VOLUNTEERING in hospitals has a long history in this
country, going back to the First World War at least. But its
contribution has often been undervalued and overlooked, the health
think tank the King's Fund says.
Recently, however, that has begun to change. In 2011,
the Department of Health (DH) declared: "Our vision is of a society
in which social action and reciprocity are the norm, and where
volunteering is encouraged, promoted, and supported wherever it
has the power to enhance quality, reduce inequality, or improve
outcomes in health, public health, and social care."
Two years later, in March 2013, the King's Fund
published a report commissioned by the DH, Volunteering in Health
and Care: Securing a sustainable future. This was followed, eight
months later, by a second report, specifically on volunteering in
acute hospitals in England.
"We were surprised, frankly, at just how diverse
volunteering already was, and at where hospital managers were
planning to take it," one of the report's co-authors, David Buck,
says. "Almost everyone said they wanted to work more with
volunteers in the future rather than fewer.
"Forward-thinking hospitals recognise that they need
to be more connected to their local communities, to help people to
stay healthy outsidetheir walls; and [that] bringing in volunteers
from those communities is part of that connection."
THE King's Fund estimated that there were more than
78,000 volunteers in acute trusts across England. That figure does
not include the contribution of volunteers in mental-health
trusts, general practice, and other settings, or those who give
their time in a governance capacity in acute trusts.
In 2008, Volunteering England estimated that
volunteers in acute hospitals produced an average "return" of £7 to
£10 for every £1 invested. But after the 70,000 Games Makers at the
2012 London Olympics demonstrated how much value volunteers can
add, King's Fund researchers recalculated the value of volunteers
in the health- and social-care sector, in 2013, to be worth £11 for
every £1 invested.
None the less, the report authors also sounded a
pessimistic note: what would be the impact on volunteering, they
asked, if the private sector was to play a much bigger part in the
NHS? What would the effect of cost-cutting be on volunteering if
money ran out? Was there a threat, real or perceived, that
volunteers could take away people's jobs? "We will do huge damage
if we start using volunteers to save money," one health
professional was quoted as saying.
In looking at the importance of volunteers' helping
the future sustainability of the NHS, the March report stated: "It
is doubtful whether the system could continue to operate without
them." It acknowledged, however, that, while volunteers do not
undertake professional roles, their support adds much to enhance
the patient experience - through their involvement in Feeding Buddy
schemes (providing extra support to assist patients with eating and
drinking while in hospital), information points, chaplaincy
services, and more.
MORE than two years have gone by since Volunteering in Health and
Care, and, Mr Buck says, "many of the pointers are quite positive."
The visibility of volunteering in hospitals has improved greatly,
he says, and it is being seen not as something marginal but
mainstream. Policy-makers at the DH and NHS England, as well as
hospital managements, are paying it increasing attention, and more
examples of good practice are emerging.
"Trust boards are starting to realise that it's
worth thinking strategically, and investing in recruiting,
training, managing, and supporting volunteers" rather than "finding
them something to do when they come through the door", Mr Buck
says. What's more, the Government has ploughed £600,000 into
"Helping in Hospitals" - an initiative from the social-innovation
charity Nesta. In a scheme launched last summer, it is assisting
six pioneering hospital trusts to expand their existing
Some hospitals have embraced the potential value volunteers can
offer to patients. King's College Hospital, in London, has had a
big push on volunteers since 2010, and in five years has increased
its roster from 150 to more than 1400. One hospital mentioned in
the acute-trusts report had a staff of 2000 and 1200
When the Pennine Acute Hospitals NHS Trust appointed its first
volunteer co-ordinator in 2008, volunteering "took off", Mary
Sunderland, who took up the post, says. "We've got volunteers on
reception, in many of the wards, in the pharmacy, in theatres, in
outpatient clinics, being cancer buddies, driving minibuses, doing
patient-experience surveys. We've got 56 volunteers in the
chaplaincy. But we still have more people wanting to volunteer than
we can accommodate.
"Anybody can volunteer as long they've got the right attitude,
and I enjoy creating opportunities for everyone. Ultimately, it's
all about the small things that make a big difference - things that
the nursing and clinical staff can't do because they're so
FEARS of "job substitution" do not seem to have been realised. "I
hope we have helped to allay them by establishing clear boundaries
between what a professional can do safely, and what a volunteer is
able to contribute," the associate director of patient affairs at
the National Association of Volunteer Services Managers, Carol
"As long as it's done correctly, there is no risk that
volunteering will put people out of work," Miss Sunderland insists.
"We make sure that each role we create for a volunteer is not like
that of a paid member of staff, and we emphasise that at no point
will a volunteer ever be counted in the staff numbers."
The head of health at Unison (which represents 460,000 NHS
workers), Christina McAnea, says: "We're not against having
volunteers in hospitals; indeed, some of our members volunteer
themselves, being publicly minded."
The issue, she says, is whether the task is an essential
service, and the test is: "What happens if the volunteer who is
doing it doesn't turn up one day? Does the hospital have to send
someone else in to do it? In that case, it is probably a job they
need to train and pay someone to do."
Historically, the majority of volunteers were white, female, and
middle-aged or older. In some hospitals, however, this profile is
changing. The University College Hospital Macmillan Cancer Centre,
in London, receives so many applications that it has to shortlist
them. A volunteer co-ordinator, Zainab Oladokun-Olawale, says: "We
get a wide range of people: a lot of students from the university
across the road, people who are out of work, people who are working
who just want something extra to do, people who are retired who
want to do something useful with their time.
"Some come because they just love to help. They want to work
with people, or give back to the community. We get people who have
relatives who have had cancer, and they want to show their
appreciation. Other people want to put something on their CV that
shows that they have other interests."
In addition, anyone who wants to go into medicine or nursing or
midwifery now has to do some voluntary work in a hospital.
NOT every hospital has been successful in attracting volunteers.
Of course, not all have tried. While some NHS trusts recruit
volunteers and manage them, others (often for historical reasons)
work in partnership with organisations such as the Royal Voluntary
Service, and their own Friends group, which recruits and manages
its own volunteers.
Some trusts have been reluctant to fund the costs associated
with volunteering, such as paying for the necessary checks, the
induction and training, and the uniforms. And smaller hospitals
outside big cities can struggle to find volunteers.
Anna Ellis, the voluntary services co-ordinator at Addenbrooke's
Hospital, which is one of Nesta's six pioneers, says: "I don't
think there will ever be a single pattern for everyone. But we can
share information, and pool our knowledge, and establish best
Addenbrooke's Hospital, in Cambridge, works hard not to waste the
experience of its volunteer workforce:
ADDENBROOKE'S HOSPITAL has 725 volunteers on its books, although
not all are currently volunteering. It adds 30 to 40 new people to
its volunteer base every month.
The hospital's voluntary services co-ordinator, Anna Ellis, says
that there are many more women than men, and 60-70 per cent are
under the age of 24, "because we're a well-known teaching hospital
in a university town," she says. But the hospital would like to
attract larger numbers of older people who are available during the
Volunteers come in once a week, and are asked to make a minimum
commitment of 30 hours over 15 weeks. "Some hospitals say that
volunteers have to do a year, but we find it's better to have a
more realistic target, and take it from there. When people pick up
their 30-hour certificate, they can consider whether they want to
"Once people get going, they can volunteer for a very long time.
We have an awards lunch every year, and this year 33 volunteers are
going to get a long-service award. Last year, someone got an award
for 50 years.
"We screen applications to make sure people are volunteering for
the right reasons, and then we go through a structured telephone
interview. We do all the checks required by law, and we also
require two references. Provided you bring the right ID, the
vetting can be completed within 30 days."
Obviously, hospitals are not asking people to volunteer for
their own good, but volunteers do gain from the experience, Ms
Ellis says. "If you're volunteering even for 15 weeks, you will
change and develop: it is a big personal learning curve, whoever
you are. We offer training and support to make the experience
better. None the less, the focus is always firmly on the patients.
Volunteering isn't work experience, and it isn't playing
Normally, staff are very welcoming to volunteers, she says.
"But, sometimes, when a nurse is eight hours into her fourth long
day in a row, and here comes a volunteer, all full of enthusiasm to
do two hours, it can be a challenge. We have to make sure that
volunteers are well trained enough not to be a burden to the staff
on the wards.
"Having said that, when I was a nurse myself, the presence of a
volunteer made me feel more valued, if anything, because here was
someone who was prepared to give their time to support the work I
was doing, and sometimes to ask me: 'Are you OK?' when things were
Linda Wright, who is 58, is a carer for her husband, but still
makes time to volunteer at the Queen Elizabeth Hospital,
"EVERY Friday, I spend two- to two-and-a-half hours on the
surgical assessment ward. I get there at 12, and help to serve
lunch to the patients, and then I clear up. I'll fetch someone a
magazine, or make them and their visitors a drink.
"The other week, an older lady was really upset because her
family hadn't been to see her; so I sat with her, and held her
hand, and she showed me some photos. I'm good at listening, and the
staff haven't got time to do that.
"I used to be in the catering business, but I had to retire
early to care for my husband, who has heart trouble. When I do my
voluntary work, one of his family comes and sits with him.
"I'd love to be trained up to do more. The QE is one of the
biggest hospitals in the country - and one of the finest, I would
say. I can't praise it enough. The staff work so hard. I see how
tired they get, but nothing's too much trouble for them. I do all
the patient feedback for the ward, and 99 per cent of patients have
such a good opinion of it.
"Last year [we] won the award for the best ward in the hospital,
and the Sister bought everybody cakes. I said to her,
"Congratulations," and she said: "Linda, you're a big part of this
as well." I get hugs from the nurses; and even the two cleaners,
who I've become very good friends with, tell me my help is
"I'm not trying to be a do-gooder, but I feel like I've done a
lot of good. I've got so much out of the NHS - if it wasn't for
them, my husband wouldn't be alive today - and I want to put
something back in for free."