CHAS: a force for economic good

By Rami Okasha, chief executive of Children's Hospices Across Scotland (CHAS)

It costs a lot of money to provide hospice care for dying children. It is highly specialist, demanding very high staffing levels of nursing, medical care and social work. The majority of CHAS’s funding comes from the generosity of the Scottish public, who provide millions of pounds a year in donations. But we also receive important contributions from the Scottish Government and local authorities. We were fairly sure this investment provides good economic sense for the taxpayer, but wanted to make sure. 

Often, the voluntary sector measures itself based on the amount of good things it can do for society. It is something charities are increasingly good at, and not just because many funders demand it. Clearly describing the intended outcomes of projects and services, and then measuring what has happened, helps improve quality. That leads to better experiences for the people we are here to serve.  

At CHAS, we are really interested in what other ways we are creating an impact on society. As a strategic partner of the Scottish Government and local authorities, it is important that we can quantify and demonstrate our added public value. The economic impact of our work is one measure of that. So, earlier this year, we commissioned work, carried out by specialists from the University of York’s Health Economics Consortium (YHEC), which showed that the services we offer are of significant economic and public value. The results are insightful and surprised me. 

The YHEC study showed that CHAS provides over £49 million of economic benefit each year, based on a total expenditure of about £18 million. It is really incredible and far exceeds the statutory funding provide to CHAS. For every £1 of statutory funding received for the year 2018/19, CHAS's experienced staff, generous supporters and dedicated volunteers generated £6.24 of public value in return. 

The medical services provided by CHAS help to reduce GP appointments and hospital admissions. The charity provides step-down care from hospital to hospice for seriously ill children, as well as hospice at-home provision and post-bereavement support for families. We knew these things had good social impact, but are now able to assess the economic impact, and in so doing demonstrate the savings to the public purse that come from investing in the voluntary sector. After all, being able to prove that preventative spend works has been the holy grail of public policy for decades. 

In these challenging times, this analysis presents such a strong testament to the effectiveness of our partnership with statutory agencies in delivering public value. Now more than ever, we need to think forward and consider how we can enable preventative investment that is supporting recovery, benefitting our wider public services and crucially providing choice to children and families. The YHEC report vividly describes, and qualifies, the way CHAS services support families when their child is ill, their family circumstances are complex, and they experience the death of a child.  

The benefits generated by CHAS services clearly demonstrate the potential to reduce demand on the statutory health and social care sector, while also providing choice for children living with life-shortening conditions and their families. The benefits include cost reduction attributable to avoiding the need for babies, children and young people and their families to use health and social care services. These can be either through avoidance of illness, or substitution of care into the hospice or hospice at home setting.  

As well as demonstrating the significant public value of CHAS services, the YHEC study underlines the importance of our ask for continued sustainable funding from the Government for children’s hospice care in Scotland. 

We have seen the need for our services increase and the Covid-19 pandemic has accelerated existing plans to help CHAS reach more families who need us. Having this analysis to inform how our service responds and transforms is key as is feedback from children and families and partners involved in delivering this highly complex care at the toughest of times. 

Additionally, the YHEC evaluation demonstrates that CHAS has the potential to achieve greater still benefits for babies, children and young people, and their families who require our services. It also highlights the significant benefit that CHAS volunteers bring to the children’s charity in terms of both capacity and value.  

Volunteering is at the very heart of everything we do at CHAS and the children and families in our care benefit significantly from volunteers who provide important additional support, and bring additional skills and experience to the care provided. Over the past year, we’ve recruited 20 volunteers and established nine new volunteer roles, with volunteering activities often taking place remotely. We now have over 750 volunteers with them donating 8,900 hours of their time. The value of volunteering must be measured broadly, looking at the benefits for the volunteer, the charity, and the people that charity is there to support – but we should not be shy about the economic activity of which volunteers are part. Harnessing the power of social good to deliver services to a better quality and a better cost than other sectors is an important driver to economic growth and longer term sustainability.  

This is not unique to CHAS, however. Many charitable and similar organisations are major employers and supporters of other small businesses. It is something of which I am very mindful. At CHAS, we employ over 300 staff and strive to be a brilliant employer. We have recently been accredited as a living wage employer and as a disability confident organisation. We work closely with a wide range of small and medium sized businesses who supply our hospices and our teams who work across Scotland. And our fundraising activities have great economic value too: we often book venues for fundraising activities, and our four charity shops play an important role on the high street and in retail zones. 

I firmly believe that measuring a charity’s social impact is absolutely essential and should be the primary measure for charities. It is why charities exist. Even if there isn’t always consensus amongst citizens about which causes are the most important, charities should be able to describe clearly the impact they have on those citizens and the wider world. 

But, I’ve also learnt not be afraid of measuring our economic impact too. As economic actors, charities should be actively thinking in this space too. Charities play a valuable role in strengthening the economy and as such are a vital tool for economic growth. Not only do charitable activities reduce the burden on public services, they also builds resilience and wellbeing of citizens. That has both social and economic benefits, which are closely interlinked. 

No charity is “just” a charity. Charities serve vital public and societal functions, and we should not be afraid of shouting about the economic impact we all have.  

 You can read the YHEC report here: https://www.chas.org.uk/news-articles/economic-evaluation-of-chas-services-published-yhec