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How can I be a better volunteer?

I spend about three and a half days a week doing voluntary or unpaid work.  A couple of things recently (writing an article and attending an event) have prompted me to consider how volunteers are used and how to get more out of them.  However, I don’t have a full picture of everyone who volunteers or what it’s like to manage them, only what I do and what happens to me, so I thought it might be better to summarise those thoughts by considering what I can do to be a better volunteer.

I do a number of different things. I chair a GP Patient Participation Group (PPG), chair a forum of PPG’s, I am on the board of the local Healthwatch, and am a Patient Leader at the local acute Trust.  I sit on two subcommittees of the local Health and Wellbeing Board, one on coordinating community engagement and the other on mental health.  I sit on a NICE (National Institute for Health and Care Excellence) committee, an NIHR (National Institute for Health Research) committee and occasional other work for the NIHR plus occasional bits and pieces for other bodies.  I also do things for free like maintaining this website and facilitating an online community which aren’t done for a particular body but which are hopefully for the general good.  The detailed issues are, naturally, different in relation to each of them, but I will just try to consider some general points.

 

The first question is, “is it worth it?”, have I made a difference?  My gut feeling is, no, not really.  I have done a lot, written a lot but nothing immediately springs to mind that I could say has significantly improved people’s lives or reduced harm.

Of course, it could be that some things have improved and I just haven’t recognised my role in that.  However, if I think of the committees, projects and functions that I have been involved with I’m not sure I could proudly say “they achieved this, and it was a great achievement, and I was part of it!”

I did receive a slight fillip recently hearing positive feedback from committee chairs about lay members more generally.  Amongst the comments was gratitude for them asking the “naïve” question that the professionals were too embarrassed to ask.  So perhaps some good things do happen without me realising.

 

Before looking at what is wrong, I should emphasise that there much that is right.  I think the majority of volunteers make a valuable contribution and are much appreciated.   People are generally very attentive to volunteers and grateful for what they do.  We are thanked and sometimes even get goody bags!  So I don’t want to paint a picture of complete doom and gloom.  It is just about what I have or haven’t been able to achieve.

 

So, what is going wrong?  One significant thing is that some, and by no means all, committees, processes and projects are set up in a way that is not likely to achieve anything significant.  That applies particularly to committees whose main purpose seems to be to “give assurance” and share information.  Another example is a committee to which strategic objectives have been delegated but which does not have independent financial or personal resources or the necessary authority to make the relevant decisions.  In another case, the original purpose of the committee seems to have been lost to be replaced by “mission creep” towards other areas which are easier to get to grips with.

There is also a risk that those who, perhaps quite genuinely, want to involve patients and the public, only get as far as recruiting one to a committee.  This may not be intended as a token gesture but can be what it ends up being.

Another issue is not being listened to.  In part this may just be me not making points well enough.  However, I think there is also a tendency to see patient representatives, whatever their background and experience, as less credible than others.  Another difficulty is that, being outsiders, seeing things afresh, the problems or issues that patient representatives and lay members tend to spot are precisely the significant and tricky ones which are either not recognised or ignored because they are too hard. 

For me, the most egregious example of not being listened to was the development of the Joint Health and Wellbeing Strategy locally.  To be fair, I was listened to about many things, which led to more consultation than there would otherwise have been and some changes to the draft strategy.  However, I also felt I had something significant to say about the fundamental nature of the strategy and the process for producing it but I felt I was ignored.  This is not that my ideas weren’t taken on board, which is fair enough, you can’t be expected to blindly follow all consultation responses, but there was no indication that they had been heard or considered.

There can also be a problem of entering a strange country where you don’t understand the language or the local customs.  This isn’t a problem for me in local government and most public services, where I have a background, or health policy which I was able to get up to speed with, but is more of a issue with medical and clinical matters (for example, a table which included: “2WW-moviprep PGD escalated for amendment” for which I had great difficulty finding a translation).  I have been maintaining a glossary since I first started this kind of work almost 10 years ago and it has now reached 63 pages but I still add items on at least a monthly basis and typically more often.  It is usually possible to find the meanings of terms or abbreviations quite quickly but sometimes it is more time-consuming especially if it is a local rather than universal expression.  Normally, context will tell you which is right, but not always.  For instance, in an anaesthetist-led project we had “GPAS”.   I found, “Guidelines for the Provision of Anaesthetist Services” which seemed to fit the context OK.  But it turned out to be some sort of software.

It doesn’t particularly affect me but there is often poor administration, particularly around expenses.  It can take a long time to be paid and expenses are seldom covered in advance.  If you are on benefits and can’t afford the bus fare to a meeting, that needs to be sorted simply, efficiently and in advance or else you won’t get representation from an important section of the population.

 

So, what have I done right?  I have turned up (which Woody Allen suggested was 80% of success).  I have generally been polite, courteous and diplomatic (perhaps too much; maybe sometimes I should have made a bit more noise).

I prepare for meetings, sometimes at great length.

I have recognised that it takes time to gain respect and I have persevered.

I have contributed by writing draft strategies reports and minutes.  I have made relevant and potentially helpful interventions in committees.

 

So, what could or should I do to make a better contribution?

I think the main thing is to have a purpose for each activity I am involved with and then to pursue that purpose.  I suppose that until now I have implicitly assumed that any collective activity with which I have been involved – a project, committee or whatever – has had a worthwhile objective and all I need to do is contribute to that collective endeavour.  My question therefore has to be, what can I achieve through that endeavour, whether it is part of the stated purpose or not.  It might help if I have written aims and outcomes for what I’m trying to achieve and then monitor how far I have achieved them.

Underpinning this is to understand the environment I’m working in and to try and circumvent any problems.  That might include, for instance, understanding the structure, processes and culture of hospitals.  It may also include greater empathy towards other people and where they’re coming from and perhaps achieving win-win benefits.  If meetings aren’t being run as well as they could be it would be better to speak up and try to help improve them rather than moan quietly to myself afterwards.

To achieve things often means finding allies and building alliances; perhaps not in my core skill set but worth trying to develop.  More generally while it makes sense to use my particular skills and abilities I should also challenge myself to do the things I am less comfortable with even if I do not rely on them for success.

There is also potential for lay members, public and patient representatives and the like to support each other more.  This would include sharing information on health and wellbeing matters locally, but also providing help to fulfil our roles.  There are regularly attempts to do this from time to time, with meetings bringing people together, but they generally fizzle out after a while.  Facilitating such efforts both online and in person is something I have done in the past and maybe I could do more of now.

Something else that is needed but which I think I have been reasonably good at is confidence and persistence to keep going.  Nevertheless, there are examples where I have in effect given up.

On the other hand, I also need to be prepared to give things up and make changes to my portfolio of activities.  Some of that can happen in an evolutionary way as I drop the less productive things and pick up on ones with more potential.  Sometimes though it may need a big bang, step change.  This could include a move away from the volunteer work altogether into other activities.

 

So, what does this mean for me?  There are clearly things I can and should be doing to enhance my contribution, and I will try to do that.  More significant is changing the things I do, perhaps radically.  Perhaps the most damning result of this reflection – damning of me as much, if not more than, “the system” – is that I haven’t really enjoyed the work that much.  There is some sense of satisfaction for some of the things (such as work for the NIHR) but mainly it is carrying on out of some sense of duty (or perhaps institutionalisation) with a constant, low-level sense of pressure.  Since I have choice over what I do, it surely make sense to at least enjoy it.  Let’s see if I can rise to the challenge of making changes to achieve that.

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