Volunteering in NHS Scotland Developing Volunteering Toolkit Summary of Pilot

Volunteering in NHS Scotland Developing Volunteering Toolkit Summary of Pilot NG09-06a Introduction Direct volunteering has been evolving within the NHS for some time. For more than a decade a strong emphasis has been placed upon the development of the structures that support volunteering. During that time issues have continually been raised re the lack of support; and/or negative attitudes towards volunteers, particularly in some acute ward settings. The Scottish Government s strategy on volunteering in the NHS now also challenges NHS Boards to develop a sustainable culture of volunteering. A response to these points within NHSGGC Acute Services, led to the redesign of the volunteer service and ultimately the development of a toolkit, which aims to address these issues and improve culture. This is achieved by ensuring that nursing staff have access to brief information sessions on volunteering; clarification on the roles & responsibilities of having volunteers as part of the team and aims to ensure that from the outset, volunteers become an integral part of a multi disciplinary ward team. The Toolkit consists of a variety of tools and activities that are designed to provide methods of engaging with staff on the subject of volunteering, exploring myths and prejudices and raising awareness. The Toolkit was designed to provide a suite of activities that could be used in a variety of situations, each with suggested timescales and methods. The activities were segmented into different levels: 0, 1 and 2. Level 0 activities were for use where there was no prior knowledge or experience of volunteering was present within a team or ward. Level 1 activities were designed for use in situations where volunteers had already been present or where the level 0 activities had already been undertaken. Level 2 activities were for use where it was clear that the staff teams were already bought in to the concept of volunteering. NHS Boards involved in the pilot Sessions were delivered in NHS Greater Glasgow & Clyde across acute sites. These have been carried out on every hospital site in NHS Greater Glasgow & Clyde 21 wards across 14 sites, with an estimated reach of 200 or more staff. It was not possible to attain an accurate figure due to staff dropping in and out of sessions as they were delivered. Produced by: A.Bigham & M.Young Page 1 of 8 Review date: None

NHS Borders was also identified as a pilot site but it was not possible to arrange sessions within the pilot timeframe. Through the delivery of the Volunteering in NHSScotland Programme it became apparent that the Toolkit would be of use in non-acute settings. Additional sessions were delivered outside of a ward environment one in a special health board (NHS Health Scotland), one to a health improvement team (East Team in NHS Greater Glasgow & Clyde) and a series of modified sessions in NHS Shetland which included acute and non-acute settings. How the sessions were delivered NHS Greater Glasgow & Clyde acute settings Sessions were delivered across 14 hospitals by Margaret Young, Services Manager Acute Division. It became apparent that the availability of staff in ward settings would be extremely limited. Due to these constraints the sessions were delivered in a more flexible discussion-based manner. The compressed sessions took an average of 15 minutes to deliver. NHS Greater Glasgow & Clyde Eastbank Health Promotion Team A session lasting 60 minutes was delivered to the Team by the Scottish Health Council Programme Manager, Alan Bigham. The session made use of the volunteering myths, reverse brainstorming exercises and two case studies. NHS Health Scotland Elements of the toolkit were used in a session that was co-delivered by Dawn Burns, NHS Health Scotland Health Improvement Programme Officer and the Programme Manager from the Scottish Health Council. The session consisted of an ice-breaker (paid and voluntary roles), discussion of experiences of volunteering, barriers to volunteering, identification of any concerns staff held about volunteering and an exploration of what volunteer tasks and roles might be appropriate. The session lasted 90 minutes and was attended by staff from a variety of office-based roles. NHS Shetland A series of short meetings were arranged in and around Gilbert Bain Hospital where the Programme Manager met with NHS Shetland staff from a variety of clinical and nonclinical roles. Discussions made reference to the content of the toolkit but followed a more exploratory nature of dialogue. Each meeting lasted no more than 20 minutes with the meetings on wards lasting no more than 10 minutes. Produced by: A.Bigham & M.Young Page 2 of 8 Review date: None

Impact and what was learned from the pilot The activities in the Toolkit had originally been developed with a more distinct training environment in mind. Whilst great care was taken to refer to the sessions as engagement and not training, it had been hoped that it would be possible to meet with staff away from the area of day to day work. It became apparent in arranging the acute sessions in NHS Greater Glasgow & Clyde that it would not be possible to release staff from their duties to undertake non-mandatory training. This led to the adaptation of the tools in order to create a more free-flowing discussion whereby staff could interact and drop in and out while the session was taking place. In all cases the sessions created an environment where staff could ask questions relating to volunteering which helped to raise awareness and ensure that clear boundaries could be set in relation to expectations on volunteers. The sessions delivered in NHS Greater Glasgow & Clyde acute settings benefitted enormously from the existing relationships the Services Manager had already developed with key staff. The delivery of the sessions ran in parallel with the intentions of the Services Manager to improve the culture towards volunteering and formed part of a plan for service redesign. Similarly, each of the other session could only have been arranged with the direct involvement of the staff from each NHS Board. It would not have been possible for the Programme Manager, for instance, to have approached ward staff from an NHS Board directly. The co-delivery method used in the NHS Health Scotland example was also helpful as the co-facilitator had knowledge of the audience and was better placed to decide which aspects of the Toolkit would be most effective. Feedback from staff who attended the sessions was collected from some of the acute staff. It was not always possible to collect feedback from staff due to the constraints on their time. The results of the feedback are covered below. On a number of occasions staff asked specific questions about what roles volunteers could undertake. In acute settings this included requests from some clinical staff for volunteers to become involved in the physical feeding of patients. On those occasions the Board policy was referred to, clarifying that under no circumstances should volunteers be physically feeding patients. On one occasion the staff group highlighted the anomaly of allowing relatives to feed patients and questioned why it would be different for volunteers. A recent volunteer survey by NHS Greater Glasgow & Clyde has confirmed that ALL volunteers now feel welcome in wards and most comment by saying that staff are lovely and make me feel welcome! Produced by: A.Bigham & M.Young Page 3 of 8 Review date: None

Unintended outcomes The sessions included some unexpected results including an extreme example which took place on two occasions: members of nursing staff said, I thought you were coming here to ask me to volunteer to do another shift on my day off. Whilst the Toolkit contains a number of volunteering myths, this was not something that had previously been conceived of when developing the Toolkit. In another example a member of staff asked if they could become a volunteer and who is now volunteering in another NHS Board. Although the intention of the sessions was to explore the engagement of volunteers by staff this was a positive yet unintentional consequence of the delivery of the session. Feedback from NHS staff Feedback sheets were introduced in the visits to wards in NHS Greater Glasgow & Clyde. Appendix x include an example of the feedback sheet used. A total of 40 feedback sheets were received from staff across nine wards. The objectives of the sessions were outlined to the staff as follows: 1. For nursing staff to understand more about having volunteers become part of the team 2. To give nursing staff the opportunity to explore their thoughts on how to use volunteers effectively to support patients and the ward environment 3. To explore some of the common myths around volunteering 4. To ensure you understand how volunteering can work best for you and the patients in your ward Almost all staff reported that they each objective had been fully met. One member of staff in one ward reported that objective 3 was only partially met. Staff were also asked to evaluate the session in relation to its delivery through their ability to interact and a personal impact on their awareness. The forms asked participants to report whether: 1. I felt able to participate in this session 2. This information session has increased my awareness on ward volunteers All but one member of staff reported that they felt fully able to participate in the session. The one respondent who differed reported that they felt able to participate most of the time possibly due to the nature of the sessions developing into more of a verbal presentation at times. Produced by: A.Bigham & M.Young Page 4 of 8 Review date: None

All staff said that the second session objective was fully met. Staff were also asked to provide any additional comments. Responses consisted of: Look forward to volunteers making things better for patients through their company. Understand more about objectives of volunteering. Will be a great resource. Very useful session. Should be done before volunteers arrive. Beneficial session. Raised awareness of benefits of volunteers. Fantastic idea. Great asset to ward. I think this will benefit the NHS. Very Good! :) Good session! Looking forward to having more volunteers! Look forward to volunteer support. Very good session - I am looking forward to the volunteers starting. Looking forward to meeting new volunteers in ward 3! I feel volunteers in the ward is of great benefit to staff and patients. Enjoying having volunteers in ward, all seem really keen. Feedback from volunteers Whilst the sessions were taking place NHS Greater Glasgow & Clyde the Board was implementing a Voluntary Services Questionnaire which was sent to all volunteers in acute settings. This allowed for the feedback from volunteers on wards where sessions had been delivered to be cross-referenced. Included in the questionnaire are a number of questions relating to their experience. Some of the questions and a sample of responses have been included below. Did the staff make you feel welcome in the ward? The staff at ward x have always been more than welcoming and supportive, I have never had any issues with the staff what so ever. The ward manger and deputy manager have made me feel welcome to the ward. The other nursing staff change regularly and are not used to seeing me as much as the ward manager and deputy manager. Staff were welcoming, helpful, open to a volunteers being on the wards, explain, approachable and friendly. I was made to feel welcomed by staff. However initially some staff did not know anything about volunteers or what they were there for and I feel that this made Produced by: A.Bigham & M.Young Page 5 of 8 Review date: None

things slightly awkward in the beginning as some staff did not know what my duties would be so were unsure about what they should be asking me to do. The staff were lovely, they were very helpful and made me feel part of the team. I have been made extremely welcome within ward x. My time and input goes along way and is very much appreciated from everyone on the ward. Every shift I report to the Sister whom has made me feel extremely welcome and regards me as a part of her team. The sister of the ward speaks to me at the start of my shift and at the end of my shift and constantly thanks me for my efforts, which is greatly appreciated and makes me feel like a part of the team. Do you feel that there are sufficient duties for you in the ward or department? I think it takes a month or so for a volunteer to become familiar with the routine of the ward and then it is easier to decide what day/times you are most valuable to patients & staff alike. I feel now my time is kept occupied from when I start to when I finish, but that is probably because I worked out myself what would fit in best with the wards routine. How supportive do you find the staff? The ward manager and deputy ward manager speak to me when I arrive and advise me if there are any patients that I should not speak to due to health issues etc. Staff are approachable and willing to answer to any questions that may have. I feel the more staff have got to know me then the more supportive they have been. Over the last month or two I really feel like part of the team now. I suppose this may be because I have shown commitment within my role as a volunteer and staff are now used to seeing me around the ward and they know when I come in and what I do while I m there The staff were very supportive and always made sure I felt comfortable in the hospital Nurses are very approachable and friendly. Often ask if I am alright and have enough to do etc. All the staff on ward x are extremely helpful and will help where necessary. If I have a question or query the staff take their time to explain and show me where to find stuff and explain any question I may have. As a volunteer, do you feel your contribution is valued? [Staff name] has always made me feel valued and at the end of every shift the staff thank me for being there and coming in, which is an awesome feeling to be honest. I think I have been placed in a really good ward with really nice staff. A lot of the patients I have spoken to have advised me that they have enjoyed the interaction speaking with me. I feel the nurses are happy as they don t get as much time to spend with the patients, and the patients appreciate you sitting down and speaking to them or Produced by: A.Bigham & M.Young Page 6 of 8 Review date: None

playing a game with them. The nurses appreciate it as well because they have more time to do other things. Staff often openly grateful when I offer help. Patients often thank me, or other visitors of patients (relatives etc) often comment on it being a good thing to do. Interestingly the comment highlighted above, I was made to feel welcomed by staff. However initially some staff did not know anything about volunteers or what they were there for and I feel that this made things slightly awkward in the beginning as some staff did not know what my duties would be so were unsure about what they should be asking me to do relates to a ward where it was only possible to delivered a session retrospectively (after volunteers had been placed). Reflection and recommendations The pilot of the Toolkit has provided additional evidence of the need to engage with staff who will work alongside volunteers. It has highlighted that despite the volume of corporate communications and Board-wide policies there is an ongoing need to converse with staff and provide them with an opportunity to ask questions. The flexible nature of the Toolkit was tested, particularly in acute settings where only 10 to 20 minutes was available for engaging with staff far less than the anticipated 45 minutes. The approach taken to establish a dialogue and to visit staff on wards proved to be successful and resulted in the objectives of the sessions being met. Key points for adoption by NHS Boards The key learning points for consideration by other NHS Boards include: 1. A roll-out of sessions must be directed from someone in authority. This is of particular importance in acute settings. In other settings senior management buy-in will be extremely helpful to ensuring the sessions take place. 2. Delivery of these sessions is resource-intensive. The Toolkit cannot simply be utilised by teams of staff who have no experience of volunteering. Consideration must be given to who has the capacity to deliver these sessions. 3. The placement of volunteers in new roles, new environments or with staff who are new to volunteering must be monitored and reviewed. This ensures that volunteers are benefitting from a quality volunteering experience and that staff are comfortable with the role and performance of the volunteers placed with them. Produced by: A.Bigham & M.Young Page 7 of 8 Review date: None

Amendments to the Toolkit The Toolkit will require a further revision before being made available to NHS Boards. These include: Replacement of the specific references of delivery in acute settings to ensure use in other settings Amendments throughout the document to refer to the need to condense activities for use in acute settings Inclusion of statistics on volunteering for challenging the volunteering myths Inclusion of media coverage on volunteering to challenge myths Development of further case studies, borrowing from examples highlighted by Voluntary Services Managers and volunteers References made to the key learning points identified through the pilot Some minor amendment to phrases used within the toolkit Recommendations Subject to the above revisions, the following actions are recommended: 1. A revised version of Toolkit will be presented to the National Group for Volunteering for their approval. 2. Capacity within the Scottish Health Council Local Officer Network will be explored with the aim of delivering a session to Local Office staff who would be in a position to co-deliver sessions with NHS colleagues. 3. The launch of the Toolkit is communicated through appropriate channels including Partnership Forum. Produced by: A.Bigham & M.Young Page 8 of 8 Review date: None