Presentation on the work of St. Francis Hospice from Pam Court, chief executive.
Minutes:
The hospice chief executive thanked the Committee for the opportunity to speak at the meeting. It was explained that new national commissioning guidance had been released for palliative care which indicated that the main part of the service would be supplied by GPs and District Nurses. A hospice would only step in when a patient’s problems had become so complex that primary care required extra help.
The hospice’s Hospice at Home team allowed a specialist palliative care service to be delivered on the same day a referral was received. This allowed terminally patients to avoid having to go through A&E.
The hospice was also now a recognised unit for Gold Standard training in palliative care and training programmes were delivered in both Havering and Redbridge. The hospice aimed to ensure more people could die in the place they preferred and also to reduce the number of unnecessary hospital admissions.
It was felt that is was essential that District Nurses were well trained in palliative care and the hospice was keen to support the District Nursing service. There was however no prospect of increasing staffing levels at the hospice. The backlog of cases waiting to be seen by the hospice had reached a total of 42 at its worst but neither the hospice nor its commissioners were prepared to close their waiting list. As such, new ways of working were being developed including handing cases back to GPs and District Nurses but wilt specialist advice from the hospice still available. It was hoped to introduce a 24:7 response time of two hours patients in urgent crisis.
Around 70 patients per week were seen by the hospice’s day therapy service. There were also specialist group sessions for patients and carers. Transport to the hospice was however very difficult with even the use of volunteer drivers costing £50-60,000 per year.
The hospice had introduced a new patient referral system and more patients were now seen in day care. The fastest growing demand was seen with the Hospice at Home service but the chief executive remained confident that a high quality could continue to be delivered to more patients. The hospice also wished to develop its education and training further. All GPs in Havering had signed up to the Gold Framework in palliative care.
It was clarified that specialist care was introduced for patients for whom primary care alone could not cope with their death. This could be due to high pain levels or other health problems. Other issues could be complex social situations or the need to cater for emotional or spiritual needs.
The hospice was part of the NHS although the NHS was only a secondary funder of its services. The hospice was also working with local CCGs to provide 24:7 community services as part of the commissioning strategy. The hospice was also very supportive of the Liverpool Care Pathway although this needed to be used appropriately and with the right communication. The provision by the hospice of training for carers on the Liverpool Care Pathway was currently being considered.
It was also hoped to open a St. Francis Hospice fund raising shop in Ilford.
The Committee NOTED the presentation and thanked the chief executive for her input to the meeting.