Dr Emma Miller, Senior Research Associate at Strathclyde University, since 2012, talks about the importance of good conversations and the Meaningful and Measurable project which proved that conversations can be critical in restoring a sense of identity, giving hope and enabling people to actively shape their own support.
Keeping a focus on what matters to people who use services should be a priority for everyone involved. Yet, no matter how many initiatives are introduced to make this happen, we still often struggle to be heard when facing systems that exist to support us.
In Scotland, there has been a focus on personal outcomes (what matters to people) through various policy initiatives and across services, for several years now. While still a work in progress, embedding an outcomes focus in organisations does make a positive difference to people’s lives. But until recently, we didn’t have an evidence base to support this claim.
Meaningful and Measurable was an action research project, funded by the Economic and Social Research Council, involving 3 universities and 8 services. The project was collaborative, aimed at sharing learning to progress knowledge about how best to improve outcomes with people, and produce evidence about the difference this makes.
There are five key messages from the project. Perhaps most important of all is the importance placed on good conversations, by people using services and staff. The project proved that conversations can be critical in restoring a sense of identity, giving hope and enabling people to actively shape their own support. A good conversation can be an intervention in its own right, even where a person is unable to fully engage in a verbal conversation. And how that is written down really matters too, again in relation to self-identity, and in how the person is viewed by the agencies who support them.
However, what matters to people can be easily lost in our complex approaches to evaluation and accountability. If we only measure what matters to systems, as with most traditional performance measurement frameworks, then good conversations get squeezed out. This tension was well expressed by a carer support worker:
“And the conversation is the crucial thing. It’s about how you record it. You know, and it’s the difference between having a conversation and going and recording it, as opposed to having a record…or a way of recording, which is then imposed on the conversation”
Although not everything that counts can be counted, it is possible to generate meaningful information from conversations about what matters, and to track progress over time for the person and the service. Amazingly, lots of practitioners are managing to work like this, despite the challenges most are facing. Where the organisation keeps the primary focus on ‘improving’ how it engages and works with people, and the secondary focus on ‘proving’ to external bodies, progress is possible. This is relevant to all of us because we all need support at some stage(s) of life, as do people we care about.