In this research report we present the findings of our evaluation of seven social action projects funded by the Cabinet Office, NHS England, Monitor, NHS Trust Development Authority and the Association of Directors of Adult Social Services. The aim of the Reducing Winter Pressures Fund was to scale up and test projects that used volunteers to support older people to stay well, manage health conditions or recover after illness, and thereby reduce pressure on hospitals.
The organisations supported by the fund comprised a range of national and local charities. These projects fell into three broad categories: community-based support, supporting discharge from hospital wards, and supporting individuals in A&E department to avoid admissions. Between them, the projects offered a wide range of services to older people – both direct (for example help with shopping or providing transport) and indirect (linking with other services).
The Nuffield Trust was commissioned to evaluate the projects. We used a mixed methods approach to evaluate the projects, with 63 semi-structured interviews with staff, volunteers and local stakeholders, in addition to an analysis of changes in hospital activity for the recipients of services, using a matched control group drawn from English hospital data.
The evaluation resulted in a mixed set of findings. From our interviews, there was evidence of services that had made an impact by providing practical help, reassurance and connection with other services that could reduce isolation and enable independence. Those involved with the projects felt that volunteers and project staff could offer more time to users than pressurised statutory sector staff, which enabled a fuller understanding of a person’s needs while also freeing up staff time.
But the analysis of hospital activity data in the months that followed people's referral into the projects did not suggest that these schemes impacted on the use of NHS services in the way that was assumed, with no evidence of a reduction in emergency hospital admissions, or in costs of hospital care following referral to the social action projects. The one exception was the project based in an A&E department, which revealed a smaller number of admissions in the short term.
This evaluation has generated lessons about how voluntary sector projects can gear up to work effectively with some of the most pressured parts of the NHS. It provides valuable lessons in turn for NHS staff and commissioners to get the best out of social action projects of this kind.