Prohibit, protect, or adapt? : The changing role of volunteers in palliative and hospice care services during the COVID-19 pandemic. A multinational survey (CovPall).

Walshe, Catherine and Garner, Ian and Dunleavy, Lesley and Preston, Nancy and Bradshaw, Andy and Cripps, Rachel and Bajwah, Sabrina and Sleeman, Katherine and Hocaoglu, Mevhibe and Maddocks, Matthew and Murtagh, Fliss and Oluyase, Adejoke and Fraser, Lorna and Irene, Higginson (2022) Prohibit, protect, or adapt? : The changing role of volunteers in palliative and hospice care services during the COVID-19 pandemic. A multinational survey (CovPall). International Journal of Health Policy and Management, 11 (10). pp. 2146-2154. ISSN 2322-5939

Abstract

Background Volunteers are common within palliative care services, and provide support that enhances care quality. The support they provided, and any role changes, during the COVID-19 pandemic are unknown. The aim of this study is to understand volunteer deployment and activities within palliative care services, and to identify what may affect any changes in volunteer service provision, during the COVID-19 pandemic. Methods Multi-national online survey disseminated via key stakeholders to specialist palliative care services, completed by lead clinicians. Data collected on volunteer roles, deployment, and changes in volunteer engagement. Analysis included descriptive statistics, a multivariable logistic regression, and analysis of free-text comments using a content analysis approach. Results 458 respondents: 277 UK, 85 rest of Europe, and 95 rest of the world. 68.5% indicated volunteer use pre-COVID-19 across a number of roles (from 458): direct patient facing support (58.7%), indirect support (52.0%), back office (48.5%) and fundraising (45.6%). 11% had volunteers with COVID-19. Of those responding to a question on change in volunteer deployment (328 of 458) most (256/328, 78%) indicated less or much less use of volunteers. Less use of volunteers was associated with being an in-patient hospice, (OR=0.15, 95% CI = 0.07-0.3 p<.001). This reduction in volunteers was felt to protect potentially vulnerable volunteers, with policy changes preventing volunteer support. However, adapting was also seen where new roles were created, or existing roles pivoted to provide virtual support. Conclusion Volunteers were mostly prevented from supporting many forms of palliative care which may have quality and safety implications given their previously central roles. Volunteer re-deployment plans are needed that take a more considered approach, using volunteers more flexibly to enhance care while ensuring safe working practices. Consideration needs to be given to widening the volunteer base away from those who may be considered to be most vulnerable to COVID-19.