A bedside view of public services

charlotte-ravenscroft-blog-07-09-2015-holding-babyA year ago, my little boy was born in a London hospital. With its 24-hour 1-2-1 care for newborns, it was the Rolls Royce of NHS services. I will forever be grateful for the care he received. Yet it was also the little things that mattered. We had the time to ask questions. A nurse held my hand.

While on maternity leave, I’ve been noticing the highs and lows of a whole range of other services. From GPs and hospitals to Children’s Centres, libraries, large and small charities. Invariably funding pressures weigh on them all – of course, nothing else is 1-2-1 these days – yet the quality of these services have often exceeded my expectations.

Three things have stood out:

  • Kindness – the people who have said hello, remembered names, carried buggies. By contrast, quite a few times I’ve been told to ‘queue over there’ and it’s not the friendliest of welcomes.
  • Simplicity – the straightforwardness of being able to call and speak to someone. Drop-in sessions. A well-publicised schedule, an easily navigable website.
  • Accessibility – the availability of help at home, or at night. Clean changing facilities. A working lift (you only appreciate this once you’ve encountered the opposite, with a buggy, at rush hour).


I appreciate of course that these things can cost money – but they also point to simple changes that don’t need to cost much. I think this is what Jeremy Hunt’s ‘friends and family’ test in the NHS is about. However reductive a measure it may seem to the professionals, it captures something about your personal experience and the way a public service ought to make you feel: safe, respected, supported.

Which could bring me on to a litany of woes about what’s wrong these days. But suffice it to say, most services, organisations and people I have encountered have been good or at least evidently driven by good intentions. A few insights that I have gleaned may be useful for some.

  • Systems – Often systems seemed organised around staff, or worse, bureaucracy, rather than the needs of patients or service users. The postnatal ward with its lights on all night. Midwives filling out repetitive forms, by hand. Unannounced closures (arriving in the snow to be told ‘we’re not allowed to call you because of “harassment” rules’).
  • Measurement – I’ve been asked about my health outcomes from eating a sandwich at a city garden shop and whether a five minute introduction to a service improved my wellbeing. The pressure on charities in particular to demonstrate short-term impact by their funders can be counterproductive.
  • Charging – Several publicly-funded mum-and-baby classes in my borough were almost exclusively attended by investment bankers and similarly high-flying professionals. Charities shouldn’t be afraid of considering whether any of their clients could afford to pay or could be invited to make a donation – especially if it would enable them to offer more free support to others.

Finally, this year has been a useful reminder that no sector has a monopoly on quality. I’ve been overwhelmed by the sheer number of high-quality services and products that I didn’t know existed before in the public, private and third sectors. From NCT volunteers and charity phonelines, to my GP and library storytime, to google and even Euan the Sheep, what matters isn’t where help comes from but that it helps.

I’m aware that the media has not always painted the charity sector in a good light this year. Yet it’s worth remembering that personal experience trumps pretty much everything else. Changing public opinion via policy and press coverage is difficult for most charities; continuing to show people how much you care about them through the work that you do, and how you do it, ought to be second-nature.


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Charlotte Ravenscroft was NCVO’s head of policy and public services. Charlotte’s wrote about funding, public service delivery, and strengthening the evidence base for voluntary action. She has also worked at The National Lottery Community Fund and the Department for Education.

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