Following on from the previous post’s criticism of NHS England and the DHSC’s approach to researching volunteering in the NHS, this piece seeks to find a way forward. A way that embraces the best of organisational cultures and promotes working relationships. A way that generates light rather than heat.

This proposal is based on a number of premises:

• Everyone is working hard and committed to providing the best service possible for their beneficiaries. NHS staff & volunteers, voluntary sector staff & volunteers and policy makers alike.
• All public sector and voluntary sector organisations want to have positive relationships with each other.
• The greatest value is gained by exploring and celebrating what is working well, rather than what is not.

So, what to investigate? Where is the pinch point, where the secrets of what is working well can be discovered?

The answer might be found back in 1948, where the then Minister of Health, Aneurin Bevan said to those who had volunteered to support health care before the NHS was formed: “Watch to see where the shoe pinches first … and if the nation cannot do it, there your voluntary services will be required”

This would suggest achieving best value for this research, would be to look at where the shoe pinches: the point where public sector and voluntary sector services touch each other.

…but no-one who is working hard to support the NHS wants to have an intrusive investigation, with the associated negative connotations of accountability associated with it. So maybe the research piece needs to give everyone a break, and help to support what they do want.

They would love to have:

• A celebration of what they are currently doing well in working in partnership.
• Lots of ideas and tips from similar organisations to improve things.

For example, one outcome would be case studies of great partnership working, ones that the organisations involved can be proud of, and others can be inspired by…. creating an organic evolution of partnership working, that aligns with the principle of ‘spontaneous order’, which is so fundamental to the voluntary sector.

A research methodology that would help to achieve this is ‘Appreciative Inquiry’ that poses a central question ‘When have things gone really well what can we learn and apply from those moments of success?’.

NHS staff & volunteers, voluntary sector staff & volunteers and policy makers – who wouldn’t want this?

The links between primary and secondary care and the Voluntary Sector are key here, and this is where the Voluntary, Community and Social Enterprise (VCSE) Health and Wellbeing Alliance offers some potential. However, if you look at the partners, the voluntary sector organisations that are linked to hospitals are largely missing. Once this is resolved this piece of research offers significant value to so many.

Let there be volunteer management!

One winters day in 1963 at Fulbourne Hospital in Cambridgeshire, an unspecified number of cloak-clad senior managers huddled around a dimly lit NHS desk-lamp, and decided to advertise a post for a paid voluntary services organiser…

So voluntary services were henceforth organised. But sometimes they needed managing, other times they needed to be led, and on frequent occasions needed to be supported and negotiated.

Someone decided that the people doing the voluntary services organising/management/leading/supporting/negotiating needed some training to do all these things, and this decision begat many training courses. Most course outlines started life as notes on napkins, beermats, the back of cigarette packets. The course outlines begat trainers and the trainers begat lots of delivery to any volunteer manager could get their organisation to fund a day’s training for them.

Let there be volunteer management qualifications!

Then in 2005, someone said “Where are the accredited training programmes for people who manage volunteers?”. There was much tumbleweed, and no-one responded…

… until a consortium led by Attend liaised with the CIPD (Chartered Institute of Personnel and Development), to tailor the Certificate in Personnel Practice, for people managing volunteers.

In parallel to this, Skills Third Sector were developing the National Occupational Standards for Volunteer Managers, which were adopted by the Institute of Leadership and Management (now ILM), who developed a suite of accredited programmes, just for volunteer management.  In the words of Sue Jones (Warrington Voluntary Action) “there was something special about volunteer management being part of ILM. It felt grown-up, like we were finally sitting at the main table, rather than being on the sidelines, sitting at the camping table with the kids.”

There were accredited programmes designed for people managing volunteers on a day-to-day basis, and for those managing volunteering programmes, and these were delivered all over everywhere. Volunteer Management was now being recognised by awarding bodies, employers and funders as credible and worth the investment.

…and then all of a sudden they weren’t. Government funding dried up, and employers decided the programmes were not so attractive if funding them came from their own budgets!

So the ILM, seeing the reduction in registrations started withdrawing ‘unviable’ programmes from their portfolio, and today the only one left is the Level 3 Award in the Management of Volunteers – the shortest of their programmes. The Level 4 and 5 programmes now sit destined to gathering e-dust in the forgotten clouds.

So, here we go again… in 2019, Attend liaised with the CMI (Chartered Management Institute), to tailor the Level 5 Certificate in Management and Leadership, for people managing volunteers. The sector once again has a nationally accredited qualification tailored for those managing volunteering programmes.

Maybe that’s where volunteer management needs to sit? As part of a mainstream national management and leadership qualification, where folks can obtain a qualification recognised by employers, tailored to volunteer management, and transferable to the wider world of work, thus future proofing the careers of those who study and pass the programme.

…maybe this approach might be more attractive to those holding the purse strings of staff development budgets!

In June this year Dr Neil Churchill, Director for People and Communities at NHS England blogged about the need to invest more in NHS volunteering to reap the benefits for patients, staff and the volunteers.

The Department of Health and Social Care and NHS England periodically fund research and discuss volunteering in the NHS. However, the focus tends to be on directly managed volunteers in a hospital setting, rather than volunteering in a wider health setting, with direct and indirect links to the NHS.

Dr Churchill’s blog and the associated report also adopt this approach. However, one can’t help feeling that something is missing…

The people…over 3 million of them!

So, there are a few hundred thousand volunteers in England who are managed by hospital volunteer managers, but according to the Department of Health’s Strategic Vision for Volunteering, “around 3.4 million people volunteer in health alone”, indicating the vast majority of volunteering within the NHS happens within independent organisations that support the work of the NHS.

For example, local hospital friends groups, who between them have 25,000-35,000 volunteers and 10 times that number of supporters in the community.

So, NHS related research and conversations tend to studiously ignore the bigger picture. Why is this?

• Unaware? Is it because the DHSC and NHS England are not aware that the majority of volunteering in health and social care happens within independent organisations that support the work of the NHS?
• Too difficult? Is researching the many and diverse ways in which 3.4 million volunteers contribute to the work of the NHS too complex for the researchers, or that they haven’t got access to these volunteering networks?
• Too expensive? Would researching this vast field of volunteering cost too much money?
• Can’t see the point? Is it that NHS staff feel they have enough volunteers for the roles that can exist within a hospital setting, and that there is no vision or appetite for engaging the wider community?
• Is it political (small ‘p’)? Is it because this volunteering is part of the wider community and cannot be controlled with the same rules… and that the research findings are likely to point to a need for a different, more nuanced approach to volunteer engagement, which is not within the skills set of many NHS staff?

Whatever the reason, the research hasn’t been done and steadfastly continues not to be done. This is a travesty, when one considers the first line of the NHS constitution is:“The NHS belongs to the people.”

Any volunteering strategy needs to create a climate where people can help where they can, and it’s the role of NHS organisations to engage the community first, and manage volunteers second.

To date however, none of the published research focuses on the first ‘strategy’ of community engagement. It focuses on the second ‘tactic’ of managing volunteers. Ever since hospitals set up their own volunteering programmes in the mid 1960s, it appears the horse has followed the cart, and keeps following the cart. It’s tactics without strategy, which according to Sun Tzu,  is “The noise before defeat“.

So, after the positive public response to the NHS during the Covid-19 pandemic, we have an opportunity to get this right. Someone, somewhere in the NHS needs to get this, and explore how to engage the community first and manage volunteers second.

For example, this could take the form of researching where community engagement works well in particular parts of the NHS. There could be exploration of instances where independent organisations and hospitals work well together, and what makes this work well, like a MoU they have worked on between them.

We just need to see what good looks like and then share this to the people (the managers, the staff, the volunteers, the community groups, the press, the politicians and the wider public). The NHS belongs to all these people …