The NHS has had a rough winter. Years of austerity, an ageing population, declining adult social care services and rising demand have placed the UK’s national treasure under stress like never before. For the last few months the headlines have come almost daily: accident and emergency waiting time targets missed; queues of ambulances outside hospitals; extreme bed blocking; and patients waiting hours on trolleys in corridors before they get treatment.
The headline that struck me the most was the warning from the British Red Cross that the NHS faces a ‘humanitarian crisis’. On the 6th January 2017, The Guardian newspaper quoted Mike Adamson, chief executive of the British Red Cross, as saying:
“We are responding to the humanitarian crisis in our hospital and ambulance services across the country. We have been called in to support the NHS and help get people home from hospital and free up much needed beds. This means deploying our team of emergency volunteers and even calling on our partner Land Rover to lend vehicles to transport patients and get the system moving.”
What do these volunteers do? A helpful summary is available in an article from BBC News on the 7th January 2017:
The Red Cross offers a ‘support at home’ service to hospitals that need to improve the flow of people in and out of hospital.
Volunteers visit trusts to see what social care needs patients have when they are discharged. They then visit them at home and help them with tasks including collecting prescriptions, doing shopping or simply offering company.
It says the number of patients its volunteers see has gone up by 10% year-on-year and the range of tasks is increasing, such as making sure people eat, helping them to get dressed or assisting them in going to the toilet.
At one trust, the organisation has been working alongside hospital matrons to arrange transport for people to take them home. It uses its fleet of Land Rovers and also provides back-up for the ambulance service.
The situation was mentioned in Sir Stuart Etherington’s 2017 new year letter to the voluntary and community sector. He said:
“Social care in particular is consuming an ever greater proportion of local government spending. The trajectory appears unsustainable. Other services important to people and communities are sacrificed to make way for the essentials. And in just the last week, charities have rightly been at the forefront of drawing attention to the problems facing the NHS. No one would claim that volunteering alone can bridge the rapidly increasing gaps between demand and supply here. But volunteering, both formal and informal, has to be part of the solution.”
Almost all of the responses to Sir Stuart’s letter that I have seen have focused on the role of volunteers in delivering services within the NHS and adult social care. But the solutions could be more nuanced and sophisticated than that.
For example, discussion of the role of volunteering in reducing demand on struggling public services has been almost non-existent. Concepts like social prescribing do not require more volunteers to be thrown at the NHS but enable primary care professionals to refer people to volunteering schemes to relieve the pressure before it gets to be a problem.
Social prescribing recognises that people’s health is determined primarily by a range of social, economic and environmental factors. Consider that research commissioned by the RSPB underlines the strong links between good physical health, good mental health and the natural environment, whilst other research quoted by the RSPB shows that physical inactivity has serious effects on human health, which cost the UK economy more than £8 billion a year. So, a doctor practicing social prescribing might refer some patients to an organisation like the RSPB to volunteer in the natural environment. These patients then improve their physical and mental health through volunteering and consequently reduce future demands they might place on the NHS.
This isn’t wishy washy idealism. People and organisations are using social prescribing and other models to make a real difference in society. For example, Altogether Betterare having success with approaches that increase the efficiency of health services, improve the health of individuals and strengthen local communities.
Sir Stuart Etherington called for 2017 to be a year in which we have a bold conversations about the role of volunteers in our society. If we are to respond then must do so with our eyes open to all the possibilities and potential, not just the risks and limitations. That includes not just how volunteering can help in times of crisis, but the role of volunteers in lessening the causes of crisis in the first place.