Chris Naylor and Claire Mundle outline the benefits of engaging with volunteers and explain how the health service can attract them and cultivate a relationship that is mutually beneficial
The 2012 Olympic Games put a spotlight on volunteering like never before. The games makers were credited with creating the “spirit of the games”, prompting many to wonder how this spirit can be recreated in other areas. In the health sector, volunteers already make an enormous contribution to patient care and to public health.
Research recently published by the King’s Fund explores the future of volunteering and makes recommendations on how the NHS and other organisations can work with volunteers in the most effective way possible. The contribution made by volunteers is often underappreciated.
“Rather than being an ‘add-on’, volunteers are becoming respected members of the care team”
Citizenship surveys indicate that around 3m people in England regularly volunteer for health and social care organisations, in either the public or voluntary sector. They are involved in all parts of the system, from assisting with mealtimes in hospitals and providing support for bereaved families, to organising community activities to help people stay healthy.
These volunteers play an important role in improving patient experience, building a closer relationship between services and communities, helping to tackle health inequalities and coordinating the care provided by different agencies.
Within the NHS, we found signs that a cultural change is underway with regard to volunteering. In some hospitals, volunteering is increasingly regarded as a core part of the relationship with the local community. Rather than being considered an “add-on”, volunteers are becoming respected members of the care team.
There are several practical things organisations can do to get the most out of volunteering; the first is simply to identify its valuable and unique elements. Far from being just an extra pair of hands, patients told us volunteers gave them something very important − a “human touch” that helped create a compassionate, caring environment. In light of events at Mid Staffordshire, this is significant.
The “peer” element often present in volunteering schemes was seen as being particularly valuable. Expert advice from someone who has been through a similar situation can make the experience of being a patient less disempowering and less frightening.
‘Publicising volunteering opportunities at local events can be an effective way of increasing representation’
There is increasing evidence to suggest that people with long-term conditions, mental health problems, disabilities and other conditions can help others to manage their condition more effectively. Peer support, whether paid or unpaid, is something that should be embraced wholeheartedly.
To derive maximum value from volunteering, organisations will need to think strategically about the role volunteers play and the contribution they can make towards meeting organisational objectives. Some of the most successful hospitals have integrated volunteering within their core human resources processes, systematically mapping the ways in which volunteers could add value in each department or service unit, then actively recruited volunteers to meet these needs.
Organisations should seek to recruit a wide range of volunteers and explore ways of broadening the appeal and accessibility of volunteering. This could include working with faith groups and grassroots organisations to extend the reach of services into marginalised communities.
Publicising volunteering opportunities at local events can be an effective way of increasing the representation of young people and minority ethnic groups. Building relationships with schools and other agencies can also support this.
It is worth developing bespoke training programmes and using induction processes to help volunteers understand their role and how it fits into the wider organisation. Induction and training processes can also serve as a valuable means of building positive relationships between volunteers and staff.
In some organisations, clinical professionals have been involved in designing training curriculums for volunteers, helping to get professional buy-in. Joint inductions for the paid and unpaid workforce can help both groups to appreciate their respective roles, while learning how they complement each other and where the boundaries between them lie.
‘Few things will make a person stop volunteering quicker than the belief that they are taking someone’s job’
As well as adding value to direct service delivery, volunteers can make an important contribution to organisational governance. As a link between patients and professionals, their perspective is a valuable one. NHS providers would benefit from giving volunteers a prominent voice, for example through representation on patient experience committees or by creating regular forums in which volunteers, governors and executives can meet to discuss ideas for service improvement.
Similarly, it is important that volunteer services managers are of sufficient seniority to have authority in strategic discussions and ensure their teams are visible within the organisation.
None of this should be taken to suggest that working effectively with volunteers is always easy. There are significant barriers that sometimes need to be overcome. In the current financial climate, more than ever, there can be sensitivities around “job substitution” if there is a perception − or a reality − that volunteers are being used to reduce costs. Few things will make a person stop volunteering quicker than the belief that they are taking someone’s job.
To deal with these sensitivities, organisations need to keep the focus firmly on quality and make sure all discussions regarding the role of volunteering relate to how volunteers can be used to add value. High-quality volunteer management is needed to make sure the boundary between paid and unpaid roles is not eroded.
Part of the role of volunteer services teams is to maintain this boundary and ensure volunteers are used appropriately. Questions around job substitution will inevitably arise; these teams need to be sufficiently skilled to handle these sensitivities and to articulate a vision for volunteering behind which all staff can unite.
The value of volunteering
Volunteering opportunities need not be limited to the hospital campus. By engaging with volunteers working in the community, hospitals can extend their reach and ensure patients are supported more effectively after discharge, potentially reducing the need for readmission. In doing so, providers have much to gain by working with the voluntary sector and learning from good practice in volunteer management.
A key challenge is to measure the value of volunteering and the return on investment it delivers. A study by the Institute for Volunteering Research placed the average value of volunteering within acute trusts at around £700,000 a year, with each £1 investment yielding a return of between £3 and £10. However, much more data is needed in order to demonstrate the business case to commissioners.
What is clear is that if the full value of volunteering is to be reached, a much more strategic approach will be needed in which volunteers are seen as an important part of the health and social care workforce. The potential prize is to go beyond the current foundation trust membership model to one in which hospitals are truly embedded in the communities they serve, with volunteering and public engagement at the heart of their activities.
Case study: King’s College Hospital, London
In 2011, King’s College Hospital recruited over 500 new volunteers and demonstrated measurable improvements to patient experience scores in those departments where volunteers had been involved in providing care. This year, it aims to expand the total number of volunteers to 1,000. A number of lessons can be learned from the success of this programme:
1. Modest investment is needed to transform existing volunteer services. King’s recruited a project manager to lead the transformation, as well as developing an online recruitment system, a volunteer training programme and publicity materials.
2. Thought must be put into what volunteers are well placed to do. King’s completed a systematic mapping exercise to identify where volunteers could add value to their services.
3. Groups in the community who could benefit from volunteering opportunities must be identified. By using local events, such as university freshers’ fairs, King’s recruited large numbers of young people and individuals from minority ethnic groups.
4. Adequate training and joint inductions with paid staff must be provided. King’s developed a training programme that included modules led by volunteers themselves, and a shared induction that was delivered to staff and volunteers together.
5. Calculate the return on investment; this helped to change mindsets and secure continued investment.
Case study: CUH Voluntary Services
Over the past six months, the Cambridge University Hospitals Voluntary Services team has transformed the administration of volunteering by implementing new online recruitment, rostering and database systems. By using improved processes to manage the volunteer workforce, the team has been able to adapt to meet the changing needs of patients and colleagues, and to monitor performance and impact. Key components of the model include:
1. Volunteer role development. The team worked with colleagues across the hospital to create flexible, appealing roles that require different skills and levels of commitment. Improved assessment and interviewing techniques have been introduced.
2. Support and training. A small number of trained “link” volunteers allow the team to offer improved ongoing support to volunteers. All new volunteers attend a professional corporate induction followed with regular one-to-one review sessions; feedback from these reviews is fed into strategy and planning processes. A portfolio of role-specific training opportunities has also been developed.
3. Communication and identity. Frequent communication and scheduled team meetings are used to help volunteers cultivate a sense of being part of a team.
4. Partnerships. The trust is also building closer relationships with voluntary sector and community organisations that provide services to the hospital and its patients.
Chris Naylor is a health policy fellow and Claire Mundle is a policy officer at the King’s Fund