The work that is not seen

This week I’ve been preparing the first quarterly report for our NHS England commissioned peer support services.

And the monitoring template is clear about what it wants to know: how many people applied, how many were assessed, how many started support, how many completed it, and what did the outcome tools scores show at the end of support.

These things matter. They help us understand reach, accessibility, effectiveness and volume of work. They help commissioners see whether public money is being used well.

But there is another kind of impact that lives behind the numbers.

Between “application received” and “assessment completed”, there might be three missed calls, two rearranged appointments, a text message sent at just the right moment, a conversation with another agency, a risk concern followed up, a colleague gently staying close to a service user who is not fully ready to start support, without pushing too hard.

It becomes a gap in the spreadsheet.

Applications: X.

Assessments competed: Y.

And somewhere between X and Y is a person trying to find the courage, time, privacy, stability or hope to say yes to support.

The same is true with outcomes.

Someone arrives scoring high on psychological distress. Six weeks later, they score a little lower. On a population level, that movement might not look significant. But in real life, that small movement might be enormous. It might mean someone felt listened to for the first time in a while. It might mean someone slept for the first time in a week. It might mean that someone moved from “I cannot go on” to “maybe there is a way through.”

Good reporting needs numbers. As data can show the shape of the work.

But it’s important to remember that it cannot always show the weight of it.

I am not making an argument against measurement. I have spent years making the opposite argument, that good outcome tools, used thoughtfully, are one of the most honest forms of listening we have. But the quarterly report will be submitted with its rows complete and its totals calculated, and somewhere in the gap between what it says and what it cannot say, there will be a team who chased, and persisted, and did not give up, but held things together long enough for someone to arrive.

That work deserves to be named. Even when there is no column for it.