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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; Garner, Ian; Dunleavy, Lesley; Preston, Nancy; Bradshaw, Andy; Cripps, Rachel L.; Bajwah, Sabrina; Sleeman, Katherine E.; Hocaoglu, Mevhibe; Maddocks, Matthew; Murtagh, Fliss EM; Oluyase, Adejoke O.; Fraser, Lorna K.; Higginson, Irene J.


Catherine Walshe

Ian Garner

Lesley Dunleavy

Nancy Preston

Andy Bradshaw

Rachel L. Cripps

Sabrina Bajwah

Katherine E. Sleeman

Mevhibe Hocaoglu

Matthew Maddocks

Adejoke O. Oluyase

Lorna K. Fraser

Irene J. Higginson


Volunteers are common within palliative care services, and provide support that enhances care quality. The support they provided, and any role changes, during the coronavirus disease 2019 (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.

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.

458 respondents: 277 UK, 85 rest of Europe, and 95 rest of the world. 68.5% indicated volunteer use preCOVID-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, (odds ratio [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.

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.


Walshe, C., Garner, I., Dunleavy, L., Preston, N., Bradshaw, A., Cripps, R. L., …Higginson, I. J. (in press). 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,

Journal Article Type Article
Acceptance Date Sep 6, 2021
Online Publication Date Sep 8, 2021
Deposit Date Jan 12, 2022
Publicly Available Date Jan 12, 2022
Journal International Journal of Health Policy and Management
Print ISSN 2322-5939
Publisher Kerman University of Medical Sciences
Peer Reviewed Peer Reviewed
Keywords Palliative care; COVID-19; Volunteers
Public URL
Additional Information Journal Owner: Kerman University of Medical Sciences; Journal Publisher: Kerman University of Medical Sciences; Received: 2021-04-12; Accepted: 2021-09-06; Published: 2021-09-08


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