Reimagining Help An evidenced-based approach to helping people reach their goals September 2020 - Nesta
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Reimagining Help An evidenced-based approach to helping people reach their goals September 2020
Reimagining Help
An evidenced-based approach to helping people reach their goals
The framework Authors
The Reimagining Help guide was developed by Nesta in partnership Esther Flanagan
with the British Heart Foundation, Macmillan Cancer Support and Tara Hackett
the UCL Centre for Behaviour Change. All four organisations were Lou Atkins
interested in developing a universal model of ‘help’ that supports Paul Chadwick
people to reach the goals that matter to them. This report builds Christina Cornwell
on the Good and Bad Help report (2018), diving deeper into the
behavioural evidence and its practical applications.
Acknowledgements
The UCL Centre for Behaviour Change collated the behaviour
change evidence (from the scientific literature and primary research) Claire Sand, Sophia Nicola, Lynne Ruddick, Anthony Cunliffe, Sally
underpinning this guide. Hughes, Finlay Green, Maria Portugal, Tim Hobbs, Richard Forsyth,
Heather Mclean, Robert Jamieson, Catherine Russell, Polly Redfern,
We worked with a co-design group of 30 frontline practitioners, Ed Wallace.
people with lived experience of long term health conditions, and
academics who helped us understand the realities of delivering and
receiving ‘help’ in health and care systems. For more information about this report, please contact:
Esther Flanagan at esther.flanagan@nesta.org.uk
We also worked with Dartington Service Design Lab. They designed
the structure and format of the guide to make it accessible and
as easy to use as possible for those delivering ‘help’ in a range of
settings.
Reimagining Help | p 2
Table of contents
Reimagining help 4
Why do we need to Reimagine Help? 5
An evidenced-based approach to ‘help’ 7
Experiencing Good and Bad Help 9
The guide 10
Understanding the guide 11
How do I use the guide? 13
Eight characteristics 14
Social connections 16
Enabling environments 19
Working on what matters 22
The right information at the right time 25
Learning new skills 28
Tracking change 31
Celebrating success 34
Managing setbacks 37
Case studies 40
Mayday Trust 41
GoodGym 44
FanFit 47
NHS Lothian Cardiac Rehabilitation Service 50
Macmillan Primary Care Home 53
Key resources and
references 56 This guide is interactive.
The side menu and the underlined content can take you to
different sections of the document and external sources.
Reimagining Help | p 3
Reimagining help
Reimagining help
Why do we need to Reimagine Help?
An evidenced-based approach to ‘help’
Experiencing Good and Bad Help
The guide
Understanding the guide
How do I use the guide?
Eight characteristics
Social connections
Enabling environments
Working on what matters
The right information at the right time
Learning new skills
Tracking change
Celebrating success
Managing setbacks
Case studies
Mayday Trust
GoodGym
FanFit
NHS Lothian Cardiac Rehabilitation Service
Macmillan Primary Care Home
Key resources and
references
This guide is interactive.
The side menu and the underlined content can take you to
different sections of the document and external sources. Reimagining Help | p 4
Reimagining help
Why do we need to Reimagine Help?
Why do we need to Reimagine Help?
An evidenced-based approach to ‘help’
Experiencing Good and Bad Help
Traditional models of health and care can encourage people to We understand that ‘fixing’ problems is sometimes the right and
depend on ʻexpertsʼ who hold knowledge and power, rather than necessary thing to do; for example, in acute care settings it is
The guide supporting people to use their own knowledge, relationships, essential for medical teams to use expert knowledge and make
Understanding the guide strengths and purpose to determine solutions that work best for complex decisions at pace, as demonstrated throughout the
How do I use the guide? them. This power imbalance is deeply rooted in the history, culture coronavirus pandemic. But we believe the majority of health and
and structures of our health and care systems. wellbeing interactions (whether with healthcare professionals, those
Eight characteristics working in community settings or even online) could build in more
Social connections All too often: Good Help principles, rebalancing power between experts and
Enabling environments
• People are told what is best for them and offered a one-size- people and using practices informed by behaviour change research
Working on what matters
fits-all solution that doesnʼt relate to the things that matter to which support people to feel more confident to reach their own goals
The right information at the right time
them. Offering solutions that are disconnected from a person’s in a way that fits with their lives.
Learning new skills
motivations are unlikely to work, yet 60 per cent of adults have not
Tracking change
discussed what is important to them with a healthcare professional
Celebrating success
(NHS England, 2018).
Managing setbacks
• There is an excessive focus on fixing medical symptoms rather
than exploring how a condition impacts on a person’s life. Yet 45
Case studies
per cent of all adults living with a long-term condition don’t feel
Mayday Trust
they have the knowledge, skills and confidence to manage their
GoodGym
health and wellbeing on a daily basis (NHS England, 2019).
FanFit
NHS Lothian Cardiac Rehabilitation Service
• There is a lack of focus on peopleʼs wider life circumstances -
Macmillan Primary Care Home
their home, relationships, social environments and finances - things
that can be significant barriers to health and behaviour change. An
example is suggesting people eat more healthily when 50 per cent
Key resources and
of families cannot afford to eat what is recommended (The Food
references
Foundation, 2018).
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Reimagining help
Why do we need to Reimagine Help? What do we mean by Good Help?
An evidenced-based approach to ‘help’ The following definition was developed using insights from behaviour
Experiencing Good and Bad Help change research and people’s lived experience of being helped and/or
helping others.
The guide
Understanding the guide Good Help supports people to adapt behaviours to reach their
How do I use the guide? goals by:
Eight characteristics • Understanding what matters to them individually, building on their
Social connections strengths and celebrating successes
Enabling environments
• Understanding the importance of their relationships and
Working on what matters
harnessing social connections
The right information at the right time
• Recognising practical barriers to change and adapting
Learning new skills
Tracking change
environments to overcome them
Celebrating success • Providing opportunities to learn new skills and access tailored
Managing setbacks information at a time that feels right for them
• Tracking how behaviours change over time and being prepared
Case studies for challenges and setbacks
Mayday Trust
GoodGym
FanFit
NHS Lothian Cardiac Rehabilitation Service
Macmillan Primary Care Home
Key resources and
references
This guide is interactive.
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Reimagining help
Why do we need to Reimagine Help?
An evidenced-based approach to ‘help’
An evidenced-based approach to ‘help’
Experiencing Good and Bad Help
Behaviour change programmes have an established evidence base
and work well for some people, but often these programmes miss
The guide
Understanding the guide
opportunities to understand the wider issues that are affecting We believe that
How do I use the guide?
people’s health and wellbeing. We think there is an opportunity to
build on this learning and apply it in different ways. Here’s why:
insights from the field
of behaviour change
Eight characteristics
Social connections
• There could be more focus on wider environmental, social and research can be applied
economic drivers of health and wellbeing (such as living conditions,
Enabling environments
community life, relationships, money and time), rather than a to a wide range of
organisations and places
Working on what matters
The right information at the right time
narrow view of what is ‘wrong’ (drinking too much alcohol,
Learning new skills
smoking and eating a poor diet), which limits opportunities to
understand the person beyond their ‘condition’.
where people interact.
Community facilities,
Tracking change
Celebrating success • ‘Help’ could be more closely tailored to each person’s goals
Managing setbacks and motivations, which may not be health focused (e.g. finding
meaningful work or a new relationship), rather than based on
local charities and
Case studies assumptions of what should change (commonly behaviours linked businesses, employment
Mayday Trust to physical health and lifestyle). and housing support, as
• ‘Help’ could be delivered in flexible ways which enable more people
GoodGym
FanFit to access the right support, rather than delivering programmes
well as health and care
NHS Lothian Cardiac Rehabilitation Service in a fixed way that may exclude people from accessing support. services can all play a
Macmillan Primary Care Home Someone working shifts, for instance, might find it hard to
attend a fixed number of sessions, and some people might feel
role in supporting people
Key resources and uncomfortable speaking in groups. to reach their goals in
references • The knowledge and skills needed to apply behaviour change ways that feel right for
practices could be made available to a wider range of practitioners
across more diverse settings, rather than limiting skills training to them.
practitioners delivering specific programmes.
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Reimagining help
Why do we need to Reimagine Help? Previous attempts to share behaviour change research and practice
An evidenced-based approach to ‘help’ have not been easily accessible to people in ‘helping’ organisations,
Experiencing Good and Bad Help especially those working outside formal health settings. In this
guide, we have aimed to simplify the evidence into 8 characteristics
The guide of Good Help. By doing this, we hope to encourage practitioners,
Understanding the guide system leaders and anyone who works in a ‘helping’ role to feel more
How do I use the guide? confident about adapting and applying behaviour change principles
in their organisation or community.
Eight characteristics
Social connections Now more than ever, there is a need to help people live well in
Enabling environments
their homes and communities. We must think more flexibly about
Working on what matters
what ‘help’ means and question whether traditional models of
The right information at the right time
health and care are still fit for purpose. The coronavirus pandemic
Learning new skills
has highlighted the importance of diversifying sources of help
Tracking change
beyond the hospital, supporting people to manage their health and
Celebrating success
wellbeing more independently and ultimately taking pressure off
Managing setbacks
public services. We hope this resource will serve as a useful guide for
reimagining what new forms of help could look like.
Case studies
Mayday Trust
GoodGym
FanFit
NHS Lothian Cardiac Rehabilitation Service
Macmillan Primary Care Home
Key resources and
references
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Reimagining help
Why do we need to Reimagine Help?
Experiencing Good and Bad Help
An evidenced-based approach to ‘help’
Experiencing Good and Bad Help
The guide Good Help makes me feel that... Bad Help makes me feel that….
Understanding the guide
How do I use the guide?
Eight characteristics I am alone in my
experiences
Social connections
Enabling environments
I don’t have the resources
Working on what matters I need to make change
I am anxious about what
I have the I am supported
The right information at the right time will happen to me
information in a way that fits
Learning new skills I need my life
Tracking change I do not have the
I have the opportunities I have the information I need I don’t have the
Celebrating success to connect with other resources I need to confidence to reach
people reach my goals my goals
Managing setbacks
My life and wider needs
are not considered
Case studies I can choose
what is right
Mayday Trust for me
My story and I am a problem
GoodGym strengths are not a person
valued
FanFit
I am told what is
NHS Lothian Cardiac Rehabilitation Service best for me
I am safe enough to say I feel blamed I am not in control
Macmillan Primary Care Home what I need and judged
Key resources and
references Others I have the
understand confidence to
what matters reach my goals
to me
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Reimagining help
The guide
Why do we need to Reimagine Help?
An evidenced-based approach to ‘help’
Experiencing Good and Bad Help
The guide
Understanding the guide
How do I use the guide?
Eight characteristics
Social connections
Enabling environments
Working on what matters
The right information at the right time
Learning new skills
Tracking change
Celebrating success
Managing setbacks
Case studies
Mayday Trust
GoodGym
FanFit
NHS Lothian Cardiac Rehabilitation Service
Macmillan Primary Care Home
Key resources and
references
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Why do we need to Reimagine Help?
Understanding the guide
An evidenced-based approach to ‘help’
Experiencing Good and Bad Help
The purpose of this guide is to help the reader, and the organisations For the purpose of this guide we have used the term ‘practitioner’
they work with, to: throughout, but this represents any person working in a ‘helping’
The guide role across multiple settings. We also refer to ‘organisations’
1. Understand what Good Help is, the behaviour change evidence
Understanding the guide
that underpins it, and what it looks like in practice providing help, but this is equally relevant to services, community
How do I use the guide?
2. Develop new ideas or adapt offers of help, which can be tested groups and other providers
out in organisations or local communities.
Eight characteristics
Social connections
Enabling environments Who is this for?
Working on what matters This guide was created for practitioners, system leaders (such as
The right information at the right time service managers, charity directors or commissioners) and any person
Learning new skills working in a direct ‘helping’ role. Most of the evidence has come
Tracking change from the health and care sector; therefore it should feel particularly
Celebrating success relevant to people working in places such as GP surgeries, hospitals,
Managing setbacks mental health and community services, local charities, day centres,
residential care and home care services. But because Good Help is
Case studies fundamentally about better ways to support people to reach their
Mayday Trust goals, it is relevant in other contexts too, including:
GoodGym • Public services, such as employment support, housing associations,
FanFit the Citizens Advice Bureau, adult learning centres and
NHS Lothian Cardiac Rehabilitation Service rehabilitation services.
Macmillan Primary Care Home
• Community facilities, such as sports and leisure centres, libraries
and places of worship.
Key resources and • Local and community businesses interested in supporting local
references health and care services to help people living in their communities,
such as cinemas, music venues, hairdressers and supermarkets.
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Why do we need to Reimagine Help? Where did the evidence come from?
An evidenced-based approach to ‘help’ We drew on three key sources of evidence to develop this guide:
Experiencing Good and Bad Help
1. Academic evidence: We worked with UCL’s Centre for Behaviour
The guide Change, who reviewed the academic literature to identify core
Understanding the guide
behavioural approaches that underpin Good Help. We have used
How do I use the guide?
UCL’s COM-B model (capabilities, opportunities and motivations
which drive behaviour change) throughout the guide. When we talk
Eight characteristics about these terms we mean:
Social connections
• Capability - people having the right knowledge and skills to do
Enabling environments
things differently.
Working on what matters
• Opportunity - people having the right support, relationships and
The right information at the right time
practical means to undertake the behaviour.
Learning new skills
• Motivation - people believing it is possible and worthwhile to
Tracking change
change their behaviour.
Celebrating success
Managing setbacks
2. Practice-based case studies: We interviewed people working
Case studies in organisations or delivering programmes that already embed
Mayday Trust
characteristics of Good Help to understand how it has been applied
GoodGym
in practice (illustrated in the examples and case studies).
FanFit
NHS Lothian Cardiac Rehabilitation Service 3. Lived experience of people and practitioners: We worked with
Macmillan Primary Care Home a group of 30 people with lived experience of long-term health
conditions (including cancer and heart conditions) and frontline
Key resources and practitioners (including GPs, physiotherapists, psychologists, nurses
references and specialist doctors). The group drew on their direct experience
and understanding of the systems in which help is delivered. They
also helped to translate the theory into language that people could
connect with.
Together, these sources of evidence have been combined into eight
characteristics of Good Help.
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Why do we need to Reimagine Help?
How do I use the guide?
An evidenced-based approach to ‘help’
Experiencing Good and Bad Help
This guide is divided into two main sections:
The guide
1. The eight characteristics of Good Help: This section aims to help
Understanding the guide
How do I use the guide?
you to understand the behaviour change evidence and generate
your own ideas for applying Good Help in your organisation or local
community. For each characteristic, you’ll be able to read:
Eight characteristics
Social connections • A description of the characteristic and why it matters
Start here!
Enabling environments • The behaviour change theory and evidence behind it
Working on what matters • Examples of the characteristic in practice Generate ideas
The right information at the right time • A checklist to assess whether your idea includes the core
Learning new skills components
Tracking change • Common pitfalls that might arise when developing and
Celebrating success implementing ideas.
Refine idea
Managing setbacks and test
Avoid Check in
2. Good Help case studies: This section aims to illustrate how Good common pitfalls with the evidence
Case studies Help characteristics have been applied and embedded into practice.
Mayday Trust Within each case study, you will find:
GoodGym
• A description of what the organisation or programme does
FanFit
• The Good Help characteristics that have been embedded and
NHS Lothian Cardiac Rehabilitation Service
how this has been done
Macmillan Primary Care Home
• What practitioners and organisations can do to implement
Good Help. This section has been structured using the COM-B
Key resources and model, and outlines what is needed at an organisational level and
references a practitioner level.
We hope that you can borrow learning from the case studies and
get inspiration for how to tailor ideas to what your local community
wants and needs.
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Eight characteristics
Why do we need to Reimagine Help?
An evidenced-based approach to ‘help’
Experiencing Good and Bad Help
The guide
Understanding the guide
How do I use the guide?
Eight characteristics
Social connections
Enabling environments
Working on what matters
The right information at the right time
Learning new skills
Tracking change
Celebrating success
Managing setbacks
Case studies
Mayday Trust
GoodGym
FanFit
NHS Lothian Cardiac Rehabilitation Service
Macmillan Primary Care Home
Key resources and
references
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Why do we need to Reimagine Help?
The eight characteristics of Good Help
An evidenced-based approach to ‘help’
Experiencing Good and Bad Help
As you go through this guide and generate your own ideas to
try out in your service, organisation or community, you do not
The guide need to incorporate all eight characteristics at once. Some ideas
Understanding the guide
focus on a single characteristic and others may cut across several
How do I use the guide?
characteristics.
Eight characteristics
Social connections
Enabling environments
Working on what matters
The right information at the right time
Learning new skills
Tracking change
Celebrating success
Managing setbacks
Case studies
Mayday Trust
GoodGym
FanFit
NHS Lothian Cardiac Rehabilitation Service
Social Enabling Working on The right Learning Tracking Celebrating Managing
Macmillan Primary Care Home
connections environments what matters information at the new skills change success setbacks
right time
Key resources and
references
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Social connections
Why do we need to Reimagine Help?
An evidenced-based approach to ‘help’
Experiencing Good and Bad Help
Why is this important? What do we mean by social connections?
The guide Organisations that draw, and build, on the social value of people’s Social connections can be any meaningful contact with another - for
Understanding the guide
relationships and communities will tap into wider sources of example, friends, family, neighbours and community members or
How do I use the guide?
emotional and practical support which cannot be provided by new people with shared experiences. When it comes to changing
practitioners alone. behaviour it can be particularly helpful to meet others with similar
Eight characteristics goals and experiences; realising you’re not alone in your experience
Social connections and believing that things can change can be an important source of
Enabling environments motivation.
Working on what matters
The right information at the right time Taking part in social activities can improve health and wellbeing
Learning new skills through learning from others - for example, sharing health
Tracking change
information, practising new behaviours and supporting each other’s
Celebrating success
successes (see Celebrating success). Social connections can be
Managing setbacks
harnessed to help people move towards their goals - for example, by
creating shared goals with friends or by asking family and friends not
Case studies to tempt them away from their goals.
Mayday Trust
.
GoodGym
If social activities are being offered, they should be delivered in a way
FanFit
that feels inclusive and safe enough for anyone to take part (whether
NHS Lothian Cardiac Rehabilitation Service
face to face or virtually), recognising not everyone has the same
Macmillan Primary Care Home
amount of time, money or confidence in social situations.
Key resources and
references Social
connections
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Why do we need to Reimagine Help?
Social connections
An evidenced-based approach to ‘help’
Experiencing Good and Bad Help
What is the behaviour change theory and evidence? Examples
• Club Soda runs social events for people trying to stop or reduce
The guide their alcohol intake. These events role-model socialising without
Social connections:
Understanding the guide
• Increase opportunities for behaviour change by exposing people alcohol, enabling people to make friends with others with similar
How do I use the guide?
to a range of behaviours modelled by others in similar situations. goals, in an environment that has a great social atmosphere (as you
Role-modelling provides people with examples to try out or aspire would find in a pub!) and interesting non-alcoholic options available
Eight characteristics (see Enabling environments).
to, and helps to establish new norms for helpful behaviours within
Social connections
a community. • GoodGym is a community of runners that combine getting fit with
Enabling environments
• Increase motivation for behaviour change because goals set within doing social good. They harness social connections by providing
Working on what matters
the context of a person’s relationships and families are likely to be opportunities for people to come together and work on a shared
The right information at the right time
consistent with their belief system, identity and culture. Seeing goal - for example, planting trees in a community garden. This
Learning new skills
others successfully change can increase people’s confidence (a key sense of shared interest and peer support helps people stay
Tracking change
element of motivation) to make changes in their own lives. Social motivated and build exercise into their regular routines (see case
Celebrating success
Managing setbacks connections also create opportunities for feedback and positive study for more detail).
reinforcement (Celebrating success), which is critical to the process • Peer-support platforms that match people to others with similar
Case studies of changing behaviour. health conditions, interests and ambitions, and virtual events which
Mayday Trust • Increase capability through the exchange of knowledge and skills help people connect with and learn from each other about living
GoodGym via interpersonal learning (learning from others). with particular experiences. For instance, TeenHeart is a peer
FanFit
support programme facilitated by the British Heart Foundation for
NHS Lothian Cardiac Rehabilitation Service
young people with congenital heart conditions; and Grapevine’s
Macmillan Primary Care Home
Teenvine Plus is a programme for young people with autism or
learning disabilities which focuses on developing friendships,
confidence and skills to achieve their ambitions.
Key resources and
references
Generate ideas
Using the information above, start
to brainstorm ideas to try out in your
organisation or community. Think about how
to co-design ideas with other practitioners
and people in the local community who could
benefit from Good Help.
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Why do we need to Reimagine Help?
Social connections
An evidenced-based approach to ‘help’
Experiencing Good and Bad Help Generate ideas
The guide
Understanding the guide
How do I use the guide? Refine idea
and test
Eight characteristics
Social connections
Enabling environments
Common pitfalls Check in with the evidence
Working on what matters
The right information at the right time
• Signposting people to a support group without 1. How will your idea enable people to connect with
Learning new skills
first exploring with them what their needs are and others with similar experiences?
Tracking change
whether it will be met by this kind of group. 2. How will you support the person to draw on their
Celebrating success
Managing setbacks • Asking someone to make a plan for reaching their social networks when developing individual or
goals without acknowledging their wider lives: shared goals?
Case studies home life, relationships, work, time and money. 3. How does your idea provide opportunities for
Mayday Trust • Setting up a support group in a way that people to receive positive reinforcement and
GoodGym disadvantages some more than others - for Use these questions to feedback? And how will this be achieved?
example, people with learning difficulties or people assess whether your
FanFit
idea includes the core
4. How does your idea support people to practice
NHS Lothian Cardiac Rehabilitation Service whose first language isn’t English, or that does not components of this new behaviours and develop new skills through
Macmillan Primary Care Home provide support for people to access the group if characteristic. opportunities for interpersonal learning?
barriers are present. 5. How will you enable a diverse range of people to
Key resources and access and engage with the idea? Are there things
references you can put in place to make it as equitable and
inclusive as possible?
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Enabling environments
Why do we need to Reimagine Help?
An evidenced-based approach to ‘help’
Experiencing Good and Bad Help
Why is this important? What do we mean by enabling environments?
The guide So much of human behaviour is directly triggered by the If people’s environments (their homes, places of work and wider
Understanding the guide environments in which people live. Organisations that recognise this communities) are set up in a way that makes it easier to access
How do I use the guide? and look for ways to adapt environments can help people to access support or undertake certain behaviours, it can help people to reach
opportunities and enhance health and wellbeing. their goals. This includes locating resources, equipment and support
Eight characteristics in closer proximity to the person - at home, within walking distance,
Social connections or in public places that people come into contact with as part of their
Enabling environments everyday routines. But it is more than just physical distance. It is also
Working on what matters about presenting things in ways that make people feel safe enough
The right information at the right time to approach what’s available - for example, feeling confident enough
Learning new skills to use gym equipment in parks or to walk into a group on debt
Tracking change management. This can be done in different ways, such as choosing
Celebrating success venues that people already trust and which are easy to find or by
Managing setbacks providing a demonstration in advance so that people know what to
expect and how things will work.
Case studies
Mayday Trust As well as public spaces, it can be helpful to support people to adapt
GoodGym their home and work environments in ways that helps them to move
FanFit towards their goals - for example, a timer on the TV to switch off
NHS Lothian Cardiac Rehabilitation Service
after a certain time to improve sleep routines, clearing a small area at
Macmillan Primary Care Home home to do exercise or putting alcohol-free beer in the fridge.
Key resources and
references Enabling
environments
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Why do we need to Reimagine Help?
Enabling environments
An evidenced-based approach to ‘help’
Experiencing Good and Bad Help
What is the behaviour change theory and evidence? Examples
• Installing free blood pressure machines in supermarkets alongside
The guide a demonstration video, information about how to interpret readings
Enabling environments:
Understanding the guide
• Increase capability for behaviour change, as people learn how to and what to do if blood pressure is high.
How do I use the guide?
adapt their own environments in accordance with the goals they • Providing free or discounted taxi rides to appointments in order to
are trying to achieve. remove barriers to accessing support.
Eight characteristics
• Increase opportunity for behaviour change by making sure people • Gaming or virtual reality to reduce anxiety about accessing support
Social connections
Enabling environments have the resources they need - for example, money, equipment, or treatment - for example, Great Ormond Street Hospital has
Working on what matters space - to do the behaviour. recreated the hospital in a Minecraft world, enabling children
The right information at the right time • Increase motivation for behaviour change by removing barriers to virtually visit the hospital before they attend and meet other
Learning new skills from the process of change, essentially making the desired children; others have used virtual reality as a method of distraction
Tracking change behaviour the easiest behaviour. This might be by ensuring during procedures such as blood tests.
Celebrating success there are plenty of cues to remind people to do the behaviour • Offering accessible bike stores and shower facilities in public
Managing setbacks or removing cues to do other unhelpful behaviours. It could also spaces and workplaces so that it is easier for people to run or cycle,
involve moving services that support behavior change closer to the rather than having to drive or use public transport; providing access
Case studies places where people live, work, learn and play, rather than having to free running shoes or other sports equipment for people who
Mayday Trust them in places that are convenient for the service or practitioner - can’t afford them.
GoodGym for example, co-location of services. • First Call support at home works with local volunteers to improve
FanFit the environments of people recovering at home - for example,
NHS Lothian Cardiac Rehabilitation Service clearing rooms so that medical furniture or recovery equipment
Macmillan Primary Care Home can be installed or picking up prescriptions or shopping for people.
These adjustments help people to focus on and prioritise their
Key resources and recovery.
references
Generate ideas
Using the information above, start
to brainstorm ideas to try out in your
organisation or community. Think about how
to co-design ideas with other practitioners
and people in the local community who could
benefit from Good Help.
This guide is interactive.
The side menu and the underlined content can take you to
different sections of the document and external sources. Reimagining Help | p 20Reimagining help
Why do we need to Reimagine Help?
Enabling environments
An evidenced-based approach to ‘help’
Experiencing Good and Bad Help Generate ideas
The guide
Understanding the guide
How do I use the guide? Refine idea
and test
Eight characteristics
Social connections
Enabling environments
Common pitfalls Check in with the evidence
Working on what matters
The right information at the right time
• Locating support/equipment in places which might 1. How will you make it as easy as possible for people
Learning new skills
be easier for organisations without thinking about to physically access the opportunity?
Tracking change
how to address barriers to accessibility for particular 2. How does your idea help people to overcome
Celebrating success
Managing setbacks
groups - for example, people living in rural locations practical barriers to behaviour change?
or those with mobility difficulties. 3. How will you put in place information or support
Case studies • Making recommendations without understanding that helps people feel confident to access or interact
Use these questions to
Mayday Trust
the limitations of people’s home environments - for assess whether your with what you are offering?
GoodGym
example, suggesting a healthy cooking course that idea includes the core 4. How will you make sure that the idea feels safe and
requires the use of an oven when the person hasn’t components of this
FanFit characteristic: inclusive enough for people? Can you connect to
NHS Lothian Cardiac Rehabilitation Service
got an oven or can’t afford to use one. and make use of existing community infrastructure
Macmillan Primary Care Home - for example, existing community groups, local
policing, green spaces?
Key resources and 5. How could your idea span multiple environments -
references for example, home, work, wider communities?
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The side menu and the underlined content can take you to
different sections of the document and external sources. Reimagining Help | p 21Reimagining help
Working on what matters
Why do we need to Reimagine Help?
An evidenced-based approach to ‘help’
Experiencing Good and Bad Help
Why is this important? What do we mean by working on what matters?
The guide Organisations that seek to understand what is important to each If people identify what is important to them and what goals they
Understanding the guide person are better able to tailor support to help people change the want to work on, they are more likely to take action. This might
How do I use the guide? desired behaviour and reach their goals. seem obvious, but many of our health and care systems are set up to
offer standardised solutions to people, with little room for tailoring
Eight characteristics support. Starting conversations with ‘what’s important to you and
Social connections what do you want to work on?’ might feel quite different to some
Enabling environments practitioners who are used to working with direct approaches.
Working on what matters
The right information at the right time People should be supported and encouraged to set goals relating to
Learning new skills
any aspect of their lives that are important to them, such as physical
Tracking change
and mental health, work and finances, or family and social life. As
Celebrating success
mentioned in Social connections, goals can also be collective (a
Managing setbacks
group of people who care about achieving the same thing).
Case studies
Once people have decided on their goals they should be supported
Mayday Trust
to create plans for reaching them, building on their strengths,
GoodGym
. interests, achievements and wider social support networks. Where
FanFit
organisations feel unable to support people with particular goals
NHS Lothian Cardiac Rehabilitation Service
(for instance, a care leaver who mentions to their GP they need help
Macmillan Primary Care Home
accessing specific benefits), they should aim to connect the person to
organisations that can help.
Key resources and
references Working on
what matters
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The side menu and the underlined content can take you to
different sections of the document and external sources. Reimagining Help | p 22Reimagining help
Why do we need to Reimagine Help?
Working on what matters
An evidenced-based approach to ‘help’
Experiencing Good and Bad Help
What is the behaviour change theory and evidence? Examples
• Practitioners often have limited time to ask open questions. Moving
The guide Medicine guides practitioners on how to make the most of 1
Working on what matters:
Understanding the guide
• Increases capability for behaviour change because people learn minute, 5 minute or longer conversations with people with a range
How do I use the guide?
what moves them towards or away from their goals - for example, of health conditions, building in behaviour change evidence to
practical resources or psychological barriers to change. support people to become more active.
Eight characteristics
• Increases motivation for behaviour change because it enables • Dance to Health connects people’s love for dance and music with
Social connections
people to connect with and focus on the things they care about, evidence-based exercises that are proven to help reduce falls in
Enabling environments
which increases commitment and engagement with the goal over older people by increasing mobilisation, endurance, strength and
Working on what matters
time. balance.
The right information at the right time
Learning new skills • Increases opportunity for behaviour change by enabling people • Supporting practitioners to have conversations that focus on
Tracking change to connect with groups or activities that link with their personal people’s strengths, interests and goals (rather than focusing on the
Celebrating success interests and goals and which unlock new opportunities for social ‘problem’). This could consist of offering coaching conversations in
Managing setbacks support and peer learning. non-clinical settings (e.g. leisure centres) that start with ‘what do
you want to work on?’ and ‘how do you want to get there?’
Case studies • Cornerstone works with people with learning disabilities, physical
Mayday Trust disabilities, autism and dementia. Each person is given the
GoodGym opportunity to select their own care team based on the staff they
FanFit feel align best with their dreams and strengths.
NHS Lothian Cardiac Rehabilitation Service
Macmillan Primary Care Home
Key resources and Generate ideas
references Using the information above, start
to brainstorm ideas to try out in your
organisation or community. Think about how
to co-design ideas with other practitioners
and people in the local community who could
benefit from Good Help.
This guide is interactive.
The side menu and the underlined content can take you to
different sections of the document and external sources. Reimagining Help | p 23Reimagining help
Why do we need to Reimagine Help?
Working on what matters
An evidenced-based approach to ‘help’
Experiencing Good and Bad Help Generate ideas
The guide
Understanding the guide
How do I use the guide? Refine idea
and test
Eight characteristics
Social connections
Enabling environments
Common pitfalls Check in with the evidence
Working on what matters
The right information at the right time
• Organisations may assume that staff already have 1. How will your idea enable people to explain what
Learning new skills
the skills required to ask open questions, set goals matters to them beyond their health condition(s)?
Tracking change
and build people’s confidence to change, but these 2. How will you ensure that staff or volunteers know
Celebrating success
Managing setbacks
techniques require practice and knowledge. how to have conversations that draw on what
• There may appear to be buy-in from senior staff, but matters to people and relate this to behaviour
Case studies the way an organisation is commissioned, regulated change?
Mayday Trust
and evaluated can make it harder to move from 3. How will you ensure that people feel safe enough to
GoodGym
‘fixing’ to ‘co-producing’ solutions with people - for share what matters to them?
Use these questions to
FanFit
example, if services are incentivised to measure assess whether your 4. How does your idea create space for people to
NHS Lothian Cardiac Rehabilitation Service
clinical outcomes (rather than person-centred idea includes the core
develop personal goals and make clear plans for
components of this
outcomes, like confidence). reaching them?
Macmillan Primary Care Home characteristic.
5. How will people be supported to reflect on their
Key resources and strengths and personal achievements and to draw
references on their social networks when developing their
plans?
6. How do you intend to support the person to work
through specific barriers to change?
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The right information at the
Why do we need to Reimagine Help?
An evidenced-based approach to ‘help’
Experiencing Good and Bad Help
right time
The guide Why is this important? What do we mean by right information at the right time?
Understanding the guide
Providing high-quality and easy-to-digest information at the People should be able to access accurate information that helps them
How do I use the guide?
right time helps people to feel in control during challenging times. to feel informed and in control of their health and wellbeing when
Timing is everything - the right information at the wrong time can they need it. It should include consideration of:
Eight characteristics overwhelm people or cause distress, which could lead to them • Timing and type of information: Rather than giving people
Social connections
avoiding or withdrawing from much-needed support. standard information at set points in their health journey, there
Enabling environments
should be opportunities to tailor information to what is needed
Working on what matters
at different points. This can be achieved by asking people what
The right information at the right time
information they want, in how much detail, and when and how
Learning new skills
they want it. For example, post-diagnosis, some people may want
Tracking change
lots of information straight away, but others may want time to
Celebrating success
process the diagnosis and involve their family and friends before
Managing setbacks
finding out more.
• Language: When information is communicated (verbally or in
Case studies
Mayday Trust
written form), it should be done in a way that is non-technical
and empathetic and that does not exacerbate anxiety. Some
GoodGym
.
FanFit
medical terms may induce more anxiety than others - for example,
NHS Lothian Cardiac Rehabilitation Service
a diagnosis of ‘heart failure’. When sharing information, an
Macmillan Primary Care Home
individual’s communication needs should be taken into account
- for example, people with learning disabilities may benefit from
The right easy-read formats, or the support of an advocate.
Key resources and
references information at
the right time
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The side menu and the underlined content can take you to
different sections of the document and external sources. Reimagining Help | p 25Reimagining help
Why do we need to Reimagine Help?
The right information at the right time
An evidenced-based approach to ‘help’
Experiencing Good and Bad Help
What is the behaviour change theory and evidence? Examples
• Asking people open-ended questions like ‘what can I tell you right
The guide Having the right information at the right time: now that would be helpful?’ will create opportunities for people to
Understanding the guide
• Increases capability for behaviour change by ensuring that people let practitioners know what they need from an interaction.
How do I use the guide?
are able to understand and act upon information when they are • Trusted health forums or helplines with specialist advisors that
ready. Education and skills-based interventions are more likely to provide access to instant support at a time and place that suits
Eight characteristics
be effective when people can access information at different points people - for example, the British Heart Foundation’s helpline and
Social connections
in their behaviour change journey. Macmillan’s support line.
Enabling environments
Working on what matters
• Increases motivation by making sure that information provided • The University of Edinburgh has designed an interactive mobile app
The right information at the right time
is in line with the individual’s emotional state. When people are to support parents and carers of children undergoing assessments
Learning new skills
experiencing strong feelings of anxiety, they may not be in a for autism. The app automatically generates information based
Tracking change
position to retain lots of factual information, so this may be better on individual preferences - for example, information on diagnosis,
Celebrating success provided when the person feels more able to take on board new treatment options, lifestyle changes and local support groups.
Managing setbacks information. • Rather than prescribed sessions, organisations like Off The Record
Bristol run drop-in days called ‘hubs’, which give young people the
Case studies flexibility to access information and support at moments that suit
Mayday Trust them.
GoodGym • Groundswell uses a peer advocacy model in which volunteers
FanFit who have experienced homelessness support others to manage
NHS Lothian Cardiac Rehabilitation Service their health and wellbeing more independently. Peer advocates
Macmillan Primary Care Home can share information in a non-medical way based on their own
experiences.
Key resources and
references
Generate ideas
Using the information above, start
to brainstorm ideas to try out in your
organisation or community. Think about how
to co-design ideas with other practitioners
and people in the local community who could
benefit from Good Help.
This guide is interactive.
The side menu and the underlined content can take you to
different sections of the document and external sources. Reimagining Help | p 26Reimagining help
Why do we need to Reimagine Help?
The right information at the right time
An evidenced-based approach to ‘help’
Experiencing Good and Bad Help Generate ideas
The guide
Understanding the guide
How do I use the guide? Refine idea
and test
Eight characteristics
Social connections
Enabling environments
Common pitfalls Check in with the evidence
Working on what matters
The right information at the right time
• Often there is an assumption that sharing 1. How will people easily access the information - for
Learning new skills
information (even in clear language) means that example, in local non-clinical settings or online - at
Tracking change
the other person has understood it, but this is not a time that suits them and in formats that can be
Celebrating success
Managing setbacks
always the case. If people are experiencing strong understood by everyone?
emotional responses at the time or if the interaction 2. How will the information be tailored to people’s
is rushed they might become overwhelmed by preferences - for example, language, format and
Case studies
the information and need more time to process volume? Will there be an opportunity to check that
Mayday Trust
it. For example, when a person is diagnosed Use these questions to the person has understood the information?
GoodGym
with a condition the default might be to give lots assess whether your 3. How will people be given opportunities to ask
FanFit
of information about symptoms, prognosis and idea includes the core
NHS Lothian Cardiac Rehabilitation Service components of this different questions at different points? Have you
treatment options. characteristic. thought about key moments for information sharing
Macmillan Primary Care Home
- for example, transition points when people might
feel most anxious?
Key resources and
references 4. How will you ensure that the information is credible
and up to date? Have you considered different
sources of credible information - for example,
professionals, peer groups, online sources and local
charities?
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The side menu and the underlined content can take you to
different sections of the document and external sources. Reimagining Help | p 27Reimagining help
Learning new skills
Why do we need to Reimagine Help?
An evidenced-based approach to ‘help’
Experiencing Good and Bad Help
Why is this important? What do we mean by learning new skills?
The guide A lack of opportunities for people to acquire new skills can be a major In Western society, a common narrative is that an individual can
Understanding the guide barrier to behaviour change. Organisations that support people to change their life if they simply put their mind to it. This narrative
How do I use the guide? learn and practice new skills will help people be more successful in places a lot of responsibility on the individual without acknowledging
reaching their goals. the wider context of people’s lives or that people need opportunities
Eight characteristics to learn and develop skills in order to reach their goals. It is often the
Social connections lack of opportunity rather than a lack of trying that prevents change
Enabling environments from taking place.
Working on what matters
The right information at the right time When people are equipped with new skills and knowledge -
Learning new skills
for example, training that enables them to enter more secure
Tracking change
and rewarding careers, it can help them to build confidence and
Celebrating success
motivation to change behaviours. It also helps when opportunities for
Managing setbacks
learning are easy to access - for example, low cost or free and located
in non-clinical settings close to people’s homes - see Enabling
Case studies environments, and are flexible enough to provide tailored support
Mayday Trust to those taking part - for example, personalised learning that maps
GoodGym directly onto people’s goals - see Working on what matters.
FanFit
NHS Lothian Cardiac Rehabilitation Service
Macmillan Primary Care Home
Key resources and
references Learning
new skills
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The side menu and the underlined content can take you to
different sections of the document and external sources. Reimagining Help | p 28Reimagining help
Why do we need to Reimagine Help?
Learning new skills
An evidenced-based approach to ‘help’
Experiencing Good and Bad Help
What is the behaviour change theory and evidence? Examples
• Blue Marble training introduces young people to a restaurant
The guide kitchen to develop the skills needed to work in a professional
Learning new skills:
Understanding the guide
• Increases capability for behaviour change by helping people to environment whilst being mentored to support their wider personal
How do I use the guide?
learn how to manage their health and wellbeing and by applying development needs.
skills that help to address the wider determinants of their health, • Envision supports young people to develop skills for adulthood by
Eight characteristics
such as communication skills and financial management. providing opportunities for young people to tackle social problems
Social connections
• Increases motivation for behaviour change, as becoming good at in teams and take community action.
Enabling environments
Working on what matters something (e.g. home cooking) makes a person feel good about • The Stroke Association provides digital training and support
The right information at the right time the behaviour and increases the likelihood that they will do it again to people who have had a stroke to support them with their
Learning new skills (e.g. experimenting with new recipes). communication needs.
Tracking change • The Bromley By Bow Centre understands that health is driven
Celebrating success by social factors, not just medical ones. They offer a range of
Managing setbacks opportunities for skills development in their local community hub,
including money management, starting a business, computer skills,
Case studies creative arts and languages.
Mayday Trust • Body & Soul’s MindSET is a free weekly livestream for young
GoodGym people to learn skills to help manage emotional distress.
FanFit • Foundation for Change offers training courses for people in
NHS Lothian Cardiac Rehabilitation Service recovery from drug and alcohol addiction to achieve their goals and
Macmillan Primary Care Home grow in confidence and self-esteem.
Key resources and
references Generate ideas
Using the information above, start
to brainstorm ideas to try out in your
organisation or community. Think about how
to co-design ideas with other practitioners
and people in the local community who could
benefit from Good Help.
This guide is interactive.
The side menu and the underlined content can take you to
different sections of the document and external sources. Reimagining Help | p 29You can also read
