How and why we began the community volunteering programme
We set up a pilot about six years ago to investigate whether there was a case to support patients thought to be in last 12 months of life. The purpose was to provide assistance to the patients to undertake community based social activities. The need for this had been identified by Nurse Specialist team.
The pilot ran for two years as a small project and then four years ago a part time coordinator was employed to develop the service.
The challenges we faced and how we overcame these
Initially waiting times were very long, this improved as the volunteer team developed. It took about 18 months to achieve an established team. Initially there was limited infrastructure (recording systems etc) in place to develop the service and time was needed to embed processes.
Need for respite for carers emerged, expanding the initial criteria from patients who were well enough to go out, to those who were often house bound or even bedbound. This meant becoming a service for both patients and their families. Sometimes patients are too unwell to be supported by a volunteer without carer skills, therefore ongoing education of referrers is necessary.
We have a large catchment area, needing diverse and flexible volunteers in all areas. Good publicity and recruitment processes are essential.
There was a limit to capacity with only a part time coordinator, so we developed a team of ‘lead companions’ with assessment skills, to meet and support coordinator matching patients with volunteers. It has been a slow process developing the team, but worth it.
On occasions, a volunteer might be the only person involved in care, so there is a need to ensure they are not expected to make clinical decisions, this has been resolved by developing a thorough reporting system and the coordinator having full access to clinical support / referral to specialist teams if a review is thought to be needed.
Gaining quantitative evidence of effectiveness of service has been difficult, as patients are often not well enough to review formally. It took 2 years to gather enough evidence to review, due to the low numbers of those able to participate. Qualitative evidence was much easier to collect.
The benefits we have seen
- Improved social opportunity for patients who feel less isolated and develop new friendships.
- Respite opportunities for carers
"I can say nothing but good about this service ... from the moment I met (volunteer) we gelled .. I have a friend for life, we have the same sense of humour .. I couldn't have been matched with anyone better." (Patient)
“the fact that she's there while I'm out gives me some peace of mind .. it's a great service .. absolutely marvelous." (Carer)
- It’s a light touch way of keeping contact with the hospice for patients who do not necessarily need specialist support at that time, when otherwise a clinical member of staff might have needed to remain involved. Better use of resources.
- The volunteer relationship is special, it adds value to the overall hospice experience that would be difficult to achieve with paid staff alone.
- Volunteers gain valuable experience for their own CV, it helps some back into paid work. They also gain a huge sense of worth from the work they are doing.
Our advice to others:
- Don’t expect to establish a fully functioning team quickly, it needs time to grow and evolve. First 18 months are needed to establish the foundation, the second 18 months to embed and develop and to respond the needs of the organisation/patients.
- Be prepared to be needs led, don’t try to make the patients fit the service, but make sure the service is a response to local need and not chasing funding.
- Look at various models both in the hospice sector and in the wider community sector, work out what your local need is before you start out, it might already exist and others might be able to provide a more suitable service, be prepared to work with others.
- Be realistic about how you can collect quantitative evidence for evaluation, be prepared it will take longer to evaluate than a traditional befriending project.
- Value the volunteer team, support is essential. Supervision and training is an ongoing need, looking after the volunteers is paramount. Don’t under estimate this need.