Volunteering, the NHS and Corona Virus
People are saying that things ‘won’t be the same’ after the Covid-19 pandemic is over. While I am not sure about that it is striking what has changed over the last few weeks.lambreWho would have thought that suddenly volunteers are seen as an important and integral part of the health system. Suddenly, as the population impact of COVID-19 becomes apparent and the UK government realises the scale of the challenge and the actual impact on vulnerable people and the NHS it clicks its fingers and creates over 750,000 volunteers. Indeed there has been such an interest in this that recruitment has had to be temporarily paused so that applications can be processed.
This is truly amazing. First, because so many people have put themselves forward to help, but as fundamentally because despite the efforts of some people in the NHS and many community organisations volunteering and the contribution of citizens as assets in their communities has been at best a peripheral issue in the NHS.
The most explicit reference to the ambition that NHS England had with regard to volunteers is here in the Long Term Plan which came out in January 2019.
Even here the primary focus appears to be on volunteering in the acute hospital sector, (according to the Kings Fund in 2013 there were just 78,000 volunteers in acute hospitals – 10% of the number recruited in 1 week during this pandemic!) the above extract probably exists in large part due to the work of the Kings Fund who have published quite extensively on this topic.
Aside from this and a tentative briefing aimed at STP/Integrated Care Systems I think that NHSE main focus has been on interface issues using social prescribing as the main tool. In other words focussing on the NHS system engages with community organisations and communities and actual and potential volunteers. This strategy is set out in the NHSE document on Universal Personalised Care.
Before Covid-19
More generally volunteering works a bit like this at place level:
- Grass roots self actualising informal groups sometimes bound together by hyper local geography – for example on my street two WhatsApp groups have sprung up in the last 2 months.
- At community level are local Voluntary organisations who have credibility with and are connected to communities of geography or interest – for example Carers Centres, Community Anchors, Mencap and interestingly hospitals.
- The local NHS – increasingly General Practice are developing (through Primary Care Networks) mechanisms such as Community Link Workers and Social Prescribers to connect with the two groups above. However, they are some way behind the groups in bullet point 2 above.
- Just as importantly local authorities have with varying degrees of success been seeking to develop joint commissioning approaches with Clinical Commissioning Groups to support local voluntary organisations and also develop bridging and connecting services such as Local Area Coordination. Local Authorities do have a long history of supporting volunteering – for example through funding lunch clubs.
During Covid-19
The creation of this army of volunteers by NHSE and the Royal Voluntary Service represents both an opportunity to move the volunteering agenda more onto the mainstream agenda of the NHS in the medium and longer term but it also presents some real challenges which include:
- While National organisations with a strong brand like the NHS can at times of crisis recruit volunteers very quickly – these only have utility if they can be connected quickly and safely with local communities and local services. It is here that local authorities and local voluntary organisations have a key role to play – they have those connections and credibility.
- For example in Sheffield the local CVS has very quickly developed targeted volunteer recruitment and produced a map which flags up community hubs, describes roles and responsibilities flagging up community hubs in the city and the local authority has now producing a community action plan to ensure a city wide approach connecting statutory services with the local voluntary sector.
In the coming days and weeks it will be crucial that this national initiative bends to the local and also makes resources available to ensure that local organisations can respond to the scale of this offer.
After Covid-19
I think we should have high expectations that NHSE will rewrite their approach to volunteering and the role of the NHS in terms of funding the voluntary sector
What do you think?
Hi Mark Thanks for this blog thought piece. It raised some intersting reflections for me on community action and more formal organisational Volunteer programmes. My old colleague Carey Bamber speaks of this in her recent peice for the RSA too.
I was a little puzzled I guess about your view that you see “self actualising informal groups sometimes bound together by hyper local geography – for example on my street two WhatsApp groups have sprung up in the last 2 months.” as a form of volunterring in the same space as for example the NHS Volunteer programme – call to action. I note that on a twitter exchange I suggested that these 2 elements (informal community led and organisational and institutionally organised and led) shouldn’t be conflated; I note also a comment in our Twitter conversation that ‘does it matter if….’ and ‘what matters is that people are doing it’ (giving time to volunteer) – I paraphrase here….. but it does matter – I say this because I think there are some signifcant issues for both elements in terms of (for example) social politics, how and who is invovled, how these manifest in places, the structural boundaries etc that help frame the response and more. We could unfold a discussion too about 250K people Volunteering into a Organisational system which might be a way of mitigating staff reductions and/or job roles etc. Which is another blog and cup of coffee altogether. Community life and local people offering and doing support is one thing – Volunteering into a formal highly strucutred and managed scheme or programme something else entirely.
Thanks for the comment Simon I don’t disagree with any of it – except for one point – see below.
As both you and I know this whole area generates quite a lot of heat and debate – you mention some of the contentious issues eg – the autonomy of community led actions versus the greater level of control of formal volunteering, substitution of paid roles for unpaid ones. As you know – in my role as Chair of Citizens Advice Sheffield the world of CABx is much more about the latter rather than the former – but I would certainly not claim it has greater value or is the same as community led good neighbour volunteering – which has flowered in response to the current crisis.
My personal motivation for writing the blog was a specific response to the NHS/Royal Voluntary Service recruitment of volunteers which I think falls into this formal volunteering category.
However, when I wrote the blog I thought it was important to recognise – NOT CONFLATE – that there a range of different forms of volunteering from the hyper local and very informal to the very formal and that all of these are not siloed – but impact upon each other.
If I had not done this – I am sure that people who are committed to this agenda would have called me out and said – “hey its not all about NHS volunteers you know – a lot is happening informally that is just as important” – and they would have been right to do so!
While I do feel slightly – “damned if you do and damned if you don’t” I always wanted this blog to be place for debate – so fair enough!
All the best – Mark
Hi Mark (and Simon),
thanks for your thoughts. It would be lovely to think that the expertise of colleagues like Jane South on volunteering in PH roles had been called on for developing the NHS volunteering role in general and the contact tracing role in particular, but see that the Government has gone out to tender for the thousands of contact tracers they need. I think they would have done far better to work with local authorities and local health systems to build on networks of community health champions (CHCs) and others. I saw a piece on Look North the other day about a volunteer led contact tracing system that a retired GP and others have set up in Sheffield and wondered what you thought about this approach? The success of South Africa in stemming the pandemic seems to have been largely down to the involvement of thousands of community health workers who were already there to work on HIV. They have been able to very quickly get out into communities to spread information about how to avoid spreading the virus. Many urban areas in the UK do have CHCs and people in similar roles but I have seen no mention of engaging them in preventing the spread of Covid 19, have you? Instead the government are going for the app plus what looks like tracers in call centre type roles – maybe there is a place for this but for many impoverished communities my feeling is that a local and more human approach would work better. What you do think?
Hi Judy – You make some good points for the discussion. I too have wondered what the Govt and its strategist did in terms of looking at established models for community engagement and learning from what works and worked in the recent past. Worryingly the Contract Tracer roles are deployed by the likes of Serco and similar Management Utilities – so, the privatisation of community resources and PH/NHS serivce? The push on AI and tech solutions perhaps belies a bigger Govt move – ? deperonalising the personal?
Also, I’m trying to find stats on how many of the NHS Volunteer Heroes have been deployed and into what type of roles? And, it would make interesting reading as to the socio/demographics of those Volunteering……
Hi Judy – lovely to hear from you. Good point about contact tracing. Its an interesting one – you will have clocked that the top down approach taken by the government and NHSE in partnership with the Royal Society for Voluntary Service seems to have struggled to gain traction – more or less due to the issues that I raised in the blog – lack of connection to local communities. Yes, with regard to the Sheffield Contact Tracing initiative – I have had a couple of conversations with Jack Czauderna (who follows this blog) so he may respond himself. Jack has described the Heeley project as a pilot – which feels right and building on community capacity does feel like the right way forward. However, what has happened is that the Government has in effect sidelined CCGs and to some degree local authorities and is driving stuff forward from the centre. This means that local pilots – while they are free to go ahead – it does feel as though they have to run separately to what the local statutory sector is doing – which at the end of the day is not particularly helpful. Maybe, as contact tracing rolls out this will change?
Hi there,
You may well have been following Devi Sridhar in the Guardian and at the Hay Festival where she made a very interesting point about the poor countries like Senegal which have done relatively well in combating Covid 19. Lacking the health facilities to treat people who became ill they focused on containment, as have other countries with more successful outcomes that rich countries like the UK and the US.
Failure to make local authority PH departments central with a focus on testing, tracing and isolating from the start seems to me to have been a key aspect of our government’s shambolic and disastrous mismanagement of the pandemic. Their obsession with handing out contracts for delivery of virtually all aspects of the UK PH response to private companies has in my view led to a much slower, inadequate and bungled approach.
Jeanelle de Gruchy reflects on the failure to involve local PH teams from early on in a piece in the online Guardian https://www.theguardian.com/society/2020/may/20/jeanelle-de-gruchy-nhs-not-set-up-preventing-illness-coronavirus-public-health