Royal Voluntary Service – volunteers improving mobility and wellbeing of older patients

RVS volunteers are working closely with clinical teams to improve outcomes for older patients. On hospital wards they help with exercise and activity sessions and in the community they also support a prevention based service which focuses on nutrition, physical wellbeing and social connectivity.

At St David’s hospital and Llandough hospital in Cardiff, volunteers support patients to do chair based exercises, to build the strength and mobility of those referred to the service. Exercise sessions focus on building muscle strength in the core, arms and legs whilst replicating the day to day movements that older people may struggle with on a daily basis. Group sessions also aim to reduce anxiety and loneliness.

In addition, volunteers give encouragement and support at mealtimes on wards and provide activities to stimulate cognitive ability and mobility.

After discharge, volunteers can provide strength and balance support in the home or in local community venues. They continue to encourage healthy eating, hydration and exercise activities and help to assess which other third sector or statutory services would be beneficial. Patients who require more intensive exercise programmes, over and above the chair based exercises, are signposted to appropriate services.

Volunteers receive full and comprehensive training on health and safety, confidentiality, safeguarding, dementia awareness, nutrition and hydration as well as being trained in ‘Move it or Lose it’ which equips them to deliver chair based exercise sessions, either one to one or in a group setting.

What difference does this make?

Independent research partners are evaluating these services in order to be able to communicate more clearly the role that volunteers can play in improving health and wellbeing outcomes. They will be looking at the impact of volunteers’ contribution by using standard, verified survey questions on health, happiness, anxiety, confidence and a standard measure for loneliness.

To date, it is estimated that 61 volunteers have contributed 1,180 volunteer hours (the value of this, as estimated by the Kings Fund, being £12,980) over 16 months, supporting 158 patients to the care that is provided by professional health care staff.

Patients have welcomed the ward based exercise sessions: ‘Your smiles are part of my therapy’ said one and ‘this is fantastic and these extra exercises will help me to go home. The staff and volunteers delivering are amazing’ said another.

RVS reports the evidence that targeted resistance exercises can reduce sarcopenia (a degenerative loss of skeletal muscle) and also can improve cognitive function. Social and physical activities for vulnerable patients aim to improve strength and balance (and hence to result in a reduction in falls), to increase the ability to carry out daily tasks and remain independent, to reduce frequency of visits to A & E or the GP and to improve general wellbeing and temperament.

The service is developing in the light of experience: in association with the physiotherapy lead, hospital volunteer manager and senior nursing staff, RVS is now setting up two groups per week at Llandough hospital and in St David’s it is introducing the service to additional wards.

RVS has secured funding for this work until 2021, with funding from Peoples Postcode Lottery funding. It is recognised as a ‘seed and scale’ project which has potential for wider adoption across the UK. Updates will be published as the work progresses.

During the Covid19 pandemic

During the pandemic the service implemented its contingency plan. Both aspects of the service, On Ward and Home Community Service have been adapted to provide a telephone befriending service as well as offering support to hospitals and other organisations, such as Care and Repair. Volunteers and staff have been supporting clients with wellbeing phone calls and the offer of shopping/delivery services.

The situation is being closely monitored and discussions will be held with the health board when hospital and government guidelines permit, to re-establish the services and enhance the pathway for our community support service, including a community Move it or Lose it class (delivered by a local MioLi Instructor). The service will also link in with RVS existing local community services which can (if required) provide support beyond 12 weeks post discharge.

RVS is a strategic partner with Helpforce UK and member of the Helpforce Steering group in Wales.

Case study by Helpforce Cymru. Helpforce is working with Third Sector Support Wales (WCVA and 19 CVCs), Welsh Government and other partners to develop the potential of volunteering to support health and social care services in Wales.