a patient volunteer programme
With support from North West London CCG Hiyos practice set up a patient volunteer programme, where patients could support other patients. This has been a remarkable journey and been independently evaluated by Imperial Health Care Partners
delivery section of report
Here is the delivery section of the report. You can download the full report below.
Hiyos Helpers is a great example of flexible delivery enabled by regular feedback from volunteers. The practice realised that the initial project on digital inclusion was having low adoption and pivoted to get volunteers involved in other practice activities such as Innovation Labs or Covid clinics. This meant that in less than one year Hiyos involved volunteers in three different projects, learning what worked and didn’t work and improving along the way.
project 1 – digital inclusion
The first project focused on patients struggling to access online services. While we cannot state that it achieved its original goals of improving digital inclusion (no specific patient data collected on those outcomes while the initiative was running), it had good feedback from patients (most of which said they would recommend it to family or friends).
Some patients had expressed need for support in accessing online tools, but many of these calls were about one-off issues (e.g. resetting a password) and some were issues that would be hard to address by a volunteer over the phone (e.g. “I don’t know how to use my computer”) – see table 2 for details. Only 10
around 18% of calls answered questions related to online service access (most frequently how to use messaging function to contact doctors). Even so, volunteers say how most patients were just happy that someone had called them and to chat for a while, even if their specific problem could not be solved in that call. This is reflected in a survey sent out to patients, where most expressed they would recommend the service (see Figure 1). This could suggest that the format and aim of the initiative were not well matched – phone calls might not be well suited for digital support of people with very low level of skill; at the same time, people did enjoy being able to talk over the phone and as such this could have worked well as an initiative to reach out to shielding people for befriending / companionship purposes.
|Table 2 – Breakout of types of requests from patients called by Hiyos Helpers. 56 calls were made of which 20 had no reply. Of the calls answered, the largest proportion were about one-off requests for account set-up or login details. Type of request||N calls||% calls|
|Login / account set up||14||25%|
|Questions about online services||6||11%|
|Lack of equipment/internet||4||7%|
|No help required||7||13%|
Patients were signposted to the service either by GP referral, or they could also sign up via a link sent in a newsletter. There is a chance that, since the aim of this initiative was to target digital exclusion, patients who felt the least confident might not have been able to sign up via a link. Volunteers then had a list of patients and contacts to call, a script to follow, and they would register the outcomes of the call in a central spreadsheet in their Teams channel.
One of the key elements that worked well in this initial project was communication – volunteers knew who to reach out to and what to do, and the Teams channel was helpful.
Some of the issues experienced in this project had to do with lack of structure: initially volunteers were given flexibility to work around their schedules rather than pre-committing to a particular time; this meant that patients did not know when they would get a call, and made it difficult for GPs referring them to given any indication on when to expect one. This lack of timeliness also meant that sometimes when patients were contacted their problem had already been solved.
A second issue had to do with the type of support needed: some requests were one-off, not easily solvable by volunteers and/or not easy to address over the phone. This meant that volunteers could not help and lost some motivation.
The one-off nature of the calls also meant that demand became lower after a while, with few people requiring regular contact. This low demand made it difficult to keep volunteers engaged and interested, and so the practice needed to adapt.
Overall, staff and volunteers felt like the project had low impact especially compared to the effort put in (e.g. time spent setting up NHS logins, training volunteers).
“It was demoralising that there was little demand for it. Lots of effort put in, and then feeling that patients were not interested.”Hiyos staff
project 2 – Innovation labs
In response to the low demand for the first project, Hiyos offered volunteers the chance to get involved in existing innovation labs, with mixed results: some volunteers managed to get integrated into their working groups and deliver activities, while others suffered from communication issues.
Hiyos has had innovation labs for ~3 years. These are groups of staff focused on certain areas that need improvement (e.g. diabetes, cervical screening). Each group starts with some data (e.g. from CCGs), and from there they identify potential issues and solutions. 11
Hiyos offered volunteers the opportunity to join groups they were interested in. Volunteers became integral members of the group and delivered some activities – e.g. one of the volunteers established a relationship with a local school, and held a quiz for local families.
Since volunteers were joining pre-established groups with recurring meetings, the schedule did not always work for them. There were also communication issues with a few volunteers and working group members failing to reply and follow-up. The timing of this involvement also coincided with a new Covid wave which meant staff did not have much time to spare for Innovation Labs projects.
project 3 – COVID 19 Vaccination clinics
When vaccination started ramping up, the practice saw this as an opportunity to involve volunteers in the Covid vaccination clinics, something that was widely regarded as a success from both staff and volunteers. A new round of recruitment was held specifically for the Covid vaccination clinics.
Volunteers were involved in marshalling, checking patient IDs, assisting patients with filling forms and cleaning the chairs in between. Typically a volunteer would sign-up to do a 7-8h day. Opportunities were advertised in the existing WhatsApp group and slots were filled easily. Staff also ensured that patients were treated as part of the team, participating in staff meetings at the beginning and end of each day.
Volunteers were generally happy with their experience and how they were treated during the clinics, although a few did mention this activity did not make as much use of their specific skills. Volunteers had clear structure and tasks, could meet each other and staff and build relationships, and have meaningful interactions with patients. Volunteers felt valued and “taken care of” by practice staff – with daily Covid tests, food and drinks, and staff being available to deal with any issues. They especially highlighted the human contact and being able to help people directly as a positive aspect of helping at the clinics.
“I really enjoyed the contact, handling people and older people in particular – making them safe and bringing them to the right place”Hiyos Helper
key recommendation for delivery stage
7. Set a clear structure for volunteers, both in terms of tasks and time commitment – e.g. have time slots when activities will be conducted that volunteers can sign up to
8. Ensure medical staff are aware of volunteers and how/when they can offer support to be able to refer and inform patients; e.g. send biweekly reminders on the service and its “opening hours”
9. Ensure the service is advertised and delivered in a way that is appropriate for the target population – e.g. partner with community organisations who are in contact with shielded patients; decide whether online, phone or face-to-face delivery is best suited to the problem being addressed
10. Define communication channels that work for the group of volunteers – in this case, WhatsApp worked well to advertise new volunteering opportunities and get quick responses
11. Have a plan to manage times of low demand – e.g. having more than one project for volunteers, back-up activities (e.g. training), communications to keep them posted on current situation and potential future opportunities
12. Map volunteers skills and interests to match volunteers to different activities and practice needs – creating a flexible and diverse pool of volunteers can allow the practice to deploy them in different ways to better meet practice needs and match volunteer interests, increasing their motivation; e.g. someone with IT skills could be suited to provide digital support, whereas highly engaged volunteers with more time available could help manage some of the volunteering activities, relieving some of the local resource