Effectiveness of a voluntary family befriending service: a mixed methods evaluation using the Donabedian model

Voluntary befriending schemes operate in many countries, promoting public health by supporting vulnerable individuals and families. Use of third sector and voluntary services to complement health and social care provision is increasingly important globally in the context of economic and demographic challenges, but the evidence base around such collaborations is limited. This article reports the results of operational evaluation research seeking to use robust routine work to generate transferable findings for use by those commissioning and providing services. The subject of our evaluation research is 'Home-Start Suffolk' (HSS) in Suffolk County, UK, an example of a third sector organisation commissioned to support the public health offer to local families.

This evaluation research used the Donabedian framework, which assesses the structure, process and outcome in delivery of health services.

Methods included a cross-sectional stakeholder survey with qualitative and quantitative elements (n = 96), qualitative interviews (n = 41) and quantitative analysis of the service's routine data (5740 visits) for the period from 01 July 2014 to 01 July 2016.

Triangulation of data from each component revealed that HSS was perceived by diverse stakeholders to successfully support families in need of additional help. HSS service users perceived the service to offer greater flexibility, to be tailored to their needs and to be more trustworthy and supportive than statutory services. Volunteering with HSS enabled people to feel productive in their community and gain new skills. Managers of social care services perceived that HSS activity decreased burden on their staff. These benefits were facilitated through a long-standing organisational HSS structure and relationships between HSS and social care. Challenges posed by service provision by a third sector organisation included the need for volunteers to negotiate the boundary between being a friend and a professional outside of a professional framework. Quantitative analysis of impact was limited by the poor quality of routinely collected administrative data, highlighting the importance of planning processes for data collection with evaluation in mind.

We believe that the results of this evaluation research provide transferrable lessons. They demonstrate how a third sector organisation with a long-standing structure and relationships with statutory services was able to reduce perceived service burden while also offering support in a more flexible and tailored way greatly valued by service users.