A straw poll of my work colleagues revealed that, like me, many think more about doing nice things for others in the run up to Christmas. Volunteering falls squarely under this heading, and is the focus of a piece of evaluation work currently being undertaken by the Nuffield Trust.
In addition to a recent evaluation of a scheme run by the British Red Cross, the Trust is currently evaluating seven projects funded by the Cabinet Office that are strongly reliant on a volunteer workforce. These projects have received funding in an attempt to reduce unnecessary hospital admissions of older people this winter and to help people to remain safely in their own homes.
The projects offer a huge variety of support to help people out of hospital more quickly (such as transport home, a hot meal or preparing the house) and reduce readmissions (by signposting other services, befriending and supporting carers). This should ultimately improve patient experience.
For one part of the evaluation we are interviewing volunteers, paid staff and other interested parties such as social care and health service representatives. Reflecting on these interviews has led me to think about the role of volunteers in supporting health and social care delivery; and in the spirit of the time of year I am going to draw on the classic story of A Christmas Carol, by Charles Dickens.
The story goes that Scrooge is visited by three ghosts on Christmas Eve who give him an insight into how he has become the person he is today and what the future will look like if he does not change his ways.
Considering the past, present and future role of volunteers seems particularly poignant given the need to minimise the increasing demand placed on services.
The Ghost of Christmas Past
Before the Cabinet Office support, a large majority of the projects we are evaluating were already operating in some form, but on a small scale and with a limited number of volunteers. When asked about the need for the different services, two broad themes were highlighted by interviewees:
- Families are increasingly scattered across the country (and beyond) meaning they are less able to provide practical support for elderly relatives, such as transport to appointments or help with shopping.
- Chronic loneliness is a significant issue for older people, which means there is a need for emotional support as well as practical help.
The presence of projects such as those under evaluation suggests an unmet need for the care of older populations – one that is neither being filled by personal support networks nor statutory services. The question is whether this need is increasing, or if it has even been properly acknowledged.
Interestingly, the majority of the projects don’t means test their support – in other words, they don’t have selection criteria based on finances available. Perhaps this is a reflection of the ever-stricter criteria for receiving statutory support. Nevertheless, it means that more people can benefit from such help. It is also likely that the services offer support beyond that of a traditional care package, which emphasises health needs.
The Ghost of Christmas Present
Our Ghost of Christmas Present shows what these projects look like today and the influence that the funding injected into the schemes has had. Volunteer recruitment has, understandably, been a focus. Most of the services need to increase their own capacity to meet increasing referral numbers.
In many senses these projects have to run like a business; they have to recruit personnel and reach targets. If they don’t they are unlikely to receive funding to continue. Recruiting, retaining, training and developing volunteers is a different undertaking than if the services were run just by paid staff; even though their time may be given for free, the associated support and resources surrounding the volunteers are definitely not.
Identifying the challenges of projects reliant on a volunteer workforce is important if the services are to be continued or successfully rolled out; this includes how to recruit sufficient numbers to meet demand and how to match the service offering to the time constraints of volunteers.
The Ghost of Christmas Yet to Come
Even though the evaluation is at an early stage, it is tempting to think about the Ghost of Christmas Yet to Come. We don't yet know what these projects offer in terms of outcomes and evaluating this type of project is tricky.
It is clear that evidence of a significant effect is needed for future funding applications, but it remains to be seen whether the projects can produce such an effect in a short time period. We also need to see if the projects are set up such that the evidence funders want to see is even obtainable.
Ultimately, by travelling with the three ghosts of past, present and yet to come, Scrooge saw the error of his ways and so the story has a happy ending for both he and Tiny Tim. There have been numerous film and TV adaptations of A Christmas Carol (while most people I've asked seem to prefer the Muppet Christmas Carol, I personally have fond memories of Sir Patrick Stewart as Scrooge) because the story has a message that people can relate to.
The question is whether volunteer-led projects such as those under evaluation can bring about the ‘happy ever after’ by relieving the increasing pressure on health and social care services.
We don’t know the answer just yet but the final evaluation – including both qualitative and quantitative elements – will be reported in summer 2015.
Davies M (2014) 'Volunteering in the season of goodwill' Nuffield Trust comment, 8 December 2014. https://www.nuffieldtrust.org.uk/news-item/volunteering-in-the-season-of-goodwill