Surviving and thriving as a small health and wellbeing charity

Natasha Thomas, Chief Executive of GSK IMPACT Award-winning charity Health Action Local Engagement, reflects on what she has learnt as a charity leader over the past 14 years.

I have been the CEO of HALE – Health Action Local Engagement – in Bradford, West Yorkshire for the past 14 years, and a lot has changed over this time. Our project has evolved from being a healthy living centre fully funded by the Big Lottery with five staff employed by the NHS, to becoming an independent charity employing 28 part-time staff.

The scale of this change presented real challenges for the organisation – and to me personally as a leader – but through being adaptable and open to opportunities we’ve been able to successfully grow and develop. We were lucky enough to win GSK IMPACT Awards in 2010 and 2012, and our charity is a member of the GSK IMPACT Awards Network which has enabled us to continue our learning and development alongside other charities. I have also been a consultant on the Cascading Leadership programme. This experience has given me some real insight into the unique challenges faced by small charities and what’s most important when it comes to surviving and thriving.

GSK Impact Award

A few years ago I attended The King’s Fund’s Top Manager Programme, which really helped me to reflect on communication and culture. I realised that as an organisation we had tended to play a role that is expected (often unconsciously); so for instance I would feel grateful if I was invited to clinical commissioning group board meetings or working groups, and although not shy at coming forward I would often have low expectations of my ability to influence change. Since this training and continued support from the IMPACT Network, I have started to understand and recognise our strength as a sector, distinct from statutory services; that we need to express that strength and that we don’t need to feel grateful for having a place at the table – we should be there. The temptation has been for us to try to mould ourselves into mini-systems that respond to what commissioners want, rather than to be assertive about the improvements our approach and our view might bring to services.

Third sector organisations are typically set up either to fill a gap in services or as a response to an identified need – often working with and on behalf of those people and communities who are most vulnerable and have complex needs. Leading an organisation that works in an area of significant health inequalities, I have constantly asked myself: how can we make things better? How can we provide a link between our communities – local people with chaotic lifestyles – and appropriate services?  To coin a phrase, how can we ensure the right service is in the right place at the right time? Additionally, because we start small we are very agile and able to find solutions quickly, which allows for a person-centred service. We also need to be innovative in relation to funding; contracts often don’t give us enough to cover our overheads so we need to look for additional funds.

As funding has got tighter and harder to secure, and more and more services are contracted out, I believe as third sector organisations we need to avoid the temptation to replicate existing services, but instead keep to our mission as individual organisations. We are able to engage local communities because we speak their language; the challenge that I have tried to reflect on and respond to is how I share my understanding of need, and of ways of doing things differently with my colleagues in primary care, in the care trust, in the local authority and with those in education, the police. I believe the answer is in the small steps of behaviour change. It made me smile the other day when I was writing a report about how we might bring about some changes among local GPs, and I found it was exactly the same as what I might write for bringing about change in a community – community and peer support, offering small incentives and case studies. We all are working within systems that in one shape or another will reflect the expectations of others. As third sector leaders, we need to work with the system to make our voices heard – this might mean learning the foreign language that is spoken, but not that we lose sight of who we are and why we do what we do.

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