By Sophie DiMauro, Reducing Inequalities Communications and Engagement Manager at Bradford District and Craven Health and Care Partnership.
“Stories are data with soul” – there are many wise words our national NHS director of inequalities Dr Bola Owolabi has said over the past few years, but it was this sentence that really stuck with me.
Stories or ‘case studies’ are often seen as ‘nice to haves’ and something that can support the work we deliver. However, it has become clear to me that actually, real, raw and powerful human stories need to be core to our work, whether this be with the people we serve, or with the colleagues who make up our workforce.
Data + stories
Data alone is not enough to convey a message. It is crucial that we are led by data and that it helps the story we want to tell. But if we want a message to really resonate, we need to appeal to the emotional side of the brain, as well as the rational. Blending stories and numbers together can be extremely powerful.
Stories are data with scars, tears, joy and laughter left in. They make people feel emotion and empathy. Stories compel people to make change happen. Together with well-presented data and evidence, a story can communicate the impact of important work to reduce inequalities.
Qualitative evidence is just as important as the quantitative. It allows us to view matters from a different perspective and can provide context. When data is presented correctly, it gives us a tangible hook – we can capture attention with a crucial statistic. In Bradford District and Craven this is the fact that people living in deprived areas of the district are more likely to die sooner than those in less deprived areas, with this difference being as much as 10 years. Stories then sit with the data to bring to life what this actually means for people living locally.
Stories help us show the human side of projects and interventions. As part of our Reducing Inequalities in Communities programme I was responsible for collecting human stories from local people involved in our projects to hear the impact the interventions had on them. This involved identifying a key factor from each project which had the biggest impact on improving a person’s quality of life; collaborating with projects and those working directly with patients and communities; going out to meet amazing people; and capturing, editing, and presenting their stories.
I learnt a few things during this process:
- Case studies and stories are different – The Human Stories exercise was not about collecting lots of case studies – I decided to go beyond this with different formats. Case studies might show indicators of success, but they aren’t enough to connect with people. To me, case studies should be seen as more of a starting point, which we then take and develop a strong story where people feel emotion.
- Quality over quantity – It’s better to have one powerful and emotive story, than five that just miss the mark, or don’t convey the message that the people who have trusted us to share their story want them to.
- People first – Stories are people gifting us their experience – it should be up to them how they tell their story (including using words that are important to them), and they have the right to withdraw their story at any time. Ethically, we must respect their wishes.
- Keep it simple – When providing context around a story, don’t assume the audience knows what you know. Set the scene with non-clinical and clear language. These stories are from people’s lives, they’re not just a patient or a number. Clinical speak is cold and takes away from the story. Talk human and use emotion to tell the story. We can also keep it simple with the storyline, most stories follow the same narrative arc: problem, solution, outcome.
- Start with your audience in mind – people want you to share their story and you have a responsibility to make sure the right audience hears it. Think about the best format for the story, not just defaulting to video or written. There are many compelling formats: video, infographics, audio, photography, blogs, podcasts.
- Listen – Sometimes conversations go down an unexpected route and this is okay. Questions are important but I found that it was key to actively listen to what the person I was talking to had to say. I didn’t use a ‘one size fits all’ list of questions. Letting a story unfold naturally is often where you find the gems of insight that have real power.
I’ve often found that people want to gather stories at the end of a project, to support the evaluation. However, if we are doing work that directly impacts the lives of people, it is our duty to have conversations and engage with people throughout a project, not just when we need a case study. If we link in with people from the start, we can create a culture of storytelling which allows us to better connect with people and communicate important messages. Sometimes the interviewer might not be you directly but someone who is trusted, who then will be responsible for sharing their story with you for the intended audience. For example, this could be a carer or a trusted community member who has an established relationship with the individual.
Connecting, listening to and having a consistent feedback loop with communities on an ongoing basis will also help us build trust. This is something that is being demonstrated through the partnership’s ‘Listen In’ engagement work and through our ‘Listening Rooms’ project as part of our local equity, diversity and belonging programme.
When we don’t have an ongoing relationship with people – whether this be our communities or workforce – capturing stories becomes difficult because we don’t have trust. Trust to tell a story takes time. It is important to be sensitive and support the people who choose to put their trust in you to tell their story, especially if the person is vulnerable. This is a privileged position to be in. Sometimes telling a story can be triggering or difficult, so some knowledge of how to handle disclosure may be necessary. We must also respect the person’s personal views and experiences; they will be different to ours.
How can stories help us change the inequalities narrative?
The national NHS framework talks about tackling inequalities in healthcare access, experience and outcomes. At a local level, the work we do needs to align with this, and the impact it is having on these three areas needs to be clear through the data we share and the stories we tell.
Paired with data, stories can help us challenge our own stereotypes, biases and assumptions and raise awareness about inequalities and injustices that people may not be aware of or have chosen to ignore. Not only can stories help us amplify the voices of those who have been and are still discriminated against, but they can inspire people to take action to reduce inequalities and promote social justice. Stories can bring hope by highlighting how local people have overcome adversity and made positive changes to their lives. This can inspire others to do the same. Our stories keep our focus on the ‘why’. They speak to the soul and move us to take action or to think differently.