How We Did It: Transforming public services into people power with Good Help

How do you adapt your services in a way that not only offers help to those who need it but offers Good Help, creating enabling relationships that build agency and change lives?

In this instalment of our ‘How We Did It’ series, Helen Chicot from Rochdale Council introduces a three-year project which has used Good Help principles to tackle the council’s most pressing challenges, transforming the way the way it works and its relationships with residents.

Why did you decide to introduce Good Help? What were the problems that needed addressing in Rochdale?

It’s a bit tricky to figure out how far to go back because I’ve been here for 30 years. You’ll be pleased to know I’m not going back that far, just a bit pre-pandemic. We’re part of the Greater Manchester City Region and we’ve been trying to transform integrated services in places. We looked at different sizes of footprints and carried out cost-benefit analysis. Looking at those things revealed some really telling insights in terms of what we really needed to design back into the system.

We were in a fortunate position because we had some very good examples of what worked that had evolved out of grassroots organisations. These examples, coupled with quite a lot of research and insight from academics and others, made clear what it was that we needed – very good quality help that’s generic rather than specific to a particular area of expertise, but that’s highly skilled and bespoke.

There were some particular conditions in parts of the system which enabled this kind of help, and this gave us a clue as to what we needed to do. A good example of that is our Community Champions programme which is an early model of social prescribing that’s been running in Rochdale since the early-mid 2000s.

What we learnt through that programme was that people in communities who understand their place and are really committed to the success of their communities are very often best placed to not just do the help but to influence the system as to how it should be operating.

I’ll share a good snippet of a case study around that – at a busy doctor’s surgery in one of our local areas that you would consider to be of multiple deprivation, a man came in pushing a pram and said, I want to sign up please. The receptionist started signing him up to the GP but it turned out part way through this process that he didn’t want to see the doctor, “I want that woman what sorts your head out.” He was referring to a local community volunteer that was linked with the GP who, as people were coming in with mental health difficulties or physical health conditions, was able to prescribe a conversation to get to the bottom of what was really going on.

We became tuned into models of help and support that would create the conditions within the system that would enable this sort of stuff to happen. There are things the system needs to do to make sure it’s safe and that it’s good quality. It takes an awful lot of admin to make sure the right people are in the right place at the right time. There’s also a need for reciprocity and making sure that people have what they need to do their work. This includes renumeration but it’s other things as well. The rest of it is about getting out of the way and not killing it with bureaucracy.

We looked at all of the different models of help that are in our system, often which come from particular theoretical backgrounds that are attached to specific parts of the system, whether it’s housing or education or employment. There are very generic things like strengths-based, solution-focused help. But we also wanted stuff that was power sharing, relational, trauma informed, and also that can stretch. It’s not just about doing what it’s there to do, it can stretch into other areas a person might need help with, it can stretch the quality or the depth of impact, and it can stretch the helper into new areas of expertise or confidence.

When we were looking out for a new model of help, we had no infrastructure organisation supporting our voluntary sector. So we were trying to hold a bit of the system up that was suffering and had been neglected for rather too long. We wanted something that would help with that as well.

What is Good Help and what made you think it would work in Rochdale?

This diagram shows good help and bad help. It’s a very simple diagram, and in many ways Good Help is that simple. This wheel is a really good starting point for thinking about system conditions, because for this pure model of Good Help to happen you need to have the right system characteristics in place.

I’m particularly drawn to the life circumstance part of the diagram. No matter what silver bullet model of help you’re able to offer, structural inequalities and inequities exist and intersect to cause the problems that we end up trying to pick up the pieces of in our compartmentalised services. Poverty, discrimination, lack of opportunity, addiction, abuse – all of those things come out of people’s life circumstances and the stuff that life throws at them. It’s impossible to uncouple a model of help from the context of people’s lives. That is why I really like Good Help because it is a model of help in and of itself, but it’s also a driver of change that can help the system too.

There are loads of stories which demonstrate how Good Help works, but I’ll just share one: Andy had been struggling for some time. In his family’s life, things had been gradually on that bad help spiral. Financial circumstances were getting worse and none of the family were reaching out for help. When Andy’s wife sadly died, everything pretty much fell apart because there was no baseline support in place. As a result, Andy became street homeless.

At the time, the system was fairly fragmented; he was in the homelessness part of the system but actually what he needed was a bit more generic than that. He was trying to get through the day and find somewhere safe to be at night. That was his existence, and everything else felt too hard, too fragmented, too distanced, and often also felt like a punishment. There was very little kindness built into the structure of the system, notwithstanding the kindness of people working in the system.

During that time, Andy met an outreach worker who connected him with a local drop in that ran regularly. The “provision” available there was really generic. It’s the sort of stuff that nowadays we would see in a good quality warm space or social space. You could get something to eat and drink, the place was warm and safe, you could access the internet, as well help, support and information. There were also opportunities to meet people and make friends.  

Andy was able to crowd source his ‘good help’ from a combination of paid workers, volunteers and peers around him. Bit by bit, he improved his life circumstances. He began to see himself as somebody with skills, somebody with something to offer other people, somebody who people sought out for companionship. Andy became a volunteer and a helper himself almost seamlessly – he was accessing help and support at the same time as giving it to other people.

Now Andy thankfully is housed and is one of our most prolific Community Champions, doing what we now call social prescribing. He takes people out on walks, he connects them with history, talks about the locality and connects them with each other. But also influences the system. He feels confident enough to tell us what works and what doesn’t and can help the system to improve based on his lived experience.

Where did you start in terms of communicating this and how did you get people on board?

Together with a colleague from Adult Social Care and the beginnings of our voluntary sector infrastructure organisation, we put together an application and went through the selection process with Good Help.

They thought we had something in us and we started initially planning a Lottery-funded project alongside some other local areas. Then Covid came along and threw a big spanner in the works. We took the decision to carry on and try and do what we could. I’m really pleased that we did that because it meant we were doing things that were quite hopeful and thinking to the future.

Fortunately, the model lends itself naturally to being flexible and you can apply it in lots of different settings. And it also meant that we could keep in touch with services outside of that emergency setting and think about delivery models so that we didn’t just become emergency command and control.

After this experience, we were fairly confident about including Good Help in emergency response by the time of the vaccine rollout. We were able to build it into the mass vaccination centres from day one so that people could access generic help and support at a point where they maybe were reaching out to the system for the first time in a long while. We’d been locked down in most of Greater Manchester pretty much the whole time so for some people it the first time they’d come into contact with people.

Hopefully no one will ever have to go through that kind of thing again but I guess the message is: just start somewhere. We’ve looked at all different parts of the system as we’ve gone along and I don’t think it matters where you start, frankly.

What did you find valuable in both the political and the executive leadership when implementing this approach?

We did a lot of work with leaders in the early days to align Good Help with the priorities of different parts of the system. We found it easy to do because there’s a strong evidence base that you can draw on and theoretical models that drive the different parts of the system. Those different parts of the system understood the principles of Good Help.

One of the things that really struck me was that during the Good Help leadership training, it always became personal. Almost everybody had a personal story about help and how it had impacted their lives, their families and their loved ones.

Co-production is often understood to involve services and people, but we’ve come to realise that there’s more nuance to it in terms of the different groups that we need to include in the conversation. Leaders face barriers to frank conversations in just the same way as frontline workers who might be silenced by the bureaucracy around their roles, or people with lived experience who haven’t got access to the conversations.

And by thinking about all these groups together, rather than thinking about leaders as a separate entity, we can create that safe space (shown in the middle of the diagram above) where we can start to really dig into what we need to do and what needs to change.

Creating the conditions that enable different people to access the conversation and making sure nobody is left out if they want to contribute has proven really helpful in terms of systems change.

How did you help the leadership feel comfortable in some of the unknown that comes with adopting a really flexible, open, responsive approach?

I wouldn’t say it was that difficult because it’s really human – I didn’t have to convince anybody. It doesn’t take a lot to look at it and think, this could help. There are no great asks, nobody is being asked to fundamentally change anything so there’s no huge risks. It’s just about the how rather than the what.

How in practice did you move a whole council to a different way of working and a Good Help approach?

We were more ambitious than that – we were going for a whole place with the council as the enabler, and it’s been a process of constantly reframing things through the filter of Good Help.

There’s not one single way to apply Good Help. For example, the more structured statutory parts of the system value audit tools and competency frameworks so they can analyse the data, test it against lived experience and identifying where Good Help could make a difference. Whereas perhaps more grassroots parts of the system are keen to test and learn, building Good Help into what they do. And leadership parts of the system are interested in how the approach can look after the workforce and prevent burnout. And we can’t forget the back-office parts of the system as well, the nuts and bolts that hold the whole thing together, because Good Help can support them as well.

A top tip I would really like to share is to not accidentally become the Good Help police. We don’t want to kill the stuff that’s grown out of the kindness of people’s hearts. It might be a bit paternalistic, it might be a bit of a sticking plaster, but actually that food bank open on that day provides a lifeline for people. It’s about introducing the approach in an appreciative and accommodating way, rather than saying, Well we’re not doing that because it’s not Good Help.

Did you get any pushback from people who thought that you were being negative about their way of working?

No because almost everybody’s good at some of it and nobody’s great at all of it. And that’s often cultural so there isn’t any personal blame attached. There are parts of the approach that you naturally lean towards as a practitioner or as a helper that might be to do with the culture of the organisation or sector that you’re in, or it might be to do with your personal traits. It’s about making sure everybody can maximise the impact of the contact that they’re having with people, and that’s quite an easy sell.

What are the key differences that this way of working has made for you in the council as well as in the place as a whole?

An important difference to note is the impact on the workforce and the liberation that comes with this approach. You hear phrases like, Oh I’m now doing what I came into this job for after X number of years. People are also able to connect with other parts of the system that might have been difficult to do before. So there’s a kind of humanising that goes on in the system.

I wouldn’t like to call this a panacea, but there is some evidence that it reduces sickness absence as well as anecdotal evidence that it reduces burnout. Rather than leading to the dehumanising that can cause burnout, Good Help introduces protective factors that keep human beings front and centre by believing in the power of relationships. Even in the really trickiest of circumstances, sickness levels have been remarkably low. It’s small numbers and we don’t have peer reviewed evidence around this but there’s certainly a suggestion there.

The other thing is that while it is absolutely life changing – and we have multiple case studies like Andy’s – the trick is to not get stuck in hero worshipping when it works because a lot of its success has to do with circumstances. And rather than criticising or blaming parts of the system that aren’t taking the approach, the conversation should be about identifying why that part of the system is being held back from achieving its potential.

What kind of changes have you made in the council since adopting Good Help?

Good Help is really heavily written into the prevention parts of the system. We’re looking at ourselves as a council facing out into our communities and considering what it is that we can do to provide the opportunities that people need in the places that they’re at, as opposed to seeing ourselves as the fixer when things go wrong. This work is showing what system change needs to happen, including changing how we commission things and how we govern things, and looking at the compassion and power that’s in our system.

To quote Bananarama and Fun Boy Three: it ain’t what you do, it’s the way that you do it. It’s very possible to build Good Help into existing commissioning frameworks. However, historically we’ve foregrounded outcomes and outputs rather than participation and inclusion. Taking a Good Help approach to commissioning has been transformative in terms of what service specifications look like. It’s really good fun to see what happens when you start to think about what it is we really value, and therefore what it is we’re going to measure.

It’s radically different to the kinds of things that we think we’re expected to do. But we’re not actually doing anything radical – we’re taking the permission that’s afforded to us in those frameworks to go ahead and do that.

You can read this interview (on page 85) with one of our commissioners to find out more.

What advice would you give to anyone thinking about developing a Good Help approach?

I think it’s just a case of starting somewhere. You don’t have to make decisions to do something radically different, although I would highly recommend that as it’s certainly kept me going these last few years. Look at where things don’t feel right or don’t feel authentic and think about how you could do things differently. How would that manifest itself? Give it a go.

There’s lots of help and support available in the report. That’s the place I kept going back to and still do to think reflectively. Something new stands out every time I look at it.

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