Find the barrier before sending another reminder

What we found in the news

NHS England's October 2023 inclusion health framework (opens in a new tab) asks services to consider how their design affects people who experience social exclusion. Its introduction identifies:

barriers created by service design

The framework concerns groups facing serious, overlapping disadvantages. It does not explain every missed appointment or unanswered invitation. It does remind leaders to examine the service's own arrangements before deciding that people simply need another reminder.

Why this matters to us

A reminder can help someone who has forgotten. It cannot make an unsuitable appointment time workable, explain an unclear eligibility rule, or supply the confidence to enter an unfamiliar building.

We are interested in what happens between an offer of support and a person's ability to use it. That space contains operational decisions: opening hours, booking rules, information, transport arrangements and who is available to answer a question.

When a service notices repeated difficulties, it has an opportunity to learn. The first response need not be a stronger message telling people to do the same thing again.

Walk through the invitation from the other side

Take a hypothetical day program offering introductory visits. Several people enquire but do not attend. The team has started sending more reminders.

Before adding another message, follow the route from the person's first contact. Can someone find the arrival information? Does the booking require an answer they may not have? Is the start time compatible with the available journey? Is it clear that they can ask about access needs or bring an agreed supporter?

Use the service as it is actually offered, including the telephone route and printed information. A staff member who already knows the building may overlook a detail that matters to a first visitor.

The exercise should produce questions to explore with people, rather than confident conclusions about their motives.

Ask without making people defend themselves

Where contact is appropriate, invite people to explain what made the arrangement difficult or unhelpful. Make it easy to decline the conversation. An invitation to contribute should not feel like a request to justify why they did not attend.

Include a way for staff and community partners to flag recurring obstacles. They may see different parts of the journey. Check these observations with the people affected where possible, because a partner's explanation is still one perspective.

Avoid requiring someone to disclose sensitive circumstances before the organization will consider a reasonable practical change. The team may be able to make directions clearer or explain a booking choice without collecting additional personal information.

Keep immediate needs separate from longer-term service learning. A person asking for help today should not have to wait for the next improvement meeting to get an answer about the support available.

Change one part you can actually influence

In the illustrative program, the team might offer a choice of arrival windows or arrange a short introduction before a larger group session. The right adjustment depends on what people describe and what the service can responsibly provide.

Name the person who can approve the change and the colleagues who need to know. Update the public invitation as well as the staff instructions. If only one receptionist knows about the alternative, access still depends on reaching the right person.

Review what happened after the change. More bookings alone would not prove that everyone found the service easier to use. Ask about the experience and notice who is still absent from the discussion. A useful improvement can coexist with barriers the organization has not yet resolved.

What this means for the people you serve

People deserve a route into support that recognizes different circumstances and choices. A person may decide the service is not for them; that is different from being unable to reach it. Make the available options understandable so they can make an informed choice, and take their account of the process seriously.

The genus connection

Configured genus public resources, calendars and staff workspaces can support clearer information about an organization's services. Reservations and follow-up tasks may help staff manage an agreed next step where those capabilities are enabled.

Technology cannot remove every access barrier. The organization still needs to decide which alternatives it can offer, keep information current and make people available to help. The partner portal overview (opens in a new tab) describes current options for supporting that work.

One question for your next team meeting

Before we send another reminder, what might our own process be asking someone to overcome?