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Volunteers in hospice and palliative careA resource for voluntary service managers$

Rosalind Scott and Steven Howlett

Print publication date: 2009

Print ISBN-13: 9780199545827

Published to Oxford Scholarship Online: November 2011

DOI: 10.1093/acprof:oso/9780199545827.001.0001

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Setting the scene: the landscape of volunteering

Setting the scene: the landscape of volunteering

(p.11) Chapter 2 Setting the scene: the landscape of volunteering
Volunteers in hospice and palliative care

Steven Howlett (Contributor Webpage)

Oxford University Press

Abstract and Keywords

This chapter discusses the changing environment in which Voluntary Services Managers (VSM) work. It focuses mostly on the recent trends and tries to highlight the trends that remain constant, the trends that change, and how these trends change. Throughout the course of this discussion, a number of questions are posed that serve as a guide to the following chapters in this book.

Keywords:   environment, Voluntary Services Managers, VSM, recent trends, guide


This chapter focusses on the changing environment in which Voluntary Services Managers (VSM) work. The majority of the book concentrates on specific aspects of the role of the VSM looking at, among other things, their place in the organizational structure of hospices, the skills and techniques they need to manage volunteers appropriately and effectively, and ethical issues that they may encounter. We must realize, however, that how we manage volunteers within the hospice walls is impacted upon by the world outside, and that world is changing. But how is it changing? What are the trends that may effect what VSMs do? Are the same sorts of people volunteering for the same sorts of reasons? Is government interest in volunteering encouraging more people to volunteer, or is the push to give voluntary organizations a greater role in public services merely making more organizations compete for the same volunteers? This chapter will look at recent trends, try to highlight which remain pretty much constant, and which are changing and how. Through this, the chapter poses some questions that readers may want to consider as they work through the remainder of the book.

Volunteers for health-related matters

The importance of volunteering hardly needs to be stressed to anyone reading this book. While it is helpful to acknowledge that volunteering has been an innate part of societies throughout history, it is more helpful perhaps to reflect on volunteering and its importance in health and social care in more recent times.

Surveys suggest that volunteering in this field has always been popular—and continues to be. Despite the development of the welfare state in the 1940s, which some predicted would undermine the need for volunteering, the involvement of volunteers within health and social care and the wider social services remained strong. It was also the area that awoke government interest in the potential of volunteering in the 1960s, and helped set the framework for how volunteers are supported and managed today. The first volunteer manager in the United Kingdom, for example, was in health when Fulton Hospital created a manager role in 1963. Elements of the volunteer-supporting infrastructure, that we are familiar with today, has its roots in managing volunteers (p.12) within the caring sector in this era. The Volunteer Centre UK (now Volunteering England) had its genesis in a recommendation by the Aves Committee, which was set up to look at volunteering in social services. Although the remit of the committee concentrated on volunteers in statutory services, it was interested in searching for distinctions between the role of paid staff and volunteers. It also recognized that the need to professionalize services must include training volunteers received but this should not erode the difference between paid and unpaid staff1. These are important issues and represent something of the continuity of the landscape, resolving, or at least managing these issues remains a task of VSMs. We will return to this in the following paragraphs. First let us consider one very important trend—are volunteer numbers rising or falling?

How many people volunteer?

Can we expect that the field of health and social care will continue to remain important and attract enough people to volunteer? And how does this translate to the hospice movement? At the outset, it is worth noting what we know about the total numbers of volunteers. So often we hear stories of a decline in civic attitudes and of less people willing to get involved. But behind the headlines the picture depends on what we are looking at. In England, for example, a survey in 2007–2008 found that 43 per cent of the adult population had volunteered formally at least once over the previous 12 months. Although data is not available to compare over the longer term with confidence we can, at least, compare the most recent figures against 2001. Overall, this suggests levels of volunteering in 2007 were the same as they were in 2001 (73 per cent and 74 per cent, respectively). But we should note these impressive figures include formal and informal volunteering (i.e. formal volunteering is within an organization, while informal volunteering is more akin to neighbourliness or doing favours for others). In fact, levels of formal volunteering have risen from 39 to 43 per cent over the period and it is informal volunteering that has dipped2. In Scotland, however, the picture is slightly different. Figures there show a fall from 43 per cent in 2004 to 38 per cent in 2005 and then to 32 per cent in 2006. In Northern Ireland there is a similar story, a 2007 survey shows levels of volunteering in Northern Ireland at 21 per cent down from 29 per cent in 20013.

The overall pool of volunteers from where hospices might draw seems therefore to vary from place to place in the United Kingdom, and it is not always clear whether the pool is expanding or contracting. We could say though that it remains relatively healthy even if it is not expanding at the rate some might expect, given the attention volunteering has received from policy makers4.

What we know about who volunteers

Unfortunately, it isn't possible to drill down further into these existing surveys to get an idea of trends in volunteering within hospices. We can get a very general picture from national surveys, for example, we know from one survey that 18 per cent of all volunteers in England are involved in the field of ‘health and disability’. This certainly stands up well against other fields—just two areas, ‘Education’ (22 per cent) and (p.13) ‘Religion’ (14 per cent) claim a greater share of volunteer involvement with volunteering in sports having the same share as health and disability5. As far as we can compare with past surveys this remains fairly constant, although there are always issues with time series in volunteering because very few surveys are conducted holding important methodological factors constant, including asking the same questions with the same amount of prompting and with the same sample sizes. How far does this help us? Identifying volunteers in health and disability can only be a rough proxy—it is not the same as hospice involvement. Furthermore, when volunteers are surveyed they can choose to identify their volunteering as to do with ‘children’ or ‘the elderly’—both of which are categories appearing in the survey. In either case, of course, volunteering for children or the elderly could be in a hospice setting.

It would be helpful to have more specific data on hospice volunteers. But even this would only help if we had a time series from which we could gauge whether hospices were attracting sufficient numbers of volunteers. We do not have this and neither do we have data on the profile of volunteers in hospices. That is, we do not know whether more of older or younger people volunteer, or whether volunteers are a good reflection of the communities in which hospices sit. Although when Chapter 7 in this book talks about most volunteers starting their volunteering when they are middle aged, this may be a picture many VSMs recognize and it does accord with what we know about volunteers in general.

Do other trends in hospices accord with what we know about general trends in volunteering? Next we consider general trends from which VSMs can start to draw their own conclusions about how their hospices perform.


Most people when asked, assume more women than men volunteer. And while this is supported by survey data, again it depends what aspect of volunteering we are asking about. We see, for example, that 29 per cent of women volunteered regularly in 20072008 compared to 25 per cent of men6, but if we look at different roles and activities, men volunteer more than women for some of them. Importantly, for this book, we can say from surveys that women in England are more likely than men to volunteer in health/disability organizations. To find more men than women represented as volunteers we would need to look in sports organizations7.


When looking at the ages of volunteers we see that most volunteering is done in the ‘middle years’. That is, the youngest and oldest age groups volunteer less7. VSMs will of course know their own volunteer profile, but when they are looking to recruit, it is useful to know that this pattern does not seem to change much over time.

Ethnic origin

However, when we consider patterns of volunteering by different ethnic origins, recent surveys paint a different picture to earlier surveys. This may be because our knowledge has increased as more surveys have been conducted. For some time it was (p.14) believed that Black and minority ethnic volunteers were well represented in their own communities and largely engaged within informal volunteering. However, more recent surveys in England and Scotland show that people from non-white backgrounds have been found to be equally likely to be involved in regular, formal volunteering as their white counterparts. There are some variations, the term black and minority ethnic itself covers a range of communities, and if we examine survey data more closely, we find that Asian and Chinese people were found to be less likely to be regular formal volunteers in surveys in England. Even then there are further differences; for example, for people with an Asian background, it was found 22 per cent of people with an Indian background, 16 per cent of Pakistani people, and 15 per cent of Bangladeshi people volunteered7.

Employment, education and socioeconomic status

Surveys have also shown that employment status and education level is a strong indicator of the likelihood of people volunteering. One of the barriers mentioned most frequently by people when asked about volunteering is a lack of time; so contrary perhaps to what might seem to be common sense, the unemployed are less likely to volunteer than those who are working. Among the employed, those in full-time employment volunteer less than people who are employed part time or the self-employed.

Surveys also consistently show that people with a higher socioeconomic status (e.g. those in higher managerial or professional occupations) are more likely to volunteer than people in manual jobs. The same is true for higher qualifications—the more qualifications someone has, the more likely they are to volunteer. For example, those with a degree or above are two-and-a-half times more likely to volunteer than those with no qualifications.

Although it is difficult to make accurate comparisons over time, it does seem that there is a lot of continuity about who volunteers. Where we see change—for example, when we look at the ethnic background of volunteers—it could be, as suggested, we know more now and are able to see the picture more clearly. What this means for a VSM is that the pool from which volunteers are drawn is relatively stable. And while again, on the one hand this is comforting; on the other there has been a lot of work in recent times not least by government to try to increase this pool, which seems to have had limited impact.

Trends inside and outside the hospice

We now turn from looking at trends in numbers to look at some key issues that are impacting on volunteering, and we will focus on a selection of trends that will frame how we look at the rest of this book. First we look at diversity. Diversity is an area in which there is broad agreement—it is good to diversify volunteers and we will consider how diversity has been encouraged and facilitated but also why barriers continue to exist for some volunteers. Then we consider the motivations of volunteers to see if there are any trends to note here. These, in turn, will highlight some of the trends about who volunteers and raise questions about how we manage volunteers. (p.15) The important issue here is the extent to which volunteering is becoming more formalized, and we will consider the drivers for this, and the pros and cons of a more formalized approach to volunteer management. Finally, we will look at how government interest in volunteering has changed over time. This will allow us to draw together the issues explored in this chapter.


We live in an increasingly diverse society, and one in which we recognize that people have a right to be involved in, and to be able to give their time freely, to organizations that recruit volunteers. Added to this is the gradual breaking down of the image of volunteering as an exclusive pastime—something only practised by a select section of the community. Diversity within volunteering is also receiving a stimulus through government policy objectives. Public Service Agreement (PS4), has since 2004 been focussed on increasing volunteering from groups at risk of social exclusion (and initiatives such as ‘Goldstar’ and ‘Volunteering for All’ have been part of this). In short, the environment in which volunteer-involving organizations operate has changed when it comes to diversity.

The Compact's Volunteering Code of Good Practice for England also identifies the importance of tackling any discrimination to ensure that volunteering is open to all8. This may include, but is not restricted to overt discrimination. One study by the Institute for Volunteering Research, for example, looked at the barriers facing potential volunteers and identified a set of ‘psychological barriers’, which included time, the image volunteering has among non-volunteers, the self-image of people at risk of exclusion, and concerns about losing benefits. Potential volunteers had exaggerated ideas of what their time commitment would need to be in order to participate as volunteers; they also had stereotypical ideas of who volunteered and what they did. Allied to this they had self-image concerns, which manifested itself as a lack of confidence that they would fit with what organization wanted from their volunteers. And, often, people in the study who received benefits worried about losing them if they volunteered. The study found a whole host of physical barriers too, for example, not knowing how to get involved, opportunities that just did not appeal, and opportunities that were physically inaccessible for them.

There are persuasive arguments for increasing diversity, namely, that by making organizations inclusive they can address and overcome systems and procedures that may be discriminatory; that diversity draws in a wider and more varied pool of skills and experience, and that diverse volunteers reflect and cater for diverse local communities and client groups. And of course, it will enlarge the pool of potential volunteers. Looking across the literature on barriers and diversity, the emerging picture is of a range of issues that are far from insurmountable. We need to ask ourselves therefore; when we look at the trends of who volunteers—are the people who volunteer more the ones who are able to overcome barriers better? Who have the confidence in their own skills and abilities; the networks to get involved or ability to access existing volunteering infrastructure and the ability to overcome access issues— whether that be the transport to get to opportunities or access to alternative care for children or relatives that means they have the time to volunteer? In other words, (p.16) if we want to see more volunteers from other sections of society, can we address barriers and help make it happen?


Do motivations change over time and, therefore, should they be considered in this chapter? One theme we can identify and consider is whether motivations are changing in the sense that people appear to be keener to get something from their volunteering. This may not be because motivations are changing per se and people are developing more instrumental motives at the expense of altruistic motivations. What we identify as people expressing motivations in terms of what they can get from volunteering may just be an indication of the successful promotion of volunteering as a reciprocal relationship. There is a well-known piece of research9, which tries to identify what volunteering is by presenting a variety of volunteer roles to a group of people and asking them to identify which are done by volunteers. The results show that people are more likely to identify a role as a volunteer-one if they feel the person gets less out of the role than they put in. But times change and many organizations realize that if they are to attract volunteers they must offer something to volunteers. Without the lure of pay, this ‘something’ is a chance for volunteers to answer the needs and wants that attract them to volunteer in the first place. In other words organizations need to answer people's motivations.

This begs some interesting questions—can we identify motivations and, if so, how do we respond to them?

The area of volunteer motivations is complex and it is often said that there are as many motivations to volunteer as there are volunteers. One line of research suggests that motivations can be categorized into six areas covering things like, the wish to acquire new skills or use existing experience; to help get over some trauma of their own; or to meet and socialize with like-minded people10. Another set of literature looks at motivations in terms of how volunteers express their own goals, and this is often in terms of learning new skills, but frequently it is also in terms of ‘giving something back’. Practically, VSMs can use this information, and we highlight a couple of findings from the literature that illustrate how research into motivations may be used. The first is that volunteers can be attracted by literature that appeals to their reason for volunteering. So, if someone is inclined to volunteer to meet their need to express their own values, recruitment literature written in these terms will appeal to those people11. So far so good. But, we are also conscious that volunteers do not always know what is motivating them, making the VSMs' task of identifying and then responding to those motives all the more difficult. Here again, analysing trends helps us; broadly speaking, younger people are more likely to be looking for experience, and older people want to volunteer to contribute to the community.

VSMs should be aware of another factor muddying how we might use this information. Motivations change as volunteers spend time in organizations, so what is identified as a motivation at the interview stage might have changed 6 months or a year down the line—another reason to have regular meetings with them. Although, inevitably the picture is complex, one identifiable general trend is for older volunteers to come to value the social aspect of their volunteering over and above other motives. (p.17) In other words, whatever motivated your volunteers to start, and however you identified ways to meet that motivation, the chances are that after a while your volunteers will value what you do to support the social aspects of their volunteering and it may well be this that is keeping them in your organization.

The formalization of volunteering

A key trend—and challenge—for volunteering is the degree to which it is becoming more formalized. Volunteering it is argued, is a diverse phenomenon in which people get involved in all manner of activities in all manner of organizations. Corresponding to this diversity of volunteering we might expect an equally diverse range of management ideas. But we are seeing the expansion of ‘the workplace model’, in which volunteering looks like paid work, but without the pay12. The reasons for this can be found in the environment in which volunteering works—the encouragement by statutory authorities to deliver public services funded by public money, which, in turn, demands adherence to policies and procedures while working to contracted outcomes means volunteers are more tightly managed to achieve those ends. Another trend ratcheting up formalization is risk and the fear of litigation in which organizations fear being exposed to risk through not to having adequate management systems—something Chapter 8 explains well.

But, volunteer managers face a conundrum. On the one hand volunteers tell us that what they want from their volunteering is fun and they tell us that they are put off by too much bureaucracy. On the other hand they tell us that while they want a light touch, they also want to know that their volunteering is well organized. Kathy Gaskin's instructive and practical research says it all in the title— volunteers want ‘a choice blend’13. We must add to this the trends we noted earlier—some sections of the community are put off by bureaucracy and procedures and so management can act against diversity. What may seem good practice to a hospice and to the VSM—interviewing volunteers, for example, may be the thing that puts people off applying. What is the point of encouraging people to volunteer as a step towards paid work, for example, if the first thing they meet is an interview—the world of paid work replicated in the world of volunteering?

Yet, many VSMs, and some of those appearing in this volume, argue that such systems are necessary. In highly regulated environments such as a hospice, they may be necessary. Hospices are scrutinized by a range of regulatory bodies—Care Commission, NQuiz, Environmental Health, HSE, Charity regulators—to name just a few. But VSMs need to look for appropriate management too— for example, do shop volunteers need the same sort of management as volunteers working directly with patients? VSMs have a fine line to walk and need to balance management approaches with the need to recruit and retain volunteers; if retired people are being recruited as volunteers, is a replica of the world of work what they want? When looking at diversifying volunteers, are procedures a barrier; what role do VSMs have in protecting the diversity not of volunteers, but of volunteering? None of this is to say that volunteer management is at odds with how volunteers want to be managed, but the move towards formalization and what volunteers want from their involvement needs skilled balancing from skilled managers.

(p.18) Government influence

Finally, underpinning much of what has been said earlier is the influence of government. This is having a profound effect in changing the environment in which VSMs work. We are living at a time when government has never been more interested in encouraging more people to volunteer. Barbara Monroe notes in the preface that she was a member of the recent U.K. Commission on the Future of Volunteering, which articulated that volunteering should become part of the DNA of society. The Commission was chaired by Dame Julia Neuberger who was subsequently appointed to advise the Prime Minister on volunteering matters. Dame Neuberger is a supporter of the idea of volunteer management and has voiced her idea that chief executives of volunteer-involving organizations ought to have some experience as a volunteer manager. Such untrammelled support is astonishing when we consider how far volunteering has come in the last 15 years—from something spoken about usually in connection to voluntary organizations to an important policy aim. Volunteering carries the hopes of adding significantly to the delivery of public services and to underpinning a collective sense of citizenship as well as expressing what it means to be a part of a community. It has attracted considerable resources because of this, but at the time of writing, wider economic conditions mean that this level of funding may not continue. This makes it even more important to note that the resources that have been put into volunteering have been skewed. They have been aimed at younger people, with an ultimate aim of helping them into paid work and learning how to be responsible citizens. They have also been skewed towards encouraging people at risk of social exclusion to be involved in communities, and towards ‘capacity building’ of organizations to involve more people under-represented as volunteers or to deliver public services. In other words, these resources have not necessarily been focussed on managing the solid body of existing volunteers. At the same time, the models of volunteer management are being squeezed and shaped into an ever smaller number of templates. The dominance of the formal model risks curtailing the initiative of VSMs in favour of policies, procedures, and rules. Whether this is something to be embraced or resisted is not for this chapter to say, but without recognizing the environment in which we work, it is easy to have our heads down with busy work loads and then look up one day to find the world has changed.


This chapter offers a brief overview of current trends and issues in volunteer management. Outside of the hospice the volunteer environment is changing and it will continue to impact on VSMs. Some things are not changing much—we are broadly seeing the same number of people volunteering in the same areas. But other things are changing and some are changing rapidly; volunteers it seems are getting more demanding, they want organizations to be able to show them why they should give their time to that organization. Some volunteers are also increasingly interested in short-term high-impact volunteering opportunities rather than the longer-term volunteering commitments upon which so many hospice services depend.

(p.19) One of the key changes we are seeing is the expansion of volunteer management, but along the route of formal practices akin to managing paid staff. But volunteering is different. Often, volunteering takes place within structured and seemingly bureaucratic organizations. Volunteering, however, is not paid work and it retains something of the value of collective action, of the pooling of time and effort to address need. This does need a different management approach—or at least recognition of how and when to apply the techniques of management. Most of the rest of the chapters in this volume address managing volunteers in hospices from this view point. It is hoped that this chapter has also added some context so that VSMs can also question as they read. VSMs can learn from the following chapters, from experienced managers who have much to teach. There are also alternative models and the chapters outlining how colleagues in other countries go about their tasks also show us that we must keep questioning how we work if we are to continue to be creative and innovative in the development and management of voluntary services in an ever-changing and developing society.


Bibliography references:

1 Davis Smith, J. (1996). ‘Should Volunteers be Managed?’ In Voluntary Agencies: Challenges of Organisation and Management (eds. D. Billis and M. Harris). Basingstoke, Macmillan.

2 Low, N. S., Butt, A., Ellis Paine, and Davis Smith J. (2007). Helping Out: A National Survey of Volunteering and Charitable Giving. London, Cabinet Office.

3 Rochester, C. A., Ellis Paine, and Howlett, S. (2009). Volunteering in the 21st Century. Basingstoke, Palgrave.

4 Who Volunteers? Volunteering Trends: 2000–2007 A Briefing from nfpSynergy Available online at http://www.nfpsynergy.net/includes/documents/cm_docs/2008/v/volunteeringtrendsjan08.pdf

5 Low, N. S., Butt, A., Ellis Paine, and Davis Smith, J. (2007). Helping Out: A National Survey of Volunteering and Charitable Giving. London, Cabinet Office.

6 Communities and Local Government. (2008). Citizenship Survey: 2007–08 (April 2007–March 2008), England & Wales: Cohesion research statistical release 4, London, CLG.

7 Rochester, C. A., Ellis Paine, and Howlett, S. (2009). op cit.

8 Commission for the Compact. (2005). Volunteering Compact Code of Good Practice. Birmingham, Commission for the Compact.

9 Cnaan, R., Handy, F., and Wadsworth, M. (1996). Defining who is a Volunteer: Conceptual and empirical considerations. Nonprofit and Voluntary Sector Quarterly 25, 364–383.

10 Clary, E., Snyder, M., and Ridge, R. (1992). ‘Volunteers' Motivations: A functional strategy for the recruitment, placement and retention of volunteers’ Nonprofit Management and Leadership 2, 333–350.

11 Clary, E., Snyder, M., and Ridge, R. (1992). op cit.

12 Rochester, C. (2006). Making Sense of Volunteering. A Literature Review. London, Volunteering England for The Commission on the Future of Volunteering.

13 Gaskin, K. (2003). A Choice Blend: What Volunteers Want from Organisation and Management, London, Institute for Volunteering Research. (p.20)