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The Volunteer Army: ‘Empty Promises are No Solution to Serious Pressures on Health and Social Care’

Consultant David Oliver laments yet another ‘Policy Zombie’ from the Government

Patients wait on beds in the corridor as Shadow health secretary Wes Streeting and Labour Parliamentary Candidate for Peterborough Andrew Pakes visit Peterborough City Hospital in March 2023. Photo: PA Images/Alamy

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You couldn’t make it up. But yet again, our current Government has. If there was a competition for empty soundbites, hollow rhetoric and detail-free, undeliverable proposals, they’d be peerless. Another week, another daft, distracting proposal.

The Guardian’s Robert Booth reported that “Health ministers are to recruit a new volunteer army for social care to ferry medical equipment and drugs to people’s homes in a bid to free up congested hospital wards.”

Volunteers would also be “sent to, though not into, people’s homes” to tackle loneliness and carry out shopping and other errands such as collecting prescriptions and living aids.   They could sign up on the GoodSam App for roles such as “check and chat” to help people with loneliness. 

The press releases and media contributions from Helen Whately, Minister of State for Social Care, were to publicise the 7 June launch of the ‘NHS and Social Care Volunteers Responders Programme’. She clarified that the volunteers would not be replacing the roles played by paid employees but somehow complimenting them and that they would also be welcome in care homes. 

I am not knocking the notion of a society where private citizens step up to support our older, frailer, more isolated, lonely, disabled or house-bound citizens and many people already do just this without being labelled as part of some new Tory-inspired task force, 

But this initiative is being badly miss-sold.

Five Million Unpaid Carers

This ‘Volunteer Army’ is not an answer to the high number of people currently stranded in hospital beds who are technically fit to leave. Some of those individuals are waiting for internal hospital processes, reviews and referrals. But most people who are stuck for long periods are waiting either for social care assessment funding or provision  (either in their own home or a care home)  or for community health services to support their ongoing recovery and treatment outside hospital. 

For Whateley to say to reporters that a major reason for delays in hospital was “people waiting for a long time for their prescriptions or medicines to come home” and that medicine and equipment could be delivered by volunteers “rather than sitting in a hospital bed until everything’s ready” is disingenuous. 

If patients need new equipment to go home, having been assessed by a ward multi-professional team, then this is requested from NHS equipment stores or sent home with the patient from hospital. Using volunteers will not speed up the supply. And hospitals are required to dispense at least 2 weeks’ worth of medication for patients to take home. A volunteer might shave a couple of hours off some discharges by bringing it home after them.

The vast majority of personal care and support is already provided by unpaid carers – general family members or friends – an estimated 5 million of them in England alone. The annual Carers UK “State of Caring” report makes it clear just how little formal state support most of them receive and the impact of caring on their own health, wellbeing or ability to work. Most people with care needs are not in receipt of any statutory social services, which are heavily restricted by high eligibility thresholds and means-testing. 

There is already a whole range of voluntary organisations providing the kind of support including befriending or “home from hospital” that the government is now claiming as some kind of innovation. Those charities in return can benefit from some contracted work or local government funding but budgets for local government have been savaged. 

Policy Zombies

We have been here before with these discredited but endlessly revived ‘Policy Zombies’. Remember David Cameron’s “Big Society” soundbites – gradually shelved early into the coalition Government? Or the COVID-era Conservative bragging about thousands of volunteers signing up to help the pandemic effort? Many of them had no role they could be deployed into as the logistical support wasn’t there and local health and social care organisations had not defined the need. 

This is before we even get to the need for criminal records checks and other types of vetting, induction, training, supervision, regulation and accountability of the supervising organisations or professional staff. 

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This latest policy wheeze is a response to the Government’s own decimation of public services. Cuts in support grants and competing cost pressures on local government, and struggles for care provider organisations to remain viable have meant major reductions in the number of people receiving formal social care services in their own homes and a fall in available care home places.

In the 13 years since the 2010 election in which population ageing and growth have increased the need and demand for care. This has been compounded by major workforce gaps with 1 in 9 social care vacancies unfilled, partly as a result of damaging immigration policy and competing sectors also now short of workers.

Community health services that can help support people outside hospital have also been hit hard by reductions in resources and staffing – for instance, a major drop in district nursing numbers. 

There is still no NHS workforce plan nor a credible long-term solution to social care funding and provision. Volunteering, third-sector organisations and community networks that can help support older people in their homes can be a fine thing.  But they won’t solve these wider structural issues. 

Meanwhile, the Conservatives want people to retire later and people who are off sick to return to the labour market. It isn’t going to leave much headroom for additional volunteering.

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