Demonstrating the impact of volunteering: Lessons from (our..) research

David Buck

Senior Fellow in Public Health and Health Inequalities, The King’s Fund

20th March 2014

Demonstrating the impact of volunteering, The British Medical Association, London

The aims

“To gain a greater understanding of the role, size, scope and value of volunteering in the health and care sector”

“To understand how health reform, particularly the development of any qualified provider, will impact on volunteering in the sector.”

..but not about the voluntary and community sector per se

The experience..

Where we started...

Where we finished...

...focus on hospital providers and reform impact on volunteering: opportunities and challenges of more diverse providers...

...much broader perspective on role of volunteers in community, as well as with providers... opportunities and challenges of reforms and wider economic environment and existing trends in volunteer diversity for providers, commissioners and volunteers

How much do we already know?

Incomplete information on scale & scope

Motivations for volunteering vary

Strong (but fragmented, few “numbers”) evidence for health & social benefits to volunteers

Building social capital & community resilience

Benefits to patients less easy to demonstrateDo volunteers complement or substitute paid staff?

Did we already know?

The relationship between services and communities

“I think volunteers are the future of the NHS, are the coproduction element, and really the NHS meeting its own aspirations of a partnership between people and government”

GP commissioner

“Without volunteering we would have no interface or a very difficult interface with this community, it’s absolutely essential to our engagement with this very diverse and very complex community”

Local authority commissioner

The changing role of volunteers

“There are jobs, there are certain tasks that once upon a time some trained staff would be doing but now they’re using volunteers more and more and more… I’m just very concerned about the whole, bigger picture of the authorities using volunteers...”

Hospital volunteer “What we’ve tried to do is to push de-professionalisation as

far as you possibly can, because that’s the way you get bang for your bucks. You create a snowball effect which doesn’t involve paying professionals who are very expensive.”

GP commissioner

Financial pressure

“What I’m hearing is a repeated refrain… something that I have not heard for a very long time, which is we don’t want to be doing this on the cheap, we shouldn’t be using volunteers to replace public services. Now it’s a long time since I’ve heard that as a refrain and my reading of it is the impact of the cuts, the squeeze on public services is making people super-sensitive to then giving their services for nothing or requiring others to give their services for nothing, so I think it’s been a bit of a game-changer”

Local authority commissioner

Key recommendations...

The aims

“To gain a greater understanding of the role, size, scope and value of volunteering in the health and care sector”

As a starting point, a national survey of NHS acute hospital trusts and case studies

Questions on volunteers, roles, impact and funding for volunteer services

Findings

Findings

Findings

Findings

A (too) simple measure of impact for our sample…

“Minimum” benefits–Across the sample the hours donated by volunteers–An average pay rate for equivalent work*

Costs–The cost of managing and training volunteers

> Benefit to cost ratio

* Band 2, Agenda for Change, several trusts in our sample using this

Findings

Findings

But measures for who and for what purpose…

– Recruiting and retaining volunteers – their experience an sense of achievement?

– Improving patient experience – patient’s experience (FFT?)

– Improving patient outcomes – outcomes from treatment (inc QALYs?)

– Costs and utilisation – impact on throughput/LoS? – Organisational relationship with community – sense of

ownership/engagement?– Commissioners – cost/outcomes/avoiding readmission

etc etc…

Findings

Findings

For more...

The final report http://www.kingsfund.org.uk/publications/voluntary-and-community-sector-health

The background literature review on benefits of volunteering http://www.kingsfund.org.uk/publications/volunteering-health-and-care

Full NHS acute trust survey results, and our views on them, http://www.kingsfund.org.uk/publications/volunteering-acute-trusts-england