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Integrated Approaches to Volunteering

This Group was formed to support organisations working within integrated care settings with the development of volunteering - including staff from ICSs/STPs, local authorities, voluntary & community sector, primary care, and other NHS settings. The Group was initially formed to support the Integrated Approaches to Volunteering national programme that Helpforce delivers in partnership with NHS England & NHS Improvement.

The Group is intended for anyone working on volunteering initiatives within an integrated care setting. We hope that members will benefit from shared learning, news, ideas, and problem solving.

The Group is set to “public” which means that all content created by the Group members, except the discussion forums, is visible to visitors of the Helpforce Connect website.

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Chris Ham: can the success of the NHS vaccination rollout be applied in other areas of healthcare?

Here is an article written by Professor Chris Ham, chair of the Coventry and Warwickshire Integrated Care System, and was publish on the BMJ . Thought it might be useful for this group.

The success of the NHS covid-19 vaccination programme shows the benefits of national leadership and local delivery in healthcare. Working at speed and scale, the programme put in place a service delivery model that delivered a standard offer to the public with the aim of achieving equity in vaccine delivery and zero waste. The question now is whether these lessons can be applied in other areas of care as the NHS embarks on restoring non-covid services, arguably the biggest challenge in its history.

National leadership focused on the design of the programme involving hospitals, general practices, mass vaccination centres and pharmacies. This was supported by a well-functioning system for sourcing and distributing vaccines helped by the military. Local delivery drew on the assets of the NHS, local government, volunteers, community and faith leaders and others to ensure the safe and effective provision of vaccines. The private sector played a supporting role on data analytics, and delivery was enabled by access to a comprehensive patient database.

If national leadership and local delivery can work so well for vaccinations, then how can the same principles be applied to other forms of care delivery? We have known for a long time that there are wide and persistent variations in how care is provided even within the framework of a “national” health service. These variations have been documented in the NHS Atlas of Variations and they mirror experiences in many other countries.

While it would be comforting to believe that variations reflecting differences in the characteristics of the populations served, the seminal research of Jack Wennberg and others demonstrates that this is not the case. Far more important are differences in the supply of services and in the practice patterns of the teams delivering care. Fragmentation of NHS services—with many organisations involved in provision—also hinders attempts to provide care in line with the best available evidence.

Integrated care systems across England have begun to tackle fragmentation by planning improvements in services for the populations they serve. These systems played a vital role in some areas in the response to covid-19, facilitating mutual aid between hospitals, enabling closer collaboration between health and social care, and supporting general practices to work together to meet the needs of their patients. Their role will be just as important in work to restore non-covid services and to deal with the huge backlog of need that has built up.

If they are to be effective in delivering consistent standards of care, integrated care systems will need to draw on expert national advice and guidance—as the vaccination programme was able to do through the work of the JCVI. There are precedents in the national service frameworks produced during the Blair government, which were supported by substantial spending increases and the backing of politicians as well as clinicians, and in guidance issued by NICE and others. A good place to start would be elective care in view of the huge increase in the number of people waiting to be treated, including those waiting longer than the 52 weeks maximum.

The argument for greater consistency in care delivery is primarily about what is in the best interests of patients, but also concerns the most effective use of scarce resources. Studies of high performing health care systems show that it is possible to deliver better care at lower cost by reducing overuse, underuse, and misuse use of services. The financial pressures facing the NHS underline the importance of improving outcomes and releasing resources by tackling variations and waste.

The NHS covid vaccination programme was successful in part because it was created in response to an exceptional threat. Adaptation of the principles it embodies to other areas of care will be spurred by the challenge the NHS now faces in restoring services at speed and scale. Addressing this challenge is much more difficult than setting up a new service from scratch—as in the vaccination programme—because it entails changing established and sometimes deeply embedded professional practices.

That is why progress depends on alignment between national and local leaders based on a shared vision of what success looks like and how it will be achieved. The “how” needs to draw on Wennberg’s insight that reducing variations requires a science of health care delivery drawing on the experience of health care systems that are in the vanguard of this work. These systems invest in quality improvement methods and ensure that clinicians and managers are supported to improve care.

Integrated care systems must learn rapidly from this experience if they are to restore non-covid services and deliver care in line with evidence of what good looks like. National leaders have a role both in providing expert advice and guidance and securing additional resources on the scale of those that enabled the vaccination programme to succeed. Ministers must enable local leaders and clinical teams to lead improvements in care and resist the temptation to reassert control as the next election approaches.

Just imagine an NHS where patients everywhere experience the same high standards of care, where unwarranted variation has been reduced, and where waste has been minimised. If this can be achieved, the enduring legacy of the vaccination programme will be its impact on all areas of care. That feels like a prize worth fighting for.

By Vy Tran 12th April 2021 Heart 0 Likes
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Darren wright Port How To

Volunteer Portability - How To Guide

One of the most enduring conversations that we have with systems interested in volunteering comes back to how make volunteer portability or passporting work. We've spent a lot of time working with systems across the country that are all at different points in there portability journey.

Based on what you have told us about your work on developing volunteer passports we have put together this How To Guide that boils down the essential considerations. We've looked at how the relevant partners might be, what the benefits you might expect to realise are and potential barriers.

From the experiences you have shared with us we've learned that a local approach to portability is essential because every system is different. We have also learned that the real work in creating a portability process is getting that local agreement on why one is needed and what the existing barriers to volunteers are.

We hope you find this guide useful and please do share your feedback. We're keen to develop this over time so anything you think we should add is useful.

By Darren Wright 9th March 2021 Heart 0 Likes
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Darren wright NHS WP

What does the NHS White Paper mean for volunteering?

Written by Darren Wright, Integrated Care Lead at Helpforce.

The recent Integration and Innovation White Paper signals a significant period of change in the NHS. The proposals to formalise the NHS management structures we know as Integrated Care Systems (ICS) are likely to mean change in terms of organisational structure, but they also provide an opportunity in embedding volunteering within systems.

It is disappointing that the White Paper itself makes no reference to volunteers, volunteering or even the role of the wide community in health creation but this could be an opportunity. The theme of the White Paper could be interpreted as a minimalist approach to legislation and instead leaving many of the service and structural decisions that impact “place” being left to local determination.

We know from our experience of the last year responding to COVID-19 that volunteering and communities are now an integral element of a system’s ability to maintain services. Many systems have come to recognise that the population are not purely passive recipients of services but are also key to the effective design and delivery of those services.

The patterns of volunteer and community engagement in systems is not even and it is appropriate that local solutions are developed that recognise the assets that exist, how that local capacity can be stimulated and the patterns of population health. Legislation would a crude tool to deliver locally responsive models of volunteering and we are supportive that individual ICSs will have the freedom to develop their own relationships, structures and partnerships.

Whilst freedom to develop local solutions is a great opportunity for systems, to demonstrate their ability to respond to local need, the current timescales pose a real challenge. A significant amount of work has already been done to outline shadow ICSs but the intention to create new statutory bodies in a little over twelve months, with a significant level of locally determined structures, risks undermining the need to base these structures on trust.

Local developments, in relation to volunteering, provide nascent ICSs with an opportunity to embed significant additional capacity into their strategic planning. We believe there are three key proposals within the White Paper to leverage the benefits of volunteering at scale.

Workforce

The most overriding challenge for the NHS at present is managing the significant shortfall in workforce. Whilst NHS and Foundation Trusts will still fall outside of the new ICS NHS Bodies the representation of Providers within the ICS governance provide an opportunity for a system wide approach to workforce planning.

Using this opportunity to embed the value of volunteering in system wide workforce planning means that a holistic view can be taken of the volunteering that happens in places. It also provides opportunities for systems to become more resilient in the face of civil emergencies. COVID-19 has demonstrated that we need to be able to plan for large numbers of volunteers who are able to support delivery at short notice.

System wide approaches to portability of volunteers, that support them to move between organisations, have successfully been put in place over the last few months. We see the move to formalised Integrated Care Systems as the opportunity to secure this progress at the heart of work force planning.

As the NHS looks to address significant backlogs in elective care, developed through the pandemic, ICSs will need to focus on the efficiency of pathways. Through our work supporting Trusts we have managed to evidence the impact that volunteers have on improving flow efficiency. We are particularly conscious of the value that volunteers play in supporting hand off between organisations which have traditionally been the key point of service failure.

ICS workforce planning provides an opportunity to make volunteers a key part of building effective pathways that are truly patient focussed.

ICS Health and Care Partnership

One of the key parts of the proposals in the White Paper is the intention to create ICS Health and Care Partnerships to bring together the wide range of partners that exist within systems. This structure that will sit beside the ICS NHS Body will be tasked with setting prioritisation and promoting integration.

We see these ICS Partnerships as an ideal body for realising the value of volunteering across systems. We know that the majority of volunteering occurs outside of NHS settings and in many cases that volunteer activity creates health and wellbeing benefits.

The ICS Partnership creates an ideal vehicle to gain an understanding of the range of volunteering that is taking place across the NHS, Local Authorities, the Voluntary Sector and directly in communities. Mapping the assets that exist across an area will provide a better understanding of the scale of available volunteering capacity.

With an understanding of the volunteer capacity that is available an ICS Health and Care Partnership will be able provide oversight of how this resource can be best used in the development of new patient pathways. We suggest that Partnerships should be looking at the volunteer component of pathway development as matter of course.

Joint Committees

Another opportunity to further develop system wide volunteering sits within the removal of barriers to creating joint committees. We have seen, from our work with ICSs across the country, that systems who have developed robust joint partnership arrangements with organisations that support volunteers are best placed to deploy volunteers at scale.

Through the new freedom to create joint committees ICSs will be able to formalise governance that can also allocate resources to support volunteering. Coupled with the new emphasis on collaboration we hope that we can move to a position that volunteers are not seen as being owned by organisations but are instead communities that can be mobilised.

The White Paper sets out a vision of how legislation can facilitate better integration, but it still leaves significant scope for local determination. In a period of frantic organisational development, it will be easy to forget some of the impressive progress that has been made in volunteering.

We have seen, over the last year, that there is tremendous repository of skills and time within our communities. People are committed to use their time to help the NHS overcome many of the challenges that it will face over the next few years. Integrated Care, and the structures that will come from this White Paper, present a perfect opportunity to work in partnership with communities and volunteers to build a better health and care system.

We want to support each of the new ICSs to embed volunteering at the heart of strategic planning. We have seen the power of the extra capacity that volunteers bring to systems and this is the opportunity to make them partners in how systems are formed.

By Darren Wright 17th February 2021 Heart 0 Likes
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Darren wright HF rel

Building Sustainable Relationships

At our Integrated Approaches to Volunteering drop in session last week we looked at how systems can create the conditions to support sustainable relationships and partnerships.

Though our work looking at the volunteering response to COVID we learned about the key role that good relationships play in creating the conditions to maximise the benefits of volunteering. We have attached a copy of the presentation from last weeks session that sets out our early thinking on this topic.

We have highlighted a number of considerations such as being aware of the existing partnership infrastructure that exists in systems and understanding the motivations of different partners.

Good partnerships are about building trust and mutual understanding. That takes time but it is effort that pays dividends when systems are faced with significant external threats.

EDITED 04/05/21 - Additional work has been carried out by the Voluntary Partnerships Team within NHSE England. You can read more about the support that is available to develop partnerships here.

By Darren Wright 15th February 2021 Heart 0 Likes
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Darren wright IAV 100221

IAV Drop in 10/02/21: Relationships and Governance

On the 10th February our Integrated Approaches to Volunteering webinar will be looking at developing relationships and partnerships within ICS areas.

Last year, when we looked at the progress that was made in mobilising volunteers in response to COVID, the power of relationships was a message that came through from everyone we spoke to. If you would like to know more about that work you can read the report here.

It is also a topic that many systems have spoken to us about over the life of this project. We've done some early to look at how relationships and partnerships can be formalised to support volunteering and we would like to share this with you.

We will also be hearing from Carrie McKenzie, from NHSE, who has done extensive work on this subject. Her national insight will be a really useful perspective in seeing what has worked and where it has worked.

The webinar begins at 11am and you can join it through this link. You do not have to register to attend. We look forward to seeing you on Wednesday.

By Darren Wright 4th February 2021 Heart 1 Like
Resources
Darren wright PC ppt

Volunteering in Primary Care Presentation

Yesterday we posted a How To Guide aimed at supporting people to develop volunteering initiatives in Primary Care.

To accompany the guide we have created a presentation that sets out some of the key points. You can use any part of this presentation in any way you want to support your own work.

If you need to deliver a presentation on the benefits to Primary Care of volunteering then please do copy and paste any part of this.

By Darren Wright 3rd February 2021 Heart 0 Likes

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Integrated Approaches to Volunteering

This Group was formed to support organisations working within integrated care settings with the development of volunteering - including staff from ICSs/STPs, local authorities, voluntary & community sector, primary care, and other NHS settings. The Group was initially formed to support the Integrated Approaches to Volunteering national programme that Helpforce delivers in partnership with NHS England & NHS Improvement.

The Group is intended for anyone working on volunteering initiatives within an integrated care setting. We hope that members will benefit from shared learning, news, ideas, and problem solving.

The Group is set to “public” which means that all content created by the Group members, except the discussion forums, is visible to visitors of the Helpforce Connect website.

Develop Images Helpforce 263 700x467