This Westminster Health Forum seminar will discuss the future of funding in the NHS, looking at priority areas, productivity and integration.
Volunteers at the heart of the NHS
Royal Voluntary Service volunteers have been supporting the NHS since it was started 70 years ago. Sam Ward, director of Commissioned Services at the charity, which itself turned 80 this year, explains how its volunteers are still at the heart of the NHS today
Royal Voluntary Service has supported the NHS since its inception. Today, the charity mobilises 20,000 volunteers to support people in need, in hospital and in the community. With a 5,000-strong team of hospital volunteers, we have one of the largest NHS volunteer forces in Britain who gift their time to help free up NHS staff to dedicate more time to patient care.
Our volunteers remain as critical to the NHS as they were in 1948, with impact analysis from our NHS partnerships showing volunteers make a huge difference to patient care and outcomes.
Volunteers in hospital
Our NHS volunteers work to make a hospital stay a little easier for older people, to help them return home stronger and more quickly and to reduce the chances of re-admission. For instance, our Supporting Your Recovery service provides trained on ward volunteers who help build patients’ confidence, resilience and muscle strength for their transition home. They provide physical and mental exercise, practical advice on nutrition and hydration and companionship for those without family or friends close by.
We also offer support to older people to aid a smoother discharge. Spending time in hospital can be disorientating and older people in particular can find it difficult to settle back at home afterwards, especially if they have no local support network. With social care under strain, many older people leave hospital only to be readmitted shortly afterwards. Working with NHS trust partners, our Home from Hospital volunteers provide practical and emotional support to help clients get back on their feet and regain their independence after time spent in hospital, to reduce the chance of re-admission.
Analysis by the University of Oxford of the Home from Hospital service in nine Leicestershire hospitals found the service not only reduced readmission rates (9.2 per cent compared to a national figure of 15 per cent for those aged over 75), it also helped significantly improve clients’ health and well-being.
Our volunteers also run hospital welcome desks and as one of the UK’s largest NHS retailers, we run over 230 shops, cafes and trolley services.
Volunteer support at home and in the community
Loneliness is increasingly recognised as a key determinant of health and well-being with a lack of social connections cited as being as harmful to health as smoking 15 cigarettes a day. Delivered in the community, our Supporting You at Home commissioned service matches volunteers with older people identified as lonely or isolated and who may benefit from practical help towards reablement and reconnection with their communities. Volunteers provide regular one-to-one support to help restore confidence and independence by building resilience and improving physical and mental strength. Referrals are made from health and social care agencies, local networks or self-referral.
Also delivered in the community, is our Supporting Healthy and Happy Lives commissioned service giving older people living with low to moderate dementia tools to help them add quality to their life through personal support and social activities such as gentle exercise sessions, Cognitive Stimulation Therapy to help improve cognitive function and hobby or interest classes. Trained volunteers deliver activities in group settings at the charity’s community centres and social clubs.
Running parallel to, and sometimes integrated within, our NHS services, volunteers provide practical help, companionship and social activities in the community, helping older people live more independent, socially connected lives. Through our Community Companions service for example, volunteers support clients living alone and identified as being at risk of loneliness, isolation and malnutrition. They visit and call clients regularly, checking that they are safe and well and provide a helping hand with shopping or getting to medical appointments.
Case study: London Ambulance Service
A seven month pilot run by London Ambulance Service NHS Trust in partnership with Royal Voluntary Service helped cut emergency calls and visits to A&E amongst frequent fallers in Merton and Hackney. The active ageing pilot ran from November 2017 to May 2018 and was set up to decrease the number of falls in the two London boroughs, with a goal of reducing demand on both the ambulance service and hospitals as well as improving outcomes in later life.
The pilot tested a new model of ‘mobility volunteers’. Older people who fall frequently and call 999 were referred to Royal Voluntary Service, who then paired local volunteers with clients. These volunteers visited clients in their homes and worked with them for a period of up to eight weeks to improve their physical function and well-being by doing one-to-one chair-based exercises with clients, as well as providing advice on hydration and nutrition.
Following six-eight weeks of volunteer intervention, the pilot had a number of positive outcomes. These included a 42 per cent reduction in falls amongst clients, a 45 per cent decrease in calls from clients to 999 as a result of a fall and a 29 per cent reduction in clients being admitted to A&E.
Clients also showed improved physical function and health and well-being, with 60 per cent showing improvements on a 30-second Sit to Stand test and almost 70 per cent having improved on walking or gait speed in the Timed Up and Go (TUG) test. Furthermore, over one in four felt their health had improved, more than one third felt happier and more confident and one in four said they felt less lonely.
Dr Allison Smith, head of Strategy and Development at Royal Voluntary Service said: “Frailty need not be an inevitable part of getting older. We know that targeted resistance-based exercises can significantly help older adults improve their physical function and reduce their risk of falls. We are very pleased with these results.”
Briony Sloper, Deputy Director of Nursing & Quality, London Ambulance Service NHS Trust, added: “Recruiting local volunteers to support frail, often socially isolated people within their community has been extremely rewarding for everyone involved. By working in a partnership like this that works across traditional, organisational boundaries, we are able to better connect communities and improve people’s quality of life.”
Our commitment to the NHS
2018 is our 80th anniversary year and the NHS’s 70th birthday. To mark the occasion and to reflect our shared history, Royal Voluntary Service recently announced an exciting new strategic partnership with HelpForce with a mission to scale up the number of volunteers embedded in the NHS over the next five years.
With continued developments in medicine helping us live longer, it is no surprise that there are constantly new pressures facing the NHS. As a society, we must find new ways to support it and I believe there are huge opportunities for us and others to do more through the gift of voluntary service. Few of us need convincing of the benefits volunteers can bring, but there is a growing recognition within the NHS of the need to bring together staff and volunteer teams on a more strategic basis. This isn’t about replacing NHS staff roles but about providing extra time for care and support, particularly for people without a network of family and friends.
Volunteers have a vital part to play in building a sustainable NHS and we look forward to playing a part in that future.