The health and care system would be on its knees without the efforts of an army of volunteers who give generously and freely of their time and who are dedicated to the services and patient groups they support. There is untapped potential for volunteers to make an even greater contribution. Volunteers are special people. They do what they do because they want to, not because they have to. This brings a special energy to their role, driven by values and a sense of doing something that is important and worthwhile.

The people who take part in NHS Change Day also radiate this voluntary spirit. Across England (and on other Change Days in healthcare systems across the world), thousands of people choose to take small actions to make a difference to the experience and outcomes of care for patients. The people who co-ordinate Change Day across England also do so on a voluntary basis. There are so many wonderful stories of the impact of this voluntary action for improvement. Multiple small actions can lead to a great deal of change across the whole system. It also supports a shift in power; building a sense amongst front line staff that we don’t need permission to make improvements to our own services.

So what would it take to maintain this spirit across the whole health and care workforce, not just on Change Day but the whole year round? What if leaders regarded everyone in their teams as “volunteers”, whether paid or not, and supported people to take action because they want to rather than have to; leading change in ways so it is embraced, not imposed? This was the provocation of the leadership thinker Peter Drucker when he called on all leaders to, “Accept the fact that we have to treat almost anybody as a volunteer.”

Gary Hamel also supports this volunteerism mindset for leaders but thinks that in many organisations there is a significant gap between potential and reality:

“Managers know how to command obedience and diligence, but most are clueless when it comes to galvanizing the sort of volunteerism that animates life on the social web. Initiative, imagination and passion can’t be commanded—they’re gifts.”

Dan Rockwell asks, “How would things change if you ignored the fact that employees are paid and treated them like volunteers?” He suggests we would:

• Focus more on people with passion and less on people with talent
• Seek agreement on expectations and deliverables
• Ask permission to hold people accountable
• Express gratitude sincerely
• Address tough conversations kindly
• Focus on aligning organisational and individual values
• Build relationships
• Listen
• Include
• Respect

For his latest book Accelerate, John Kotter has studied the way that change is accelerating across industries and is becoming more disruptive. He concludes that the traditional ways of organising change, via hierarchical structures and performance management systems, committees and sub committees won’t create impact at the pace and scale required to stay ahead of the curve. Rather, it needs a large number of engaged, energised individuals and that isn’t something a leader can mandate or programme, manage. Kotter concludes that leaders will get better outcomes from their efforts at transformational change if they build a “volunteer army” of staff from every level of the organisation as the “engine” or energy source for change efforts. This network of volunteers should sit alongside the hierarchical mechanisms in a “dual operating system” for change.

Stephen Covey, one of the world’s most influential leadership thinkers, died in 2012. The last thing he wrote was the foreword to a book, Turn the ship around. The words in this foreword are a prediction for the future:

“Our world’s bright future will be built by people who have discovered that leadership is the enabling art. It is the art of releasing human talent and potential. You may be able to ‘buy’ a person’s back with a paycheck, position, power or fear but a human being’s genius, loyalty and tenacious creativity are volunteered only.

The world’s greatest problems will be solved by passionate, unleashed ‘volunteers.’”

Too often we treat people as conscripts when we should treat them as volunteers and we are left with a situation where front line staff in health and care feel powerless to make even the smallest changes in their services. So maybe the legions of people taking action to make a difference for NHS Change Day and the millions of people who volunteer for the English NHS week in and week out are some of our best role models for change. Maybe leaders of health and care might climb on the shoulders of these giants.