3. What this talk covers
• Mid-term strategy review
• Our 20 year impact on stroke research
• Contracted services update
• Promoting our need for voluntary income
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4. 2010 to 2015
Mid term strategy
review
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5. Background
• Our charity – the Stroke Association - is not about just
“surviving” year to year
• Stroke is a big cause and a big responsibility
• Our aim is nothing less than making a fundamental
contribution to lessening human misery
• We have to be a big enough charity to make that
difference: we have to grow…
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6. The story so far…
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7. First phase
2005 to 2010
2005 to 2010 2010 to 2015
2010 to 2015 2015 onwards
2015 onwards
Establishing stroke as a major
Establishing stroke as a major
health concern and developing
health concern and developing
our infrastructure
our infrastructure
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8. Second phase
2005 to 2010
2005 to 2010 2010 to 2015
2010 to 2015 2015 onwards
2015 onwards
Establishing the Stroke
Establishing the Stroke
Association as a major charity
Association as a major charity
player
player
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9. Third phase
2005 to 2010
2005 to 2010 2010 to 2015
2010 to 2015 2015 onwards
2015 onwards
Consolidation and growth
Consolidation and growth
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12. Prevention
• Know Your Blood Pressure reaches 30,000 people a year
• We refer over 4,000 people a year for follow up with their GP
• 50% of people know that high blood pressure is the biggest risk
factor for stroke, and awareness of high blood pressure far outweighs
other risk factors
• Partnerships with Rotary, St Andrew’s First Aid, Ambulance trusts,
Change4life
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13. Research
• Increased our annual spend on research through collaborations with
other funders and the Princess Margaret Research Fund
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14. Research
• UK Stroke Forum going strong with 1382 Delegates at the 6th
Conference in 2011
• Expanded UK Stroke Forum activities to include an annual Northern
Ireland conference in collaboration with ACPIN
• Performing the role of hosting the endorsement programme for the
Stroke Specific Educational Framework from Department of Health
• Secured funding from Skills for Care to become an accredited
provider of QCF training in Stroke Awareness.
• Achieved and retained NHS Information Standard (IS) accreditation
for all our information products
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15. Services
• 340 Commissioned Services
• 289 contracts
• £12.3m Contract income from Health and Social Care
• 586 staff of whom 211 full time and the majority are
professionally qualified in health or social care
• 2,791 volunteers of whom 13% are stroke survivors
• 25% clients of working age and 7% BME
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16. Services
• Moved helpline team from London to Bromsgrove
• Formed Children’s Committee, and secured funding for
pilot children and stroke service development in London
• Developed and integrated electronic client relationship,
management and data system into our work enabling
impact reporting and capacity for research activity in
future
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17. Infrastructure
• Increased accommodation away from London with
Bromsgrove and Cardiff
• Integration of datasets across organisation nearly complete,
providing platform for marketing analytics
• First Capital Appeal success: the Life After Stroke Centre
fundraising appeal exceeded target by 11%
• We now have more than 2000 legacy pledgers
• Quality goals being achieved
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18. But also…
• A hugely successful Action on Stroke Month (thanks to you
for your participation)
• Our new brand, website, intranet, and ever increasing
social media activity
• Doubling of the number of campaign supporters in the last
year alone
• Listening to stroke survivors, leading to our high profile Life
After Stroke and benefits campaigning
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20. Financial changes
Double dip recession
Reduced commitment to give from some donors
Turmoil in the health service in England
UK-wide cuts in health and social care funding
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21. Political changes
Localism agenda in England
Increased nationalism in devolved nations
Demands from beneficiaries for support against
withdrawal of benefits and rights
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23. Where are we now…
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24. Opportunities
• New brand is proving its potential to attract more people
and companies to us
• Recession has, at least, had positive impact on ease of
quality recruitment
• New services developments: Stroke Companion; 6
month,12 month reviews
• Recession creating more partnership opportunities
• Getting closer to large Charity of the Year win
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25. Threats and Weaknesses
• Some small scale competition for contracts
• “Tesco-isation” of voluntary sector continues, making it
harder to get profile
• Concerns about de-prioritisation of stroke due to knowledge
deficit in new structures and closure of stroke networks
• Demand from stroke survivors for support on welfare rights,
we have no objective on this
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26. Threats and Weaknesses
• The cuts of £1.8 million last year have tested and
restricted our abilities as an organisation
• The volunteer support infrastructure we want and need
is not in place
• Staff training budget very restrained, despite new
demands as we gain new services
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27. Threats and Weaknesses
• No cost of living or increment pay rises for two years;
threat of losing good staff increasing
• Graduate recruitment programme closed down
• Business development possibilities suspended
• Marketing and promotion budgets inadequate and internal
organisation needs review
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28. Shared understandings
• Next few years about sustainability and consolidation,
meeting need for £1million extra net per annum
• Need to become more market able, capable of effectively
reaching and relating to key audiences/customers, and
conversion to supporters
• Beyond incremental growth is needed in fundraising, this will
need support from communications to happen
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29. Our structures
• We need to look at our structures to make sure we can
overcome threats and weaknesses…
• We need to better understand and meet the needs of our
audiences…
• …So we will be redirecting resources and investing in
better data analysis and audience insight and in our
marketing
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30. Our structures
• We will move our Business Support team to be part of the
CEO’s office
• Our Partnerships team will move into Communications
• We are shifting the emphasis of our Regional Fundraising
team by making all of our events activity come under one
team and by promoting much more community fundraising
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31.
32. Our 20 year impact on
stroke research
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33. Between 1991 and 2011, the Stroke Association
awarded more than £28 million as project and
project grants addressing issues all along the care
pathway for stroke.
Project and Programme grants awarded broken down by research area (1991-2011 )
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34. Our prevention research
• one in ten people who experience a TIA will go on to have
a major stroke within a week
• treating TIA patients in an emergency TIA clinic can
prevent 80% of them going on to have a major stroke
• the ABCD score to help doctors predict who is most at risk
of a major stroke after a TIA
• improved the quality of carotid artery surgery to prevent
more strokes
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35. Our research has saved lives
• paramedics can use the FAST test to accurately identify
stroke patients
• evidence shows that stroke units save lives
• more widespread use of thrombolytic drugs to dissolve
blood clots
• giving aspirin immediately after stroke can prevent a
second stroke
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36. Our rehabilitation research
has improved lives
• ‘early supported discharge’ so survivors
can leave hospital earlier
• increase in occupational therapy
available to stroke survivors
• Functional Electrical Stimulation (FES) to
improve hand and arm function in stroke
survivors with arm paralysis
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37. Our rehabilitation research
has improved lives
• improved our understanding and
consideration of communication
difficulties
• led to new speech and language
therapies
• web-based tool to improve reading for those with loss of
vision in one eye (Read-Right)
• screening tool to better identify stroke survivors with
psychological problems (BCoS screen)
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38. Research Capacity Building
30 Clinical Fellowships:
46 Junior Research Fellowships/Bursaries:
5 Senior Research Fellowships:
3 Clinical Research Fellowships:
New for 2012: Princess Margaret Research Development Fellowships
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41. Context
• Major restructure in England has led to planning “blight”
• NHS in England to save £20bn
• Cuts to LA funding of 28%
• So far, we have suffered the loss of some services, and
valued colleagues, and had some with reduced funding…
• …But we have made gains too
• Overall at standstill, a remarkable achievement compared
with some other charities
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42. Looking forward
• Recent count, 5 out of every 6 services have contracts with
end dates of next March or earlier…
• …But we expect the vast majority to be renewed
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43. Commissioners as customers
• Social Services (1/3 of our contracts) no change, we
continue to argue our case – and it’s a good case
• NHS Commissioning Managers, those who manage our
contracts remain unchanged
• GPs will be making many decisions, working in Clinical
Commissioning Groups (CCGs)
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44. CCGs: what do we know?
• Like many, we know relatively little
• We have interviewed just under 1 in 10 across the
summer
• No indication that they won’t support stroke, or the
voluntary sector, or that they plan cuts to
community services
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45. We have a strong
case…
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46. And we have a lot
of work to do…
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47. And we continue
to develop new
services.
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51. Cancer is the most
popular cause to
donate to, followed by
children and young
people
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52. “Please indicate which types of charities you have given
money to in the last 3 months, and which you have
volunteered for.” Prompted
44%
Cancer 42%
35%
Children and young people 31%
24%
Hospices 21%
23%
Veterans/ armed forces 17% 21%
Animals 20%
17%
Health & medical (excluding cancer) 15% Nov-11
16%
Older people 12%
13%
Overseas aid and development 24%
13% Sep-11
Rescue services 13%
13%
Homelessness and social welfare 11%
11% Mar-11
Disability
7%
Environment and conservation 6%
Dementia 5% Mar-10
Religious 7%
7%
Sensory I mpairment
3%
Not sure 5%
17%
None of these 19%
0% 10% 20% 30% 40% 50%
Base: 1,000 adults 16+, Britain.
Stroke Helpline 0303 3033 100 Source: Charity Awareness Monitor, Nov 2011, nfpSynergy
stroke.org.uk
53. Competing against
these charities is not
possible, we need to
take a different
approach
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55. Sure enough this is
shown in the
‘spontaneous
awareness’ figures of
charities working in
the health sector
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56. “Please can you name the first charity, voluntary
organisation or pressure group that comes to mind” / “And
which other charities, voluntary organisations, pressure
groups can you think of?”
1% of people name Stroke
Association as a charity working
in the health field ie c 500,000
people.
Base: 1,000 adults 16+, Britain
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Source: Charity Awareness Monitor, May 12 (Online), nfpSynergy
57. Personal situation and
a person’s tastes are
key reasons to donate
to charity
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58. Tastes, preferences and passions,
Charities… “that I admire”… “am
comfortable giving to”
“Things that happen
to appeal to me”
Personal and Professional backgrounds,
“Touch a chord”
“Close to my heart”
CGAP report (2010) “How Donors choose Charities”
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59. Personal links are
demonstrated time
and again by people
fundraising for us
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60.
61. Most of our supporters
have strong, often
personal ties to stroke
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62. Q= What is your link to stroke?**
**this was a survey monkey (online) survey, 3 quarters of respondents were over the age of 46
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63. And here’s yet more
research that shows
these are key reasons
for people donating to
charity
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65. Therefore, targeting those with an affinity to the
cause is not just important for us, it’s essential!!
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79. True or false?
• Stroke Association helps many thousands of stroke
survivors and their families each and every year…
• Survivors and their families feel grateful for the help they
receive, and are likely to feel empathy with the situation of
other people who will have strokes in the future…
• Many stroke survivors and their families will already be
charity-minded and actively give to or support other causes
they care about…
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80. But…
• Although many stroke survivors will go on to support us
through volunteering, currently very few of them or their
friends and family, following their experience of benefiting
from our services, become active donors or supporters
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81. Therefore
• We are embarking on a staff engagement programme to:
• Help fundraisers to build strong, mutually beneficial
relationships with their colleagues from other
departments
• Support all staff to help their colleagues, at appropriate
times and in an appropriate way
• Increase understanding of what voluntary income
provides for the association and how we wouldn’t exist
without it
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82. Our fundraising challenge
• We need to tap this great potential to grow the number of
people who regularly give us a donation
• That means improving our marketing analysis and our insight
into potential donors:
• What can we do for them?
• How do we reach them?
• How do we engage with them emotionally?
• How do we develop our relationship with them?
• How do we convert them from passive to active supporters?
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83. Our fundraising challenge
• To win at least one major charity of the year
partnership
• To build together the stroke community
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84. We all need to be
ambassadors for
our cause…
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This year has been momentous so far… We have launched our new brand We are celebrating 20 years of making a difference And we are half way through our 2010-2015 strategy
Trustees and Directors met in September to review progress The following slides are the major issues covered, and the consequences that flow from that
In 2003 we were a £10 million charity People said we were punching above our weight The truth was we weren’t of sufficient weight We needed to grow, to increase our capability
First phase, 2005 to 2010 Established stroke as a major health priority Established fundraising growth: better infrastructure, a major donor team, donor cultivation, legacy marketing, charity of the year capability, better data about our doors and potential donors. Established ourselves as UK wide Established greater public awareness of stroke Established more service contracts Established all the basics of a voluntary sector organisation Established better relationships with stakeholders
Second Phase Established the Stroke Association as a ”major” charity player: with increased influence, a solid constituency of stakeholders, quality assurance and a stable financial basis Continued to push growth in fundraising and improved our infrastructure Built on public awareness of stroke to make sure people understood stroke and the necessity of more and better services and treatments Established more services, and made sure service contracts covered most of our infrastructure costs
Third Phase We need to consolidate the Stroke Association as a ”major” charity player and brand We need to bring in enough income to meet all of our infrastructure expectations, and want to create substantial surpluses for research and enhanced services. (£50m mark? We want to engage with the public to demonstrate success in research, service improvement and treatments and to accelerate giving as a result We need to grow our service provision meeting more of the needs of more people, with the added bonus that service contracts will more than cover infrastructure costs
Written before change in Government, and dramatic changes in Health, Welfare Benefits, and Social Care policies and structures Written with assumptions on donor behaviours following previous trends Did not factor in the impact of our new brand Agreed more prioritisation to prevention work Key driver to continue growth and improvement curve
We’re going to look at: Prevention Research Services Infrastructure
Events organised by staff and through our partnerships (with Rotary, St Andrew’s First Aid and the Ambulance Trust) enable us to reach a wide audience with the message of high blood pressure and stroke. At these events we are able to capitalise on our relationship with organisations such as Change4Life, who produce useful information to pass on to people who visit our events to encourage healthy lifestyles.
340 Commissioned Services – up from 300 in 2010 289 contracts – up from 250 in 2010 £12.3m (£11m) Contract income from Health and Social Care – up from £11m in 2010 586 staff of whom 211 full time and the majority are professionally qualified in health or social care – up from 500 in 2010 2,791 volunteers of whom 13% are stroke survivors – up from 2530 25% clients of working age and 7% BME
This review is about building on and adjusting in the light of circumstances the 2010 to 2015 strategy document, not a complete rewrite Next few years about sustainability and consolidation, meeting need for £1million extra net per annum just to stand still Need to become more market able, capable of effectively reaching and relating to key audiences/customers, and conversion to supporters Beyond incremental growth is needed in fundraising, this will need support from communications to happen
We need to look at our structures to make sure we can overcome threats and weaknesses We need to better understand and meet the needs of our audiences – our beneficiaries, our volunteers, our campaign supporters, our donors and, crucially, our potential donors So we will be redirecting resources and investing in better data analysis and audience insight and in our marketing
We will move our business support team to be part of the CEO’s office - This will help us to drive improvements across the Stroke Association and to improve our planning Our Partnerships team will move into Communications `– so we can really develop our work with stroke survivors, stroke clubs and other partners and so that work can improve our external communications And we want to shift the emphasis of our regional fundraising This emphasis on community fundraising fits with the challenge of localism that we face and our need to develop the stroke community through more volunteering, through our community development pilots and through the building of our campaign supporter base
But let’s move away from strategy to look at the impact we have had with our research over the last twenty years… 20 Years of Stroke Association Research Funding Between 1991 and 2011, the Stroke Association awarded more than £40million to support vital stroke research. This research has had a big impact on our understanding of stroke, on the way stroke is treated in the UK, and ultimately on the lives of stroke survivors and their families. Our funding has provided a lifeline for stroke researchers and clinicians at a time when funding for stroke research was notoriously low. Our priority has been to fund clinical research that makes the maximum possible difference to the lives of people affected by stroke.
shown that one in ten people who experience a ‘transient ischaemic attack (TIA)’ will go on to have a major stroke within a week shown that treating TIA patients in an emergency TIA clinic can prevent 80% of them going on to have a major stroke within 3 months developed the ABCD score to help doctors predict who is most at risk of a major stroke after experiencing a TIA improved the quality of carotid artery surgery so that more strokes are prevented
We’ve shown that paramedics can use the FAST test to accurately identify stroke patients . This research formed the basis of the FAST stroke recognition campaign. We’ve contributed to the evidence to show that stroke units save lives (Nottingham Stroke Unit study). We’ve promoted the more widespread use of thrombolytic drugs to dissolve blood clots during an ischaemic stroke (International Stroke Trial-3 feasibility study). shown that giving aspirin immediately after stroke can prevent a second stroke (co-funding of the International Stroke Trial-1).
developed a programme of ‘ early supported discharge ’ so that stroke survivors can leave hospital earlier after their stroke increased the amount of occupational therapy available to stroke survivors living at home or in care homes developed Functional Electrical Stimulation (FES) to improve hand and arm function in stroke survivors with arm paralysis.
Our rehabilitation research has: improved our understanding and consideration of communication difficulties after stroke led to new speech and language therapies for patients with communication difficulties developed a web-based tool to improve reading in stroke survivors with loss of vision in one eye (Read-Right) created a screening tool to better identify stroke survivors with psychological problems (BCoS screen)
Between 1991 and 2011, we awarded more than £12million to build stroke research capacity Awarded 30 Clinical Fellowships to talented doctors to become stroke specialists, many of whom are now leading stroke units and services around the country or are actively involved in clinical stroke research. Awarded 46 Junior Research Fellowships/Bursaries to allied health professionals to study for a PhD and embark on a career in stroke research. Awarded 5 Senior Research Fellowships to allied health professional to built up their own stroke research group. Awarded 3 Clinical Research Fellowships in collaboration with the Medical Research Council to allow doctors to pursue a career in stroke research and develop a research group. New for 2012: Princess Margaret Research Development Fellowships Flexible award for supervisors to build research capacity. “ When I started, in 1992, stroke was an area of research that the Medical Research Council would barely entertain. In the early 1990s only three people [in the UK] were interested in stroke; about seven years later nearly 100 people were training to be stroke physicians and now 20 years later we have the NIHR Stroke Research Network and all the major research funders investing in stroke. ” . Professor Marion Walker MBE - PhD and first lectureship post at Nottingham were both funded through the Stroke Association chair. Professor Walker was one of the first occupational therapists to receive a PhD. She is now an international leader in stroke rehabilitation.
Plans to rapidly grow services by 2015 have had to be re-thought No growth next year, then gradual return to growth the year after and continuing slowly Unless a new service type were to “take off” again
Immediate future Recent count, 5 out of every 6 services have contracts with end dates of next March or earlier But we expect the vast majority to be renewed
Social Services (1/3 of our contracts) no change, we continue to argue our case – and it’s a good case NHS Commissioning Managers, those who manage our contracts remain unchanged GPs will be making many decisions, working in Clinical Commissioning Groups (CCGs) Many influencers too!
We meet mainstream policy e.g. 6/12 reviews, supporting self management, control through information In every service we can demonstrate outstanding outcomes Our audits show that we can save the NHS and social care money
Our managers face an enormous task in converting our contracts to new CCGs And we have to promote better what we do e.g. our Communication Support publicity over the winter and spring
Piloting services that help “transfer of care” (discharge) and prevent readmission Self-management support, including new technology Supporting volunteers and communities to extend and enrich services into the long-term
This is prompted awareness by total marketing spend – mostly fundraising marketing e.g. Direct marketing… as you can see, there is a direct link between what you spend and how well known you are
BUT…..1% yet this is still 500,000 people!!!
This is demonstrated by sector-wide evidence
And by what we know about people who do events for us
And by what people who donate to us tell us
And by yet more sector wide evidence
Our light bulb moment… whoops, forgetting our carbon footprint here
That’s better…. So, our light bulb moment here is that we need to re-focus our efforts on reaching out to people that have some affinity to stroke, some understanding of the devastating , effects of stroke either personally or professionally.
… I hear you ask
Well. Lets look at an example from another charity – Macmillan Cancer Support. Long held up as a good example of a successfully function organisation, a successful brand and mature fundraising operation. Some clever people at Macmillan realised that for every person they supported through their Cancer Support work…
… There was a network of 17 people that were ‘touched’ in some way by the cancer the Macmillan beneficiary was experiencing. This was therefore the size of their potential support – the beneficiary and the 17 people surrounding them.
Now…. Lets apply the same logic to the Stroke Association. Every year, we directly reach around 35,000 people through our Life After Stroke Services…
I’m sure you’re all familiar with your 35,000 times table, so you can do the sum… Using the Macmillan model (which may or may not be correct), that’s 595,000 each and every year that we could view as potential supporters
And imagine what that is over the next ten year period? The answer?
In a nutshell, that’s a lot of people that should be warm to us….
A huge amount of people that should have a reason to support us
A gigantecimal amount of people who should be choosing us above any other cause
A whopping great big number of people that represents the size of the opportunity facing us. Our challenge is to work out how best to get our messages to them and through them to others
Currently the Stroke Association helps many thousands of stroke survivors and their families each and every year. We’ve already seen that’s TRUE – it’s currently at least 35,000 each year and you can double that figure if you take into account calls to the hotline for example Survivors and their families feel grateful for the help they receive, and are likely to feel empathy with the situation of other people who will have strokes in the future. We know that’s TRUE because, our latest collated national impact survey results showed that 87% of respondents said that they would recommend the Stroke Association’s services and we’ve already demonstrated that personal experience is more likely to result in support Furthermore, many of them will already be charity-minded and actively give to or support other causes they care about. Well, that’s probably also TRUE… Giving is good. We love to give. We are a giving nation. Giving makes us feel good about ourselves. Giving is what makes Britain Great.
Although many stroke survivors will go on to support us through volunteering, currently very few of them or their friends and family, following their experience of benefiting from our services, become active donors or supporters of the charity. This is the tantalising gap we are deciding to fill.
We are embarking on a staff engagement programme that will help create and maintain a culture of the whole organisation supporting the Stroke Association to be successful by increasing support from those closest to our cause.
We need to win at least one major charity of the year partnership We need together to build the stroke community in very locality to help us in our work to campaign for better stroke services or to defend those under threat; to volunteer with us to provide more support to stroke survivors; and to help us to raise the funds that make all of our successes possible.