Ahead of the launch of our fourth Health Leaders Survey tomorrow, Dr Jane Collins, Chief Executive at Marie Curie and member of the panel blogs on the role of the voluntary sector in the NHS.
People often talk about the role of the voluntary sector in the NHS as though this is somehow a new or unusual thing, but actually Marie Curie and many other voluntary sector organisations have been around for as long as the NHS – some longer – and have proven expertise in delivering high quality care and support.
People also often talk about services provided by the voluntary sector as a ‘nice-to-have’ but less important than the core business of the NHS, which is usually thought to involve hospitals and the GP surgery.
This ignores the fact that the NHS is actually already wholly dependent on the support of the voluntary sector in many areas. This is especially evident in end of life care, where voluntary sector organisations like Marie Curie, Sue Ryder and many independent hospices deliver the bulk of expert palliative and end of life care to people who have a terminal illness.
We use charitably raised funds to deliver our services, usually matching, but often going beyond any funding we receive from the NHS. Without this extra source of funding, the NHS would probably have to invest hundreds of millions of pounds – if not more – to deliver the same care that the voluntary sector now provides for people at the end of their lives.
The Nuffield Trust's fourth survey of 100 health and social care leaders, which launches tomorrow, found that 82 per cent of respondents expect volunteers to play a greater role in their own organisation in the next five years. In spite of this, only 41 per cent think that the voluntary sector is very well or quite well equipped to perform a wider role in the NHS.
How well equipped do you think the voluntary sector is to perform a wider role in the NHS?
This is a valid point which needs addressing. The geographical range and size of providers makes it hard for the NHS to engage with us and for us to engage with the NHS. Most voluntary providers are small and local and there are huge numbers of them. The NHS can appear impenetrable. Having personally moved from the NHS to the voluntary sector, I would also say we are much more competitive, largely driven by our need to fundraise and so less willing to collaborate. This is something to overcome if we are to be seen as reliable service providers.
Whilst I champion the contribution of the voluntary sector, it would of course be wrong to think that voluntary sector organisations are all valuable or better than the NHS just because they are charitably run. The voluntary sector, just like the NHS, has the responsibility to research, innovate, and develop new and better ways of providing reliable care and support for the people that need our services.
But we can play a significant role, particularly in our communities up and down the country. One of the reasons we at Marie Curie welcomed the Five Year Forward View is because we have, for a long time, championed investment in community services and the restructuring of health and social care services to meet the needs of people in their usual place of residence. For nearly a decade we’ve worked with commissioners and a diverse range of providers to ensure smooth transitions for people with a terminal illness from hospital into care at home or a care home. In this regard, we have already anticipated the plan set out in the Five Year Forward View. We, and others, are ready to play a critical role in making it a reality.
The role of volunteers is, I think, one of the largest untapped resources that the voluntary sector has to offer. What they can do to help delivery of care and support is severely underestimated in the UK.
At Marie Curie we are investing heavily in our own ‘Helper’ programme, which matches trained, non-clinical volunteers with people who are living with a terminal illness. These volunteers provide emotional and practical support in the home, companionship and crucial respite for carers. It’s a service that is meaningful for both the terminally ill who have an outlet for their feelings – and for their carers. These low-cost interventions can be delivered by volunteers and have a profoundly positive impact on mental and physical wellbeing, potentially avoiding costly health and social care interventions later.
The role of the voluntary sector is not really in question – it is already deeply embedded in the NHS and relied upon by health and social care professionals, patients and carers.
But we can and want to do more.
The question for us in the voluntary sector is how we can support NHS organisations to work more easily with us. Forming local consortia or creating a local ‘market place’ so NHS providers can meet relevant local providers is a way forward. Many local authorities have already created voluntary sector groups which could easily be accessed by the NHS. The question for the commissioners and NHS leaders is how much will they draw on our expertise and our ability to innovate to meet the Five Year Forward View? We are ready to help. The appetite for change is already there; we just need the encouragement and challenge to take the next step.
Dr Jane Collins is the Chief Executive of Marie Curie. Please note that views expressed in guest blogs on the Nuffield Trust website are the author's own.
Collins J (2015) ‘The voluntary sector: ready, willing and able’. Nuffield Trust comment, 18 March 2015. https://www.nuffieldtrust.org.uk/news-item/the-voluntary-sector-ready-willing-and-able