When contemplating the huge challenges facing our healthcare system and the increasing amount of lonely and isolated elderly people in the UK, I end up in the same place: why not copy the Jersey Post?
A couple of years ago the Jersey Post (Jersey's postal service) was in a bad place. It had a poor brand image and was losing employees as it confronted the reality of the digital age along with most other postal services in the world. In addition, Jersey has a burgeoning ageing population and one in five households has someone with a disability.
A charming and perspicacious gentleman called Joe Dickinson, an employee of the Jersey Post, came up with a deceptively simple solution: the Call & Check service where postmen call regularly on those who are vulnerable and living alone and literally ‘check in’ on their welfare with a few friendly questions. They report back to family or call the mandatory emergency contact if urgent action is required. A great idea with all sorts of physical, emotional and financial benefits. But in my opinion, Joe’s real genius was turning this into a live pilot: it’s been running since November last year in St. Brelade with 25 islanders taking part; it won the Jersey Post a prestigious international award and it’s about to roll out in two other parishes prior to rolling out across the entire island. It seemed like a good idea to experience Call & Check first hand.
Joe, David and Karl prior to embarking on a Call & Check experience
I flew to Jersey in the company of David McCullough, CEO of the Royal Voluntary Service and his Director of Strategy & Development, Karl Demian, who had been equally inspired by the scheme. Joe picked us up (looking exactly as we’d envisioned) and we joined the endlessly energetic and amicable postman, Ricky Le Quesne, on two of his Call & Check visits. Whilst these were clearly the poster children of the pilot, it was difficult not to be struck by a number of things. Five to be exact:
1\. Shades of Loneliness:
Both of the ladies we visited with Ricky had reasonably extensive family living on the island (which you can drive around in just over 2 hours). As they talked about the nagging loneliness that comes with the passing away of both partner and friends and the loss of independence from being unable to drive or walk very easily, I couldn’t help thinking of the thousands of elderly living alone in the UK with no close family and restricted mobility. How much keener their sense of isolation? How much more relentless their solitude? It was a sobering realisation and gave me a renewed sense of urgency around the need for action.
2\. A question of time:
Our second lady, Margaret who is 87 years old, had the undeniable chattiness of the lonely. Again, one couldn’t help thinking about the UK mainland equivalents and asking oneself: how would a system so focused on operational efficiency embrace a service whose impact requires a certain generosity with time? I couldn’t imagine stalling Margaret in mid stream without it feeling somehow cruel….so how might we design around such a tension?
Ricky on a Call & Check visit with Margaret
3\. Attracting those in need:
We heard that many of the islanders who signed up did so as ‘self-referred’ even though one lady confessed to thinking of it as ‘a bit of a joke to start with’. That’s encouraging news but as discussed in my last blog, huge swathes of the lonely and isolated will not self-identify so how might we help others sign them up without their loss of dignity? What is the right language? What happens in the absence of family and friends?
4\. The right business model:
We learned that currently C&C is a free service but it’s estimated that each visit costs the Jersey Post the equivalent of a recorded delivery (£3.75). But where would the greatest financial value be realised in this service? So far, Call & Check has prevented a couple of A&E scenarios so there is arguably a longitudinal benefit for the NHS if it's operating at scale. A subscription service or ‘peace of mind tax’ is potentially a great revenue stream for any delivery service. Then there’s a multitude of future possibilities: think about technology-enabled solutions that help with adherence and missed GP appointments equating to millions of pounds in savings for primary care. So who should be funding a scheme like this?
5\. Recruiting for empathy:
Lastly, you really need an empathic workforce to deliver this. Imagine a suicide watch on your postal round. Imagine curtailing Margaret’s stream of conversation without sounding villainous because you have a round to complete. Think about those who revile ‘being watched’ or those in a dire situation at the time of calling. How patient and gentle and endlessly kind one would need to be. How many Rickys are out there and up for it?
In many ways, Jersey is a brilliant petri dish - a showpiece of all that might be on our larger, more complex and possibly more hostile island. But Jersey has some unique characteristics: business and the community blur into each other; the Jersey Post is a PLC; there is a community proximity that comes from a very small island and the spotlight and judgement may well be inclined towards the benevolent end of the scale . Whilst I am a huge admirer of Joe’s passion and stamina, we’ll need it by the bucket-load to try something similar over here.
But what an incredible design challenge. What barriers to overcome; what inherent tensions to circumnavigate; what nuances to tease out and what assumptions still to test. So perhaps it’s not a straight copy but how I wish, at the very least, we could be inspired to act like the Jersey Post.
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