What does the NHS White Paper mean for volunteering?

17th February 2021

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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.

Darren wright NHS WP

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