Helplines and advice lines: practical learning for remote service delivery
Covid-19 forced most charities to start delivering some services digitally or by phone, often for the first time. As we emerge from lockdown, many organisations will be thinking about how to balance this new 'remote' offer with their existing face-to-face activities.
Here we capture ten key things to consider when looking at delivering information, advice and support services differently post-lockdown, based on learning from providers of well-established helplines and advice lines.
- 1. Check that your service is needed
- 2. Establish what your callers want and how you will respond
- 3. Be clear about what your service is and what it offers
- 4. Think about how you’ll manage demand
- 5. Choose your technology carefully
- 6. Put quality and safeguarding measures in place
- 7. Skilled staff and volunteers are key to a quality service
- 8. Take care of wellbeing
- 9. Create information resources that complement your work
- 10. Think about how you will collect data and report on the difference you are making
1. Check that your service is needed
Before starting or maintaining a remote service, it's worth checking whether others are already delivering something similar. They may have more experience, a strong reputation or be better resourced than you to provide this long-term. The directory of Helplines Partnership members is a useful starting point.
If there's already a service offering specialist support on a similar issue, consider signposting to them, rather than setting up something new. HeadStart Blackpool planned to set up a helpline as part of their service to support young people's mental health, but young people told them, "Childline is better and free." Instead, they used the money they would have spent to promote Childline and invest in other wellbeing services.
Explore ways to collaborate with others. Partnerships can improve your service by:
- Ensuring a steady flow of referrals. Parents Against Child Exploitation (PACE) say that parents find out about them from the internet; referrals from statutory services and children's and young people's charities, and through word-of-mouth.
- Ensuring your information is accurate and up to date. The Crohn's and Colitis UK information and support helpline in Scotland worked closely with expert partners, including the British Society of Gastroenterology and the British Society of Paediatric, Gastroenterology, Hepatology, and Nutrition (BSPGHAN), to ensure that their information about coronavirus was accurate.
- Increasing access to specialist advice. 78 local Citizens Advice offices in England have a welfare benefits advice project funded by Macmillan Cancer Support. The Multiple Sclerosis (MS) Society partnership with the Disability Law Service (DLS) offers free legal advice on issues including disability discrimination and community care in England and Wales.
- Avoiding sending callers round the houses. Signposting agreements with partners, and the right technology to support them, can prevent callers having to make numerous calls and repeat their story multiple times, saving them time and money.
2. Establish what your callers want and how you will respond
Think about how people will want to contact you. Advice and helplines are typically delivered by telephone, but many are 'multi-channel' and use other communication tools like email, text messages, online chat or social media.
Make it clear what your service will offer. Helplines and advice lines provide a safe, confidential space to talk about things people may find difficult to share with family, friends, or with face-to-face services. They are often free or low-cost, and may be the first step in the caller's journey.
Many sit alongside a range of other services. Like the LGBT Cymru helpline, which is a gateway to other services like counselling. Since Covid-19, they've found not only do more people want support, but they need more of it. This could mean someone to talk to in confidence, 'support buddying' for those who are particularly lonely, or counselling sessions.
Starting small can give you time and space to establish the demand for your service, and what, specifically, callers want. The Muslim Women's Network UK established its helpline from an understanding that other service providers weren't meeting the needs of Muslim women and girls. With an initial small grant they handled 814 contacts from 335 women in the first year. This helped them secure funding to expand the service, which now supports around 100 callers each month.
It's also important to consider the following:
- Your opening times must be accessible to your users - that might mean evening or weekend working.
- There may be predictable times of the year when people most need support, or you may work with people in crisis or with health conditions that can happen suddenly and unpredictably.
- Your delivery channels should be accessible to everyone, especially if you're supporting people with a disability, groups who largely communicate online, or beneficiaries who are only comfortable with the telephone.
- Be clear about the reasonable adjustments that people can expect. This may include text relay services for people with hearing impairments, or information in alternative formats like braille or easy read.
- Decide if you can offer choice to callers. For example, Compassionate Friends offer the option to talk to a call-handler of the same sex (dad to dad, or mum to mum). Others operate on a strict rota basis, where it is not possible to ask for a named or specific advisor.
- You may need to offer interpretation or translation if you are working with people whose first language is not English or Welsh.
The FreeVA helpline supports survivors of domestic and/or sexual violence. Some of their team members speak more than one language and they use a third-party service to provide interpreters, who can join the call to communicate in the caller's preferred language. They also provide a text-based service for people who are deaf or hearing impaired, or who aren't quite ready to talk.
3. Be clear about what your service is and what it offers
Most people use a helpline or advice line at a time of stress or crisis. Being clear and specific about what you can and can't offer is important. It helps manage peoples' expectations and ensures they don't feel disappointed. You can set this out on your website or in marketing materials.
Compassionate Friends provide a helpline for bereaved parents and their families. Their website states that people can ring the helpline, "once, many times or simply from time to time," and that it doesn't matter how long the caller has been bereaved for. "Everyone's loss and way of grieving is unique so please do phone when you feel the need."
- offer an impartial listening ear, emotional support, reliable information, and signposting to specialist organisations;
- give callers an opportunity to talk and be listened to;
- reassure callers they aren't alone in what they are going through and help people feel heard and understood;
- don't tell people what actions to take, or undertake work on the caller's behalf;
- provide information and resources that enable people to make more informed decisions for themselves.
Helplines may employ paid staff, or use volunteers, sometimes with personal experience of the issue they support.
Survivors of Bereavement by Suicide (SoBs) gives confidential peer support to around 7,000 people every year. Their volunteers have been bereaved by suicide so, whilst many callers don't initially know what they want to talk about, the empathetic approach means they quickly feel able to talk freely. With National Lottery funding, SoBs have employed a coordinator and paid for training and resources to support volunteers like Josie, who explains, "SoBs offers something that a lot of counselling can't provide. People who understand what you are going through because they have been in your shoes."
In addition, advice lines:
- usually provide specialist, personalised advice on medical, financial or legal matters;
- often outline rights, options and choices and give advice on the steps to take to resolve an issue;
- may employ qualified professionals like solicitors or nurses;
- may employ people or volunteers with personal experience of their specialism;
- may offer individual casework.
Parents Against Child Exploitation (PACE) provides ongoing telephone casework for six to 12 months, plus access to peer support through an online Parent Forum. One parent explained that, "PACE helped me to understand exactly what was going on with my daughter and advised me on who was best placed to help. But it was enough just to know that there was somebody there to listen."
4. Think about how you’ll manage demand
Consider the likely demand for your service, the pros and cons of different ways of delivering it and how you will resource this. Multi-channel access helps make your service more inclusive but comes at a cost as you need to have enough people to manage them all.
Calls offer the most time to discuss issues in detail, compared to text messaging or email. But, if demand outstrips your ability to reply, you'll need to think carefully about things like whether or not to offer a call back service or how you'll manage confidentiality.
An unanswered call, or a long wait on hold, can be distressing for callers, so think in advance about how you will mitigate high demand.
- direct people to quieter times via a recorded message or your website;
- provide answers to frequently asked questions online;
- use a virtual receptionist service to triage calls;
- collect and use data to plan your staffing levels, ensuring more people are working during busy times.
Emails and texts can come in at any time of the day or night and may quickly become overwhelming for small organisations. We've heard of one that received 100 WhatsApp messages from a single person in one night.
5. Choose your technology carefully
You may need to invest in new technology if you need a sophisticated way to distribute calls between advisors, transfer people to a partner organisation or collect call data. The right technology won't be the same for everyone.
- Will your call handlers work at a fixed location or between their home and office?
- Who are your callers and what technology are they comfortable using?
- How important is confidentiality? Do callers need to cover their traces for their own safety?
- How complex are the issues you deal with? Is your preferred tech a suitable channel for this level of detail or complexity?
- Do you need call statistics to help manage peaks and troughs of demand?
- What reporting do you want to be able to provide to your trustees or funders? What data will you need in order to do this?
Also think about who will cover the cost of the call – you or the caller - and if it's safe for your number to show up on a caller's phone bill. The Helplines Partnership offers a range of freephone numbers that are free to call from UK landlines and mobile phones and that are not listed on itemised phone bills. This offers additional confidentiality for vulnerable callers, but the helpline provider bears the cost, so you will need to budget accordingly.
6. Put quality and safeguarding measures in place
"It is better to provide an effective, well-resourced helpline for a few hours a couple of days a week than a poor-quality, under-resourced service for longer periods of time." Helplines Partnership
All helplines must provide high quality, reliable information that is up to date and evidence based. You also need to pay attention to customer service, so that callers have a positive experience. And you must put in place effective policies and processes.
The policies you need will depend on the nature of your service, but basic things like explaining whether calls are confidential and the legal requirements on when you may need to breach confidentiality; what will happen to any data you collect; and what will happen if you identify someone as being at risk, are a good foundation.
Some services require Disclosure and Barring Service (DBS) checks for staff and volunteers.
Be sure that you have the right insurance in place. Professional indemnity insurance offers cover in case of legal claims against your services or advice. If you use volunteers you'll need to speak to your insurer to arrange cover that includes them in addition to paid staff. Umbrella organisation like NCVO and SCVO offer a range of advice on choosing an insurer.
You will also need guidance to help staff make tough decisions around how to manage or end calls that become difficult or abusive, and how to handle repeat or nuisance callers.
Some helplines work towards external quality standards to help them continuously improve. A number of standards exist for health information and customer service, and the Helplines Standard accredits best practice in helpline work.
Look to others for good practice and advice when you draft your policies, most helpline managers are generous and willing to share their own policies, and the Helplines Partnership offers helpful resources like a toolkit on safeguarding.
7. Skilled staff and volunteers are key to a quality service
"Great helpline volunteers do more listening than talking, are comfortable listening to the experiences of others and pay attention to their own well-being and boundaries." Survivors of Bereavement by Suicide (Sobs)
All staff and volunteers must have detailed knowledge of their area of specialism, as well as skills to manage calls well. This includes listening, empathy and supporting callers through difficult emotions.
When recruiting it's important to test for the full range of skills. Whilst specialist thematic knowledge can be taught or acquired on the job, attitudes and behaviours may be harder to change. MWN UK have to reject some candidates at interview stage because of lack of commitment to their ethical principle of, "non-judgemental support."
A helpline role can mean a very steep learning curve for new staff and volunteers so ensuring they are well supported is vital. Initial induction and ongoing training should include:
- practical skills, like how to use the phone systems, IT and databases;
- 'soft' skills, like active listening, effective use of questioning and how to manage difficult calls;
- specialist, in-depth knowledge of the issues you work with.
These are essential and must be updated regularly. Most helplines do this through a mix of induction, regular scheduled training and ongoing peer support. This can include pairing new advisors with a more experienced buddy, mystery shopping and call monitoring or recording. You should make it clear if you record calls and ensure that your policies account for this.
Be clear about what is and isn't acceptable behaviourally too, in order to reduce risks for both the caller (being given subjective, biased or inaccurate advice) and the call-handler (triggering or reliving past trauma). Openly discussing feedback and learning helps ensure that advisors are confident and equipped to manage a complex range of questions and situations.
8. Take care of wellbeing
Dealing with calls about upsetting issues, and where people express strong feelings and emotions, can be tough. They may bring back personal memories and experiences for advisors with lived experience of similar issues. So it's important to support your staff and volunteers to maintain their wellbeing and reduce the risk of burn-out, emotional fatigue, or vicarious trauma. These could include:
- healthy working practices, like limiting the length of shifts, scheduling breaks, and routing calls to advisors equitably;
- de-briefing sessions with peers or supervisors at the end of each shift;
- supervision and support, for example monthly sessions with a counsellor. Services offering counselling like Accord NI, ensure clinical supervision is available for their staff.
- opportunities to support each other, like agreeing non-verbal signals if a colleague needs help or a break.
- agreeing an amount of time that people with lived experience should wait before they work or volunteer on the helpline, especially if they have faced trauma, neglect or abuse.
If call-handlers work from home, be aware of the challenges this can present to confidentiality, comfort and wellbeing and proactively address these. The Helplines Partnership homeworking toolkit may be useful.
9. Create information resources that complement your work
Often callers will face a complex range of issues, so most find it helpful to have access to print resources like factsheets to review after the call. These can provide a reminder of the key points discussed, or break down complex information into more manageable chunks. They can also offer more detailed information to those who want this.
Providing information in a range of other formats is essential for people who have sensory, cognitive or communication disabilities. This could include easy read, braille, audio recordings or films.
Online and peer support forums are other useful resources to consider.
If you work with health or social care issues, the Patient Information Forum has useful resources about best practice in developing information resources, including involving your users and communicating without bias.
10. Think about how you will collect data and report on the difference you are making
The deep insights gained through conversations with callers can be an important source of knowledge to inform other parts of your organisation's work. They can ensure that your information materials reflect the reality of peoples' experiences and don't just reflect what is written in official guidelines. And they can inform your policy work and give decision makers and commissioners a compelling set of stories about how their policies are affecting people in practice.
This can support your overall charitable aims and purpose, give you credibility, and help you be a critical friend to others in your area of specialism. However, stories must be used ethically and responsibly, and anonymised in order to protect confidentiality.
Understanding more about who your callers are and what they want to talk about will also help you be more responsive and focus on where you can improve your service. For example if you find you are only reaching white people, or women, you will need to develop a proactive plan to diversify.
The fact that many helplines need to operate confidentially means that they deliberately do not collect data that could identify a caller. Funders should take a pragmatic view about what monitoring or evaluation they ask for, to ensure that helplines don't feel obligated to 'inflate' their impact from this limited data.
Most helplines still see the value of showing the difference they are making and have thought about this in a number of ways:
- Reach and demand: telecoms providers offer call data packages that can give information including the number of unique or repeat callers you have had, where people are calling from, when they call or the number of calls you have missed when you are busy or closed.
- Who your callers are: you can ask every caller and log this on a call management database, or you could run regular monitoring weeks where you ask for this information from a sample of callers.
- The difference your helpline makes: Asking callers to complete a feedback questionnaire can help you capture your impact. Remember to think realistically about the likely outcomes of a one-off call. For example, it will be unrealistic to make bold claims like reducing hospital admissions, but you might be able to show that you've helped callers feel better informed or more confident to discuss their issue with a school, GP or other service.
Remember to make your monitoring proportionate: it won't be appropriate to ask people in crisis for feedback, or to call with a survey at a stressful time. Don't be overprotective of your callers either – most will be happy to help, or will readily say no if they don’t want to take part.
NCVO Charities Evaluation Services has published a blog on experiences of monitoring and evaluating helpline services which looks at some of these questions in more detail.
We're making sense of what we're seeing and hearing from our grantholders at pace, so there'll be things we've missed, haven't noticed yet or, perhaps, misinterpreted.
We welcome comments or challenge, so that we can continuously improve and develop, and make this work practical and useful.
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This page was last updated: 28 July 2020.