Voluntary Sector Research Articles

Professionals’ understanding of the County Lines phenomenon: Insights from a study exploring the perceptions of young peoples’ supported accommodation staff

This paper presents findings of a study exploring professionals’ understanding of the County Lines phenomenon. Employed across two voluntary sector young peoples’ supported accommodation projects a purposeful sample of fifteen (n = 15) practitioners were recruited as study participants. The study purpose was to explore professional perceptions of criminal exploitation in the context of County Lines and identify how practitioners recognised and responded to children and young people at risk. Questions guiding the study included: (1) What are practitioners’ perceptions of criminal exploitation and County Lines? (2) How do practitioners recognise and respond to children and young people at risk? With a review of literature, data collection methods comprised a: (1) case study vignette and (2) self-reporting questionnaire. Utilising aspects of content analysis combining highest frequencies of most common terms and references presented in data, comparable participant responses were coded into four (n = 4) key categories. Categories included: (1) Knowledge of criminal exploitation and County Lines (2) Recognising risk and vulnerability factors (3) Understanding methods of exploitation and responding to risk and (4) Practitioner attitudes, bias and stereotypes. Findings highlight disparities in professionals’ understanding in relation to: (1) what County Lines is (2) how and why some children and young people are criminally exploited in the context of County Lines and (3) how practitioners identify and respond to children and young people at risk. Need for development of enhanced knowledge-depth for safeguarding practice is identified as required around practitioners’ understanding of: (1) risk, vulnerability factors and the signs of criminal exploitation through County Lines (2) importance of ensuring multi-agency statutory safeguarding referrals and responses are undertaken (3) how legal frameworks including the National Referral Mechanism and Modern Slavery Act (2015) can offer victims protection and (4) importance of theoretically informed relationship-based practice with children and young people guided by trauma-informed principles.

Experiences of Remote Provision across a Voluntary Sector Organisation Providing Mental Health and Wellbeing Services for Young People.

The global COVID-19 pandemic presented not only challenges for services but also opportunities for reflection and change. This study aimed to understand young people, parents/carers, and professionals' experiences of remote provision across a voluntary sector organization to inform the nature of future delivery. Reflections from professionals (n = 7), young people (n = 7), and parents/carers (n = 2) were collected through semi-structured interviews and focus groups. Data were thematically analysed. Five overarching themes were identified: 'Accessibility', 'Remote therapeutic experiences', 'Translating to online', 'Spaces of comfort/discomfort', and 'Moving towards hybrid provision'. The COVID-19 pandemic changed service provision, notably with accelerated digitalisation. Although the service became more accessible, the digitalisation of services impacted the relational experiences for young people. Nevertheless, online provision was described as a 'steppingstone', allowing young people to engage in online therapy or group programmes before transferring to in-person provision. Although remote provision can lead to improvements in young people's mental health, this format was not suitable for all. When considering future models of provision, assessing needs, preferences, and access to private space and hardware are all important considerations when deciding which format to use to achieve the best possible outcomes.

The role of civil society and the voluntary sector in children's global surgery

An unacceptable inequity exists in the burden of pediatric surgical disease and access to surgical and anesthesia care between low- and middle-income countries (LMIC) and high-income countries (HIC). Civil society organizations (CSOs) and the voluntary sector have been integral in addressing this imbalance. This article summarizes the roles that these organizations have played in improving pediatric surgical care globally and how their roles have evolved over the years. CSOs and voluntary organizations have historically provided operations on LMIC patients; however, the focus has shifted to building sustainable surgical systems by training a skilled workforce, improving local infrastructure, and contributing to research and advocacy efforts.

Nonprofit Organizations 1 Year After the Covid-19 Crisis: Understanding How the French Voluntary Sector is Opening up to Adaptations Related to Societal Orientation

Nonprofit Organizations 1 Year After the Covid-19 Crisis: Understanding How the French Voluntary Sector is Opening up to Adaptations Related to Societal Orientation

Managing the unmeasurable: Developing a new performance management framework for the voluntary sector

IMPACT The concept of management control ‘as a package’ is explored within the context of five voluntary hospices in the UK, using a comprehensive framework, Simons’ levers of control. not applied widely in the voluntary sector. This article argues that, to enhance its practical application in this sector, this framework needs to be modified to include broader concepts of ethos, responsibility and judgement. This tool can be used in further research as well as providing a framework for discussions between voluntary organizations and their stakeholders about a balanced approach to managing and accounting for their organizational performance, not predominantly through measurement.

Lifestyle medicine: a cultural shift in medicine that can drive integration of care

Our traditional medical mindset and healthcare culture are being severely challenged. In the face of novel infectious diseases, such as Coronavirus 2019 (COVID-19), along with rising levels of chronic diseases, such as obesity, type 2 diabetes mellitus, psychiatric illness, cardiovascular disease and cancer, many argue that current healthcare practices are failing to meet our needs. Energy and vision for a new way of practicing medicine are colliding, from both top-down, driven by policy, and bottom-up, driven by clinicians and patients. Policy makers have laid out the need for integration of healthcare delivery to address the complex chronic disease burden; creating integrated care partnerships, health and wellbeing boards and primary care networks to bring together 'at the place level' primary and secondary care, mental and public health services, social care and the voluntary sector. In practice, this is starting to build lasting working relationships between previously siloed services, to address the complex environmental, social, cultural, lifestyle and biopsychosocial drivers of ill health rather than simply providing access to hospitals, doctors and medication. Similarly, out of frustration with our traditional pharmaceutically driven medical model, grass-roots clinicians have built a new vision for their role in this better integrated health system, with the discipline of lifestyle medicine.

Interventions to improve access to primary care for inclusion health groups in England: a scoping review

BackgroundEveryone in England has the right to primary care without financial charges. Nevertheless, evidence shows that barriers remain for inclusion health populations such as vulnerable migrants, people experiencing homelessness, Gypsy, Roma, and Traveller (GRT) communities, and people who sell sex. There is little evidence for what works to improve access. This study was a scoping review of interventions to improve access to mainstream primary care for inclusion health groups in England. MethodsIn this scoping review, we searched databases (Embase, Medline, APA PsychInfo, the Cochrane Collaboration Library, Web of Science and CINAHL) and grey literature sources, including the National Health Service and National Institute for Clinical Excellence, for articles published in English between Jan 1, 2010, and Dec 31, 2020, with no limit on study design. Data were extracted according to inclusion criteria, including interventions taking place in England and targeting people with insecure immigration status, people who sell sex, people experiencing homelessness, and GRT communities. Results were presented in a narrative synthesis. Findings39 studies describing one or more interventions were included: four peer-reviewed articles (one randomised trial, two quality improvement projects, and one mixed-methods study protocol) and 25 grey literature items (38 interventions in total). Interventions mostly targeted people with insecure immigration status (17/38, 45%), and a majority (12/38, 32%) took place in London. The most common types of intervention were training, education, and resources (such as leaflets or websites) for patients or staff (25/38, 66%), and most interventions targeted GP registration processes (28/38, 74%). Interventions commonly involved voluntary and community sector organisations (16/38, 42%). Most interventions were not evaluated to understand their effectiveness (23/38, 61%). Sources with evaluations identified staff training, direct patient advocacy, and involvement of people with lived experience as effective elements. InterpretationInterventions to improve access to primary care for inclusion health groups in England were heterogeneous, commonly undertaken at community level, and developed to serve local inclusion health groups. Considerations for policymakers and practitioners include groups and geographical areas less commonly included in interventions, the elements of positive practice identified in evaluations, and the need for evaluation of future interventions. FundingNational Institute for Health and Care Research (NIHR 202050).

Social prescribing as a community health-promoting tool: lessons from a country exchange visit

Abstract Issue Social Prescribing (SP) describes evidence-based interventions designed to improve health and wellbeing by referring individuals with non-medical, health-related social needs to health-promoting community-based support and services. Differences in national health systems, sociopolitical infrastructures and terminology, has however created a heterogeneity on SP practice and limited its implementation. Description of the problem On may 2022 the Portuguese National Institute of Health Dr Ricardo Jorge in partnership with EurohealthNet, organised a Country Exchange Visit to Lisbon. The purpose was to discuss SP and other health promoting primary care strategies in practice at European level and explore the political, financial and practical enablers that connect community and primary health care and social services, in order to build up knowledge-base to foster further SP policy and practice. Results Participants from ten European health authorities visit on site several community-based initiatives and shared information about relevant activities in their countries. In particular, brainstorming sessions between participants and the twelve key SP partners from the voluntary and community sector, were continuously facilitated by organizers. A summary report was published, providing an overview of the knowledge exchange. Lessons Overall, the importance to strengthen the collaboration between health and social sectors was recorrently highlighted. Co-funding between the governmental bodies and development of intersectorial partnership projets were pointed out as key innovative approaches to launch and scale up sustainable SP implementation. It was noted that despite the evidence showing the health benefits of a SP model, quality of individual interventions should be ensured and supported by common evaluation frameworks. The development of new training and competence modules adapted to contextual needs was considered particularly relevant to foster SP implementation. Key messages • Social prescribing represents an innovative tool that enables health systems to meet in a better way the new societal challenges by a complete paradigm shift to a biopsychosocial model of care. • Implementation of social prescribing and its integration into national health systems is crucial to develop new models of care and health to face 21st century health problems.

Children England's demise reveals ‘existential’ risk to charity sector

A key feature of the children's voluntary sector for more than 80 years, infrastructure body Children England is to close, citing financial challenges, with its chief executive warning that more will follow

The role of the voluntary, community, faith, and social enterprise (VCFSE) sector within integrated care systems (ICSs) and its contributions to health outcomes – a logic model

The voluntary, community, faith, and social enterprise (VCFSE) sector should be a key partner in the design and delivery of health and care services, alongside statutory partners (e.g., NHS, local authorities) and local communities. However, there has been limited discussion of how the VCFSE sector feature in integrated care models and what outcomes their involvement can contribute to. This study developed a logic model to articulate the potential role of the VCFSE sector within integrated care, by reviewing existing evidence, and engaging with a range of relevant stakeholders. This logic model could be usefully applied as a framework to plan and evaluate future projects and activities which involve the VCFSE sector in integrated care.

How to develop young physical activity leaders? A Delphi study.

The International Society for Physical Activity and Health advocates for increased capability of the physical activity workforce as a key ingredient to a system-based approach. Young leader programmes are gaining traction globally as peers are a primary influence on young people and positive role models are important for increasing or maintaining physical activity. Yet, there is limited understanding of 'what works' for training young physical activity leaders. This study aims to develop a consensus on how to identify and support young people to become physical activity leaders. An iterative three-phased mixed methods Delphi consensus approach. A rapid review focused on the feasibility, acceptability and impact of existing young leader physical activity training (phase one); focus groups (n = 3) and interviews (n = 6) with 15 practitioners and young leaders to examine young physical activity leader training needs (phase two); and a three-round questionnaire process (phase three). Stakeholders (n = 43) from across the public, voluntary and education sectors, academics and young leaders completed all questionnaires. A consensus was reached for 75 statements related to: young leader traits prior to and following training, recruitment methods, training content, delivery format and context, relationships, incentives, and skill development. The Delphi process, combining insight from multi-sectoral stakeholders, identified a range of factors that underpin young leader training programmes. These factors should be applied to develop a curriculum and comprehensive training programme to provide young leaders with the required capability to be effective within their roles, and ultimately support an increase in physical activity amongst children and young people.

The effectiveness and cost-effectiveness of a group domestic abuse perpetrator programme: protocol for a randomised controlled trial

BackgroundIn contrast to evidence for interventions supporting victim/survivors of domestic violence and abuse (DVA), the effectiveness of perpetrator programmes for reduction of abuse is uncertain. This study aims to estimate the effectiveness and cost-effectiveness of a perpetrator programme for men.MethodsPragmatic two-group individually randomised controlled trial (RCT) with embedded process and economic evaluation. Five centres in southwest England and South Wales aim to recruit 316 (reduced from original target of 366) male domestic abuse perpetrators. These will be randomised 2:1 to a community-based domestic abuse perpetrator programme (DAPP) or usual care comparator with 12-month follow-up. Female partners/ex-partners will be invited to join the study.The intervention for men comprises 23 weekly sessions of a group programme delivered in voluntary sector domestic abuse services. The intervention for female partners/ex-partners is one-to-one support from a safety worker. Men allocated to usual care receive no intervention; however, they are free to access other services. Their partners/ex-partners will be signposted to support services.Data is collected at baseline, and 4, 8 and 12 months’ follow-up. The primary outcome is men’s self-reported abusive behaviour measured by the Abusive Behaviour Inventory (ABI-29) at 12 months. Secondary measures include physical and mental health status and resource use alongside the abuse measure ABI (ABI-R) for partners/ex-partners and criminal justice contact for men.A mixed methods process evaluation and qualitative study will explore mechanisms of effectiveness, judge fidelity to the intervention model using interviews and group observations.The economic evaluation, over a 1-year time horizon from three perspectives (health and social care, public sector and society), will employ a cost-consequences framework reporting costs alongside economic outcomes (Quality-Adjusted Life Years derived from EQ-5D-5L, SF-12 and CHU-9D, and ICECAP-A) as well as the primary and other secondary outcomes.DiscussionThis trial will provide evidence of the (cost)effectiveness of a DAPP. The embedded process evaluation will further insights in the experiences and contexts of participants and their journey through a perpetrator programme, and the study will seek to address the omission in other studies of economic evaluations.Trial registrationISRCTN15804282, April 1, 2019

345 Integration of care for older adults: an evaluation analysis of the clinical pathways from the emergency department

Abstract Background There is an urgency globally to create novel healthcare models for the older adult population considering the ever-growing demographic. Ireland’s Integrated Care Programme for Older People (2016) emphasises the importance of delivering healthcare to older adults in their community with focus on the direct access to services from the Emergency Department (ED). This ‘frailty at the front door’ team sought to evaluate the clinical pathways facilitating direct integration of care into the community following completion of the Comprehensive Older Adult Assessment (COAA) in the ED of a model 3 hospital. Methods The team conducted an evaluation analysis of the critical pathways referring patients to the community directly from the ED. The team recorded the quantity of referrals to each community service on discharge over a period of six months from October 2022–March 2023. This included Health Services Executive (HSE) services and voluntary sector services. The results included admission avoidance pathways. The team completed a case study review for individuals readmitting to the ED within 7 days and 30 days. Results 796 Older Adults were assessed by the team in the ED. 368 Older Adults were discharged directly to the community. From January–March 2023 there were 79 admissions avoided. For those discharged, there were 440 onward referrals made to community-based services. These included 91 referrals to Primary Care Physiotherapy, 83 to Public Health Nurse, 60 to Primary Care OT, 45 to the Community Intervention Team, and 11 referrals to the Dementia Advisor. The 7 day readmission rate ranged from 0–4% per month. The 30 day readmission rate ranged from 5–13%. Conclusion There was a high level of integration of care between the ED ‘frailty at the front door’ team and voluntary or HSE community services. The low readmission rate demonstrates the effectiveness of the discharge pathways in enhancing the safety of discharges.

Impact of Voluntary, Community and Social Enterprise (VCSE) Organisations Working with Underserved Communities with Type 2 Diabetes Mellitus in England.

The Voluntary, Community and Social Enterprise (VCSE) sector offers services and leadership within the health and care system in England and has a specialist role in working with underserved, deprived communities. This evaluation aims to identify best practices in self-management support for those living with type 2 diabetes mellitus (T2DM) and to develop a theory of change (TofC) through understanding the impact of VCSE organisations on diabetes management. An appreciative inquiry (AI) was carried out and co-delivered using qualitative interviews and an embedded analysis with VCSE partners. A voluntary service coordinated seven VCSE organisations who assisted with recruiting their service users and undertook interviews to identify the impact of existing activities and programmes. People living with T2DM were interviewed about services. Themes were as follows: (a) individual and group activities; (b) trusted services and relationships across the community; (c) long-term engagement; (d) sociocultural context of diet and nutritional choices; (e) experience of adaptation; and (f) culturally appropriate advice and independent VCSE organisations. The structured educational approach (DESMOND) for T2DM was accessed variably, despite these services being recommended by NICE guidelines as a standard intervention. The VCSE offered continuity and culturally appropriate services to more marginalised groups. This evaluation highlights the importance of targeted engagement with underserved communities, particularly where primary care services are more limited. The TofC is a unique insight into the impact of VCSE services, offering bespoke support to manage T2DM, suggesting areas for improvements in capacity and offering the capability to sustain the VCSE sector as an essential element of the T2DM care pathway in England.

Voluntary organizations and the provision of health services in England and France, 1917–29

ABSTRACT As the First World War came to an end, governments in the UK and France began the process of planning for reconstruction. In both cases health services emerged as key features of the post-war settlement with ambitious new Ministries of Health proposed to coordinate and deliver essential services. Public health infrastructure was at the heart of these plans, with the physical and social conditions that caused disease to be the focus of state activity. But there was also a need to take on key causes of mortality and improve the institutional infrastructure necessary to challenge old and new threats to life. Yet neither the funding nor political will existed to overhaul service provision in these areas. As a result, in both countries it was necessary for voluntary organizations to fill many of the gaps in provision expected or promised by the new state commitment to health care. To meet these tests a number of interested parties – the Rockefeller Foundation, the Red Cross, the Croix-Rouge Française, the Order of St John, voluntary hospitals and local charities – extended their work. Their contributions underpinned an extensive mixed economy of provision that ensured the reconstruction of health services in a way that met at least some of the promises of government. This article focuses on three key areas of voluntary involvement in health in post-war Britain and France: maternity and child welfare services; hospital services, especially tuberculosis provision; and accident response, in particular ambulance services. It argues that while local and national governments focused on improving health through environmental transformations, the voluntary sector stepped in to extend personal services aimed at saving individual lives, curing those suffering from specific diseases and preventing deaths through better education and care.

Awards Shortlist

The CYP Now Awards highlight some of the best work with children, young people and families. Every year there are challenges that service leaders and practitioners have to tackle, but the 12-month period covering this year's awards has been particularly turbulent. What shone through all of the 509 entries to this year's awards is the passion, determination and innovation applied by professionals across public, private and voluntary sector organisations to improve outcomes for disadvantaged children, young people and families. Thank you to everyone who entered and congratulations to all the finalists.

Relationship‐based practice and contextual safeguarding: Approaches to working with young people experiencing extra‐familial risk and harm

AbstractThis article explores the synergies between relationship‐based practice and contextual safeguarding when working with young people experiencing extra‐familial risk and harm (EFRH). The article draws on data from interviews, observations, policy reviews and case files from two sites in England who are testing contextual safeguarding approaches to EFRH, including a children and families social work department and a voluntary and community sector organisation. The findings evidence how relationship‐based practice in contextual safeguarding facilitates practitioners' understanding of places and their peers. The discussion draws on the theory of social defences to evidence that despite willingness and commitment to relationship‐based practice, without systemic and cultural organisational support to respond to EFRH, efforts to do so may undermine and cause harm to practitioners engaging in this work.

The legacy of voluntarism: Charitable funding in the early NHS

AbstractBefore 1948, approximately one‐third of the United Kingdom (UK)’s hospital beds were located in voluntary hospitals, many of which continued to benefit from the funds generated by their historic endowments. When the National Health Service (NHS) was created, the vast majority of these hospitals were taken over by the State. This paper examines the neglected question of what happened to these endowments and the role which charity continued to play in the funding of NHS hospitals more generally. It makes an explicit attempt to examine the development of hospital services in each of the UK's constituent nations and shows how the treatment of endowments and the role of charity differed between them. It also highlights the continuing importance of arguments over the ‘boundaries’ between ‘essential’ and ‘non‐essential’ forms of health service expenditure, and between the roles of the statutory and voluntary sectors more generally.

Assessment Of Funding in the Implementation of National Health Insurance Scheme in the Federal Capital Territory (FCT), Abuja, Nigeria

The National Health Insurance Scheme (NHIS) is an initiative of the federal government of Nigeria targeted at easing the financial burden of healthcare on the general public while enabling access to quality healthcare services. However, progress checks in implementation suggest that there is a considerable gap between policy objectives and outcomes. In light of this observation, the paper examines the extent to which funding affects the implementation of NHIS in the Federal Capital Territory (FCT), Abuja. The study, which is survey research, was anchored on Grossman’s health production function theory and employed the instrument of questionnaire to elicit data from Health workers in nine health institutions spread across four Area Councils in Abuja, namely, AMAC, Gwagwalada, Kuje and Kwali and NHIS staff. The data were analysed using Statistical Package for Social Science (SPSS). The study observed that the paucity of funds affects the effective implementation of NHIS in FCT to a high extent. It concludes that the problem of paucity of funds is a hindrance to the effective implementation of NHIS in the FCT. The paper recommends that the community and voluntary sectors of NHIS should be aggressively implemented; that government budgetary allocation to the health sector should be upwardly reviewed and sustained; and finally, that the HMOs should be closely monitored to ensure that capitations to accredited NHIS health facilities are remitted as at when due.

Adapting to change during the pandemic: The impact of COVID-19 on people living with HIV, and their coping strategies

Background: COVID-19 lockdowns led to people living with HIV experiencing lack of social connectedness, social isolation, difficulties with using technology and accessing health care and support services easily. The presented study sought to understand the challenges caused by COVID-19 and coping strategies. Methods: The study was conducted using focus groups with nineteen participants. Participants lost social connectedness, struggled to learn technology, and felt isolated in the absence of face to face peer support activities provided by HIV community support services. Participants employed a range of positive coping strategies including appreciation of the outdoors and volunteering. Conclusion: People living with value social contact and face-face support offered through HIV voluntary sector organisations. The absence of this led to compromised social and emotional wellbeing. This focus group-based research with provision of communal lunch however, played a part in addressing isolation, appreciation of social contact and limiting the psychological impact caused by COVID-19 lockdowns.