“They make the tea and make you welcome”: public perceptions of volunteer roles in public health Jane South Karina Kinsella Centre for Health Promotion Research UKPHA, 24 th -25 th March 2010

Acknowledgements This independent study was funded through the National Institute for Health Research (NIHR) Service Delivery and Organisation (SDO) Programme. The views expressed in this presentation are those of the research team and not necessarily those of the NHS, the NIHR or the Department of Health. The study was delivered by a partnership between: –Centre for Health Promotion Research, Leeds Met –Policy Research Institute, Leeds Met –NHS Bradford & Airedale –Public health group, Government Office Yorkshire & Humber The research team would like to thank the research team, advisory and steering group and all the people contributed to this study sharing advice and experience; helping with the public involvement events; and providing research and library support.

Public Health Skills and Career Framework (2008) LevelExamples Level 1Has little previous knowledge, skills or experience in public health. May undertake specific public health activities under direction. Volunteer workers – e.g. breastfeeding Level 2Has gained basic level public health knowledge through training and/or development. May undertake a range of public health activities under guidance. Peer educator, lay health worker. Classroom assistant, refuse worker. Level 3May carry out a range of public health activities under supervision. May assist in training others and could have responsibility for resources used by others. Community food worker, health trainer, dog warden.

‘People in Public Health’ Study Aims To improve understanding of valid approaches to identifying, developing and supporting lay people who take on public health roles in community public health activities. To undertake research on public perspectives regarding the acceptability and value of lay people in public health roles To aid public health commissioning and planning by identifying elements of good practice and how these might be applied to different contexts.

Scientific Knowledge Literature Review Practice based knowledge Expert Hearings Site visits Primary Research Case Studies Study design

Case studies Walking for health (local scheme) Breastfeeding peer support Neighbourhood health project Sexual health outreach Community Health Educators Interviews with 90 participants: –Public health workforce –Lay people in public health roles –Other partners Interviews and focus groups with 46 service users in 3 of the case studies: –Walking for Health (20) –Breastfeeding peer support (11) –Neighbourhood health project (15)

Roles – being the lynchpin for activities “Well it wouldn’t be running if it wasn’t for them would it? They’ve organised it. Well they work a lot in all the sort of voluntary things. And they don’t get paid do they, they put lots of hours in and it seems a shame that they don’t get anything for what they do. Sometimes they work quite late in the evening by the time they’ve finished.” Neighbourhood health project

Roles - being the ‘glue’ “They are the glue aren’t they, they keep us all together. [name] is a great communicator, even though I haven’t been for a few weeks he gave me a call to see how I am, he makes you feel as though you are part of the group”. Well I moved to [area…] 9 years ago and I find it very hard to get to know people, how do you meet people and I used to get very depressed actually, I never said hello to anyone, there was never a familiar face and I wanted to feel I belonged, and after joining the group I do feel like I belong, I feel I have an investment in the area whereas before I felt like I was just someone who’d moved here…” Walking for health

Roles - improving connections “P1: […] with the volunteers they make the tea and make you welcome […] We have a little raffle; we have a laugh and joke. Sometimes it can get out of hand. We have speakers come in and… P2: We have speakers come in once a month to give us little talks like dentist people come in and say something.” Neighbourhood health project

Awareness of boundaries P3: Yes because she tells us like if we have like a medical query she’ll actually tell us I can’t answer that and she’ll advise us to go to a doctor if we’re worried about our baby or something. She wouldn’t give us medical advice […] P4: She points you in the right direction. She directs you.” Breastfeeding peer support

A caring and personal relationship “He’s not just a good communicator but he has got good people skills, and also he is friendly, warm and hospitable and he is aware of everyone’s pace.” Walking for Health “She’s like a mum and she gives you support and sometimes you need that” Breastfeeding peer support “You can talk to them if you want to. If you want to talk quietly you can go to one side and talk to them. They’re patient with you.” Neighbourhood health project

Skills and qualities Service users’ views Good communication skills Approachable and non- judgemental Basic health knowledge Language and cultural skills Other stakeholders’ views Good communication skills ‘People’ skills Empathy and caring Confidence Open-minded Enthusiasm Local knowledge

Levels of participation “Well she always asks have you got any ideas who we should call in to talk to you. She always asks our opinion and we tell her and she tries to arrange what’s suitable for us.” Walking for Health “Having said that I'm happy to help, taking the back post of the walk and stuff and making sure everybody is alright, I’d quite like to help and I’ll quite happily communicate things but I wouldn’t particularly want to be a leader.” Walking for Health

Public Health Skills and Career Framework (2008) LevelExamples Level 1Has little previous knowledge, skills or experience in public health. May undertake specific public health activities under direction. Volunteer workers – e.g. breastfeeding Level 2Has gained basic level public health knowledge through training and/or development. May undertake a range of public health activities under guidance. Peer educator, lay health worker. Classroom assistant, refuse worker. Level 3May carry out a range of public health activities under supervision. May assist in training others and could have responsibility for resources used by others. Community food worker, health trainer, dog warden.

A community workforce?

Conclusions Recognition of volunteer/lay contribution by service users Recognition of skills required – most importantly ‘people skills’ Distinction between professional and lay support BUT social connections within and outside programme blur boundaries between volunteer and ‘service user’

Find out more The report from the study is due to be published through the NETSCC Summary planning guidance is being produced Visit the PIPH website and Register your interest in the study