Life at VSO: Meet Penny Prestage, International Medical Manager

"I started as a volunteer when I was 18 with an organisation called Project Trust. I had volunteered before, in small ways—things through school and little community projects. Even at that young age, I realised its power to shift how you see the world.  

I spent a year in South Africa, which was still under apartheid at the time. That experience had a huge impact on me. I was working with children, and when I returned to the UK for university, I knew that whatever I did, I wanted it to make a difference and improve people’s lives. 

At first, I considered social work. It wasn’t about working outside the UK or in the global south—I was open to any role where I could have an impact. I took a job in residential social work, which I found immensely challenging but also incredibly important.

After a while, I became interested in volunteer management. I took a job with a small church-based organisation, setting up one-year projects for young people in the UK. That’s where I truly began to see the power of volunteering—how sharing lives can change lives for everyone involved.  

I’ve always known from my own experience that as a volunteer, you often gain more than you give. That process is life-changing, and it continues to have an impact long after the experience ends.’’ 

The organisation was great, but like many small charities, I was doing a bit of everything—fundraising, volunteer training and support, recruitment, and placement negotiation. I felt like I was gaining broad experience, but I wanted to learn best practices in volunteer management. That’s when I started looking for a larger organisation, where I could specialise and develop my skills. 

What role did you take on as you joined VSO?

I got a job with VSO in their applications team, which was closely linked to volunteer assessment. Over time, I became more interested in assessment and eventually became Head of Assessment. But VSO is a place of constant change. Around the time I went on a maternity leave, my role changed.

When I returned, the Head of Assessment role had become an eight-day-a-week job, so I started job-sharing, working three days a week. I specialised in early returns and reviews of whether volunteers should proceed with their placement following a problem, but with my second maternity leave, there was another restructure while I was away.

When I came back, I was given a new role, managing both the travel team and the medical team. I was still working part-time, and travel was extremely demanding, so I didn’t have much direct involvement with medical at first.

VSO is always evolving, and while that brings challenges, it has also allowed me to grow and adapt. Whether in assessment, travel, or medical team management, I’ve gained a broad understanding of how different functions support volunteers.

What has remained constant is my belief in the power of volunteering. When volunteers are well-placed and well-prepared, they can create lasting change—not just in communities but also in themselves."

I’ve seen first-hand how volunteering transforms lives, and that’s what has kept me committed to this work.

Transitioning from travel to medical team management

How did your role evolve as you transitioned from managing travel to managing the medical team?

The medical team wasn’t used to having much management involvement, so at first, there was a lot of concern about confidentiality. They operated as a closed team with a closed-door approach, which was understandable.

One of my main goals as their manager was to build trust and gain better insight into the decisions being made. I wasn’t medically trained, but I had general management experience, and the medical team was a part of VSO, so it was important to bridge that gap. 

A key skill I had to develop was managing experts. You can’t be a control freak in that kind of role—you must acknowledge that doctors and nurses know far more than you do about their field. My role was to facilitate a multidisciplinary approach, where each role contributed something valuable—whether it was the doctors, nurses, medical advisors, or the administrative team.  

How was the medical team structured when you took over? 

The structure has changed over time, but broadly, it was always set up with medical advisors, who weren’t VSO employees but acted as consultants overseeing clinical standards. They were responsible for the nurses' clinical work, while I had formal line management responsibility for the nurses and oversaw the team’s overall operations. 

A big part of understanding how to manage the medical team was learning how to create an environment where doctors could operate safely and ethically within their professional boundaries, while also ensuring that VSO’s broader management structures and duty of care responsibilities were met. 

Also, medical insurance became a much bigger focus, and I had to develop expertise in that area. Initially, when VSO mainly sent UK-based volunteers overseas, medical insurance was only needed for the duration of their placements. Volunteers would return home and re-enter the NHS for any long-term care. 

However, as VSO shifted to global recruitment, that approach no longer worked. Volunteers were returning to countries where healthcare access wasn’t guaranteed, and we needed a way to support them. The UK system also changed—there was a time when you could return from an assignment, get medical treatment on the NHS, and then go back to volunteering, but with longer waiting lists, that became much more challenging. 

This shift meant we had to find ways to provide medical support beyond just emergency care. Managing our insurance partnerships became a key part of my role, ensuring that all volunteers and staff had appropriate cover, no matter where they were from or where they were placed.

Over those years, how did your role evolve with VSO’s shift to global recruitment?

The medical team’s duty of care responsibilities expanded as global recruitment increased. It wasn’t just about medical support; we started working closely with the security and safeguarding teams, which led to the formation of a formal duty of care team including the three disciplines of medical, security, and safeguarding, ensuring that all three areas were aligned in responding to incidents and supporting volunteers and staff.

The medical team could no longer operate in isolation—it had to work as part of a coordinated incident management approach.  As we developed formal incident management protocols, confidentiality remained critical, but we also recognised that other teams needed to be involved.

Reflections on leadership, mental health, and growth 

What do you think makes a good leader in this space?

Managing a medical team requires a respect for experts—you must trust the team and gain their trust. You’re managing people with specialised knowledge, and you must respect that expertise and help VSO integrate those insights in to the way the organisation acts or responds.  

I’ve always seen myself as a bridge—between what VSO needs, what the medical team needs, and what’s best for the people we support. That means properly listening, setting aside my own assumptions, and communicating effectively between different stakeholders. 

One thing that’s never been in question is that every person in the medical team is here to support our VSO people and their families. We may deal with horrible, difficult situations, but at the core, we all want to make things better.

That’s been a huge privilege of this job—being with people at critical moments in their lives, knowing that what we do matters."

Even in the most frustrating moments, whether it's dealing with insurance issues or managing a particularly difficult weekend on-call, I never doubt that this work is important. We always try to share thank you letters and emails among the team because it’s never just one person making an impact, it’s always a team effort.

Another key aspect of the role is advocacy. Over the years, I’ve developed an understanding of medical insurance policies, how they work, how they can support people, and how to navigate them on behalf of volunteers and staff.

When someone is sick or injured, they’re often facing this system for the first time, whereas I’ve done it hundreds of times. Being able to advocate for them, guide them through it, and make sure they get the support they need is incredibly rewarding. 

How do you think you’ve changed personally and professionally through this journey?

I had my counselling training but working with some amazing doctors has nurses has taught me so much about responding to people. In particular one doctor who specialised in mental health taught me about well-being and support. She had a simple but effective approach.

If someone was struggling, she’d schedule a 10-minute check-in each week. If things got worse, of course, she would recommend that the person returned home, but often, those 10-minute calls made a huge difference. 

It reinforced the idea that solutions don’t always have to be big and dramatic—sometimes, just showing that you care and are paying attention is enough. It’s something that has stayed with me, even if I don’t use it in a formal way.

There’s also something about staying with a situation, not rushing to fix everything at once, but monitoring and supporting over time. That’s something I’ve learned through my work, through parenting three children, and now in caring for my elderly father. You can’t control everything, and sometimes the best approach is to stay present and take it step by step.

In a crisis, your mind might jump ahead to worst-case scenarios, “Will we need an air ambulance? Will we have to evacuate someone?” But I’ve learned to stay in the moment, deal with what’s in front of me, and trust the team to handle things as they unfold. I’ve also realised the value of 'good enough'.

Perfection isn’t always possible, and trying to control every variable can do more harm than good. Instead, I’ve learned to take things one stage at a time, adapt when needed, and accept that sometimes 'good enough' is enough. 

Evolving challenges, future aspirations, and the power of volunteering

What brings you joy outside of work and what are your aspirations for the future?

Family brings me joy. My children don’t live at home full-time anymore, but they still pop back often, which I love. Since the pandemic, I’ve also discovered a love for gardening —nurturing plants in a way I never had the energy for when my kids were young.

As for what’s next, I’m still figuring that out. The thought that keeps going around in my head is about the power of volunteering to bridge divides.

Volunteering has a unique ability to create real understanding across differences, especially for young people, whose minds are more flexible. I’ve seen firsthand how the impact of volunteering lasts a lifetime. I’d love to see more youth volunteering within the UK and Europe.

I’d love for VSO to be encouraging that kind of work, in Britain as well as globally."

Life at VSO

Here at VSO, we have a team that operates across the world. Our Life at VSO blog series, aims to give you an insight into what life is like working at a world leading international development organisation.

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