Category Archives: Volunteering

Community Engagement, Volunteering

Independent Voluntary Organisations and the NHS

An opportunity missed – and one that can be addressed

“The NHS belongs to the people.”

Those opening words of the NHS Constitution provide a useful starting point for thinking about the relationship between the NHS and independent voluntary organisations.

Independent voluntary organisations are part of the communities the NHS serves. They bring relationships, experience, trust, connection and insight developed outside NHS structures. Their independence can be part of the value they bring.

The two recent NHSE documents on quality and patient experience recognise the importance of people, communities, volunteers and partners in achieving quality and good experience. They provide a strong basis for recognising the contribution of independent voluntary organisations.

The opportunity has been missed in the current framing.

The documents give considerable attention to volunteering. They also recognise the wider contribution of communities and voluntary organisations. What remains less clear is the distinctive relationship between the NHS and an independent voluntary organisation working alongside it.

That distinction matters because partnership is shaped by accountability as well as purpose.

Two relationships, different accountabilities

1. NHS-managed volunteering

A volunteer works within NHS management and governance arrangements. The NHS holds responsibility for the role, supervision, safeguarding, boundaries and accountability.

2. Independent voluntary organisations working alongside the NHS

An organisation works in partnership with the NHS while retaining its own governance, purpose, accountability and relationships with its community.

Independence means separate governance and accountability, alongside working in partnership with NHS objectives.

Why different accountabilities matter for quality

An independent organisation can contribute more than people and time.

For NHS-managed volunteering, supporting volunteers is part of creating the conditions for a good patient experience.

For an independent organisation, the route is different: its own relationships, experience and accountability become part of what it can bring to the partnership.

Its contribution can include lived experience, community knowledge, trust, advocacy, connection and relational insight. It can hear concerns that may otherwise be missed, provide early insight into emerging issues and help the NHS understand people’s experience behind the numbers.

Independence also creates space for challenge.

An organisation may raise concerns, advocate for its community or question an NHS decision. That is part of having a different accountability and can contribute to a better understanding of quality and experience.

A practical way forward

The distinction can be built into how the quality and experience frameworks are applied:

1. Make the relationship clear.

Be clear when the NHS is working with NHS-managed volunteers and when it is working with an independent voluntary organisation.

2. Make accountability clear.

Set out what each organisation is responsible for and what they are seeking to achieve together.

3. Make the contribution visible.

Recognise lived experience and relational insight alongside quantitative measures.

4. Protect independence.

Shared objectives and clear responsibilities should sit alongside separate governance and identity.

The proposition

The NHS belongs to the people it serves. Independent voluntary organisations are part of the community life through which people connect, contribute and are heard.

The recent NHSE quality and experience documents provide an opportunity to recognise this more clearly.

Shared purpose can sit alongside distinct accountability.

Independent voluntary organisations can contribute to NHS quality and patient experience because they are rooted in different relationships, governed through different accountabilities and able to bring perspectives from beyond NHS structures.

Working well together means making those differences clear and respecting them.

The NHS belongs to the people.

Volunteering

Volunteering in acute trusts in England – understanding the scale and impact

Attend’s reflection on the King’s Fund report

The King’s Fund published a new report today, entitled ‘Volunteering in acute trusts in England – understanding the scale and impact’. This was undertaken when they realised from earlier work that there is a significant lack of data on a local level on volunteering in NHS acute trusts.

We have been highlighting this lack of data and robust research for some time, and welcome the research as an initial attempt to understand the scale, scope and value of volunteers in NHS acute trusts in England.

There are a few areas however that we feel the report doesn’t consider, and wanted to take the opportunity to highlight these areas with a view to future research and truly understanding the bigger picture of volunteering in NHS acute trusts.

A key finding in the report is that out of the 3 million people volunteering for health, disability and welfare organisations in England, approximately 78,000 people volunteer in acute trusts. However, as the report openly admits, this statistic fails to capture data about volunteers supporting the work of external groups who operate in acute trusts. It highlights that the limited data could be due to the respondents being unaware of how many volunteers are recruited by external organisations. If this is the case, it presents quite a sobering picture of acute trusts having little knowledge of who in the local community is ‘reaching in’ towards them.

From our own knowledge as a member body for independent volunteering organisations in health and social care, we know that there are many such organisations that offer their services to acute trusts. Attend’s data highlights that Friends Groups alone have an average of 46 members and 343 supporters, often with 3 or 4 Friends Groups linked to separate units in each acute trust. So we would suggest that when considering volunteering in NHS acute trusts we need to recognise and gather evidence on this sector of volunteering as well as those working within the trusts internal structure.

In particular, we would like research to explore how this group of volunteers and supporters represents evidence of significant reach into the local community. The volunteering endeavours of these groups create positively fertile ground for acute trusts to develop their community engagement strategies.

The report also cites an £11 return on every £1 invested in volunteering, However that is for volunteer-involving organisations with paid staff infrastructure. It is worth noting that 85% of charities in the UK are ‘volunteer led and run’ organisations, with a much higher return on investment.

The report also talks about ‘service delivery’ volunteering, which reflects the artificial division made by acute trusts between service-delivery and fundraising. Therefore the report fails to capture and celebrate the volunteering contribution to fundraising. Last year, Attend’s member groups raised £56.8 million through their voluntary fundraising activities.

So although we wholeheartedly welcome research that starts to quantify and explore volunteering in acute trusts we would suggest that this report is missing out the contribution of a large section of the volunteers and is actually about volunteering FOR acute trusts, not volunteering IN acute trusts. By not capturing sufficient data to compare the contribution of ‘independent external volunteering’ and ‘trust organised volunteering’, we are yet to fully understand how volunteering is enabling acute trusts to engage with their wider community, and also what value for money the volunteers across England really offer.

For a Chief Executive of an acute trust, this would be key information to establish how best to invest, what is essentially a limited budget, into volunteering.