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September 5, 2018

NHS – A shared project

When William Beveridge conceived the welfare state, his vision was of a ‘shared project’ between the state and the population at large.  60 years on many now feel that we have strayed too far from Beveridge’s original vision. We expect, in return for paying our taxes, everything for free without any obligation on our part. That outlook is being challenged by a new NHS focused charity – Helpforce – which could, if it catches on as its founder hopes, transform the health services of every community in the country. It makes a lot of sense.

Tom Hughes-Hallett

Tom Hughes-Hallett’s new charity HelpForce has already achieved great results by recruiting volunteers. Now he challenges the nation to fulfil the original NHS vision of shared benefit and shared responsibility

I am a HelpForce volunteer, and I’d like you to become one too. It is a life-changing experience. HelpForce? You’ve probably never heard of us — so here’s the general idea. On one of my shifts I found a patient in great distress with obvious mental health problems outside our hospital. I brought him in, calmed him down and helped him to his appointment. Result: a contented patient, no staff time wasted and immense personal satisfaction for me.

A fellow volunteer rings and reminds patients to go to their memory clinics. Attendance has leapt from 15% to 100%.

Another volunteer, whose decision to join was spurred by a difficult patch in his life, told me his children are proud of him for doing so.

Motorbike fanatics across the country act as volunteer couriers, riding 900cc bikes to deliver urgently needed blood — saving lives and feeling useful.

This is what we do in HelpForce. We help hospitals, patients and staff in the NHS, and in return we achieve a sense of purpose doing something exciting and challenging. This is why I founded HelpForce.

When I was chief executive of Marie Curie, a cancer care charity, we had 10,000 volunteers supporting 4,000 staff, and they made all the difference. I now chair Chelsea and Westminster Hospital, where 6,000 people work. I see amazing, committed staff supporting an ever-increasing number of patients, yet there are only a few hundred volunteers helping them.

Why is the NHS failing to engage its own citizens? It was this glaringly obvious question that led me to create HelpForce with the notable support of the Royal Voluntary Service and other charities and NHS trusts. We are on a mission to inspire as many people as possible to enjoy being part of the health and care of British people. I would like to see volunteers underpinning every aspect of our NHS, which is to my mind the world’s greatest health system.

I can imagine a Britain where millions of people are proud to be the HelpForce — a Britain where giving back to the NHS and other public services is ingrained in our social fabric, where you can expect companionship and support through your entire time in the health system and where communities support nurses and doctors to produce a more complete healthcare experience.

In our vision, vulnerable patients will be accompanied through the health system by a safe and reliable volunteer.

What could it look like? If you are a nurse, volunteers will take the pressure off you, happy to be bleeped to run errands, enabling you to provide more expert care. They will sit with the most vulnerable, lonely, distressed and even troublesome patients. In your hospital, fewer nurses will leave as they recognise they are working for a hospital that takes their health and wellbeing seriously.

If you are a patient, imagine never being alone on a visit to hospital. A volunteer will pick you up and take you to your appointment. They will stay with you during the appointment and take notes. They will explain what the treatment involves. They will take you home and pick the milk up on the way. They will sit with you until a friend or relative gets home. They will remain your companion. 

Ambulance services will send a paramedic accompanied by a volunteer. If all you need is to be checked, don’t worry, because the volunteer will stay with you until you feel better, and the guilt you felt for calling an ambulance that somebody else needed will go away. 

If you are in hospital, a trained volunteer will support NHS physios and help you out of bed every day so that you are in good shape to go home more quickly. They may help you with applying for benefits.

When it is time to leave, there will be no waiting around, because volunteers will collect your prescription and drive you home. When individual hospitals are facing bills of £12m or more to help patients get home, volunteers can reduce that cost, allowing the money to flow back to clinical services.


If you are terminally ill, you will not die alone. A volunteer will be with you. In the event that you want to go home for your final weeks, they will support you in doing so. 

Digitally, the possibilities for HelpForce are almost boundless: WhatsApp-style groups linking volunteers across the nation to share best practice; a “Tinder” for volunteering, matching safe and reliable volunteers with patients or staff who need their support; and a “TripAdvisor” of the best volunteer experiences.

In the past 18 months we have moved from being a concept in my imagination to the beginning of a nationally recognised movement in Wales, Northern Ireland, Scotland and England.

The HelpForce idea is so simple and could be so successful, yet most people do not even know it is possible to volunteer at an NHS hospital. 

In 1942 the social reformer William Beveridge published what became the blueprint for the postwar welfare state, using words that have been my constant inspiration: “The state, in organising security, should not stifle incentive, opportunity, responsibility; in establishing a national minimum, it should leave room and encouragement for voluntary action by each individual to provide more than that minimum for himself and his family.” 

We have moved far from Beveridge’s original vision of a shared project to build a better Britain — shared between the state and the population. Now we as citizens expect everything free in return for paying our taxes. We have moved from a society that balanced rights and duties to a society that believes in duty-less rights. Unsurprisingly, compassionate communities have become a threatened species. 

In the NHS there are too many patients supported by too few staff, who are becoming increasingly frustrated and exhausted. The NHS system has become gridlocked by demands for more funding, when innovation and new models have to be found.

 We are in an economic environment where rapid, bold, action-based solutions are needed. 

New figures show that in 40 years’ time our population of pensioners will have increased by 9m. Medical advance is to be celebrated, but the consequences can be complicated. Longer lives — yes. Better lives? Doubtful, when you may live your final decades with a host of chronic illnesses. 

You can see why so many NHS leaders have become pessimistic. But we can be optimistic if we think differently and build a new, shared NHS owned equally by citizens, communities and the state.

A seemingly impossible healthcare challenge is less daunting if we begin to balance rights with duties through volunteering support.

An exciting shift is evident, with people of all ages wanting to get stuck in to support our public services. Giving time and talent has become more important than giving money, and an increasing awareness of the inequities in our society provides fertile ground for the creation of a social movement that can bring Beveridge’s vision back.

This is timely, as confidence in established charities is falling. Charities that get too close to government lose public trust, find their hands tied and fail in their own stated mission, as we have seen with recent high-profile cases. When this failure happens, we all lose, but the beneficiaries lose the most.


There are many shining examples of charities that are getting it right — the Royal Voluntary Service, Marie Curie, Alzheimer’s Society, British Red Cross and St John Ambulance, to name only a few volunteer-driven organisations. HelpForce is working closely with them and smaller, local charities to bring the best of their work into the heart of the NHS.


We identify local excellence, evaluate it, share best practice and expand nationally to help the NHS everywhere to use volunteering to support patients and reduce the strain on our wonderful but often exhausted NHS staff. By doing this, we will see volunteering unblock the obstacles along the care pathway, ridding the chief executives and their staff of constant headaches.


Never do we seek to replace paid employment. We seek only to support paid staff, allowing them to carry out the roles for which they have been trained, and we are working closely with trade unions. Volunteering is a natural pathway into the NHS workforce at a time when the NHS needs more people to join its ranks.

All over the UK there are wonderful examples of NHS trusts benefiting already from new forms of care provided at least in part by volunteers through small local charities, and large ones such as the Royal Voluntary Service.

Now it is your opportunity. We are inviting individuals and communities: “Be the HelpForce. Get involved personally; put your own skin in the game.”

Contact your local hospital and offer to help, or email — or visit— to find out