouldn’t exist without itStroke Helpline 0303 3033 100stroke.org.uk
Our fundraising challenge• We need to tap this great potential to grow the number of people who regularly give us a donation• That means improving our marketing analysis and our insight into potential donors: • What can we do for them? • How do we reach them? • How do we engage with them emotionally? • How do we develop our relationship with them? • How do we convert them from passive to active supporters?Stroke Helpline 0303 3033 100stroke.org.uk
Our fundraising challenge • To win at least one major charity of the year partnership • To build together the stroke communityStroke Helpline 0303 3033 100stroke.org.uk
We all need to beambassadors forour cause…Stroke Helpline 0303 3033 100stroke.org.uk