Strategy is about choices. Almost no charity can do everything in its mission. Charities simply aren’t large enough to reach every person their objects dictate. So how do charities make the choices of the services they should provide to make the maximum difference with their limited funds?
Let me explain this dilemma in a bit more detail.
Every service or activity has a number of variables:
Variable 1: the number of people who need help,
Variable 2: the number of people who can be helped,
Variable 3: the success percentage of each type of activity.
Hospices provide a good example of these dilemmas. Let’s say that each year in a hospice’s geographic patch 1,000 people die from a chronic condition (so that is variable 1). So that’s the total people who need help in dying with dignity and in a way that reflects their wishes.
In its in-patient service a typical hospice might have 20 beds and each person needs a hospice for 3 months. So that is 80 people helped over the course of a year (and this is variable 2).
Having done some research the hospice knows that 90% of the 80 people do die with dignity (so that is variable 3). This means that the success percentage is 8% (80/1000) and the success rate is 90% (nine tenths of people die with dignity). The problem is that the charity is only reaching a low percentage of the total audience at 8% of the need, but with a high degree of success at 90%. It would need a much bigger hospice to really reach more people, and that is way is too expensive to be possible.
This type of activity is low numbers but high success and high cost per person
So to tackle this dilemma hospices now have a ‘hospice at home’ service. People are looked after at home, typically by family, with some hospice support. The number that the hospice can reach this way are much higher for the same cost as running the in-patient service. Maybe 200 people a year (all the numbers in this blog are entirely illustrative) but the research suggest that only half the time does the service really deliver.
So this type of activity reaches medium numbers (200), medium success (50%) and medium cost per person (more people are reached for the same resource).
Our apocryphal hospice therefore decides to lobby its local NHS hospitals that everybody who dies in them of a chronic condition gets a death like the person who was dying in a hospice. It puts the same energy into this as the in-patient and hospice at home service. Like any campaign there is a lower chance of success. Research might show that 2 in ten of the hospices who have lobbied have been successful.
So this type of activity is high numbers (all 1000), low success (20%) and low cost per person (if successful the activity reaches more people, but it doesn’t always work)
These three activities tackle the organisations’ mission in very different ways. They are logical and alternative strategies. They represent the choices many organisations face in their strategy: they can reach lots of people but the chances of impact is lower, or reach fewer people and have a greater chance of impact.
It’s not just hospices who face this dilemma. This is true of information provision about welfare benefits, medical conditions (or anything else) for example:
·if somebody who needs help meets an information provider face to face, they can be given leaflets, the leaflets can be explained, so the chance of the information sinking in is greater.
·If somebody rings on the phone less people can be reached, but the telephone operator can explain things to them, or sort out their issues in a way that the internet can’t do.
·Over the internet information provision reaches lots more people, but many users may not fully understand the information, or forget its advice or lose interest.
·Finally, let’s say a charity works out 1 million people need help. It can never reach those people face to face, or over the phone, or even through the internet. It doesn’t have the budget. So the charity decides to campaign on information provision to be better via the NHS, or change the reason that the information is needed at all, then it can do away with the need for its service completely.
With each of these services the numbers of people reached increases, the chances of success decreases, and the cost per person decreases
Three key points at the heart of this strategic dilemma
1. Know your services, activities, and impact
In order to be able to make the right decisions on these strategic choices, a charity needs to know what the key variables are. How many people need help, how many people are helped through each of the different services/activities on offer, and how effective are the different ways of reaching people. Unless a charity knows these three variables its hard to make informed strategy choices.
2. Charities should have strategies which spread their risks: of impact, numbers reached and cost per person
Having established these key variables its important that charities then deliver services which spread their risk, and tackles issues in different ways. Diversity is key. If all the services work in the same way, then services are less resilient (when things like Covid hit). The amount of learning is also reduced if there is only one way of delivering services. And the type of people reached is probably less diverse if only a single type of service is employed.
3. Campaigning makes perfect sense as a strategy to reach more people
Campaigning gets a lot of grief from right-way politicians. However as a way of spreading risk, learning more, and reaching more people campaigning is an entirely logical strategic choice. In other words campaigning is not wild-eyed political choice, but a coherent strategic choice as a way that a charity can deliver its