3. Jam, Jerusalem or jobs in the NHS?
Inner North Central London Branch
(MFD) That this meeting of RCN Congress discusses the "Big Society" within the context of the NHS and the work undertaken by volunteers.
Debate report
Dominic Walsh from the North Central Inner London branch asked Congress to consider the implications of David Cameron’s “Big Society”. Dominic questioned the motives of the concept and warned Congress about the potential impact of removing the red tape currently in place to recruit, train and support volunteers.
A lively debate ensued with RCN UK Safety Representative Catriona Forsyth describing nurses as the “invisible voluntary workforce”. Lee Ranyard from the North Tyne branch reminded Congress about the voluntary work undertaken by RCN activists, saying: “We do this in our own time, and in doing so, save patients’ lives, improve services and keep the NHS going.”
Several speakers took to the stage to express their gratitude and respect for the invaluable work carried out by volunteers in the health and social care sector. Maria Nicholson from the Buckinghamshire branch echoed this sentiment but stressed the difference between valuing volunteers and exploiting them.
Former Chair of Congress Jason Warriner advised caution against this kind of debate “doing the work of volunteers a disservice.” In his closing remarks Dominic concluded that the exemplary voluntary work described by the delegates should not be disregarded, but that the nature and amount of work taken on by volunteers should be closely monitored.
Background
The Big Society was the Conservative Party’s flagship policy idea for the 2010 general election and is now part of the legislative programme in the Coalition Agreement (Cabinet Office, 2010). The policy’s stated aim is to create a climate that empowers local people and communities, building a big society that will 'take power away from politicians and give it to people’. Applying only to England, the policy programme has garnered both support and criticism.
The original idea, launched in the 2010 Conservative manifesto, identified five priorities for action:
• give communities more powers (localism and devolution)
• encourage people to take an active role in their communities (volunteerism)
• transfer power from central to local government
• support co-ops, mutuals, charities and social enterprises
• publish government data (open/transparent government).
It was re-launched following the general election, and four 'vanguard’ areas were chosen for Big Society projects:
• Liverpool, Merseyside (withdrew from pilot in February 2011)
• Eden, Cumbria
• Sutton, Greater London
• Windsor and Maidenhead, Berkshire.
Traditionally, volunteers in hospitals have supported care staff by looking after patients’ non-clinical needs; for instance by providing afternoon tea services, assisting with the distribution of hospital library books, or running hospital radio services.
Although such programmes are usually operated at individual hospital level, some programmes are run by national organisations like the Women’s Royal Voluntary Service (WRVS), which supports traditional ‘ward book delivery services’.
However, using volunteers is not cost-neutral, and a properly managed volunteer programme requires robust support structures as well as financial investment to cover induction and training costs, and travel and subsistence claims.
Long term volunteer programmes must also manage matters of discipline, as evidenced by the 2004 Help the Hospices survey (Smith, 2004) which identified personal problems, volunteers not following protocols, staff challenging volunteers, and volunteers challenging staff, as major issues.
However, savings can be made by using volunteers. For example, a 2004 article on their use in North American hospitals cited a case study analysis of 31 hospitals in and around Toronto which identified an average benefit of $6.84 for every dollar spent – that’s a return on investment of 684 per cent (Handy and Srinivasan, 2004).
In 2008, NHS Scotland implemented its volunteering strategy which required each NHS board to achieve the Investing in Volunteers quality standard by 31 March 2011; to have a nominated lead to provide board leadership; and to produce a strategic action plan for volunteering. As of October 2010, 15 NHS boards in Scotland had achieved Investing in Volunteers status.
The Welsh Government is also supportive of voluntary organisations working in health care, and has set up a Compact and Partnership Forum to promote meaningful dialogue with the sector.
Northern Ireland has a strong tradition of volunteering within the Health and Social Care (HSC) service, and the five HSC trusts have a dedicated team to encourage volunteering; a good example is the Western HSCT, which has over 150 volunteers, many being young students looking for careers insight.
References and further reading
Cabinet Office (2010) The coalition: our programme for government. London: Cabinet Office. Available at: www.cabinetoffice.gov.uk/sites/default/files/resources/coalition_programme_for_government.pdf (accessed 5/3/12).
Handy, F. and Srinivasan, N. (2004) Valuing volunteers: an economic evaluation of the net benefits of hospital volunteers, Nonprofit and Voluntary Sector Quarterly, 33(1), March, pp. 28-54. Available at: http://nvs.sagepub.com/content/33/1/28.full.pdf+html (accessed 5/3/12).
Smith, J. (2004) Volunteering in UK hospices: looking to the future, London: Help the Hospices. Available at: www.ivr.org.uk/images/stories/Institute-of-Volunteering-Research/Migrated-Resources/Documents/V/Volunteering_in_UK_hospices_2004.pdf (accessed 5/3/12).
