Transforming End of Life care in Surrey
Our team today
• David Perry
Chairman
• Nigel Harding
Chief Executive
• Dr Fiona Bailey
Medical Director and Consultant in
Palliative Medicine
• Pam Walmsley
Deputy Director of Clinical Services
Agenda
• Setting the scene
• Our care services
• The challenges we face
• Planning for the future
• Conclusion
Setting the scene
• Our services are working at full capacity, serving over
5,500 patients and their families every year
• Our current structure and facilities will not allow us to
meet the increase in demand we expect from an ageing
population with complex end of life needs
• The NHS challenge is keeping people out of hospital and
beyond 2015 we have no certainty that we will have the
ability to retain our site in Weybridge
• We have conducted a strategic review which has led to
plans we believe will transform Hospice provision
Total numbers of
patients
Comparing usage
to giving:
Setting the scene
• The review produced a challenging Strategic Plan for the
Hospices. With two key recommendations:
• to reshape the organisation, moving to a single inpatient unit
• to grow capacity in day care and community care
services
• The loan from Woking Borough Council has enabled the
Hospices to act quickly on these recommendations
• One in-patient facility with two community hubs
Our care services
Our care services
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Hospice support in the home
Community Clinical Nurse Specialists
In-patient care
Day care units – over 2,600 attendances
Counselling for adults, young people and families
Complementary therapists
Occupational therapy
Physiotherapy
Spiritual care
The challenges we face
Growing need for Hospice care
• 39% increase in the number of patients admitted since 2011
• 20% increase in patients referred to our Community Teams
since 2011
• 7% increase in attendances to Day Care
• 20% increase in non-cancer referrals in the last two years
Pressure on care services expected to
increase
• Annual mortality rate is set to rise by 2016
• People are living longer and more likely to have chronic
disease
• The number of people living with Cancer will increase
• By 2021 over 1 million people will be living with dementia
• Projected 135% increase in population aged >85 by 2033
The need for our services has
grown extensively and now we
must plan for the future
Options
• Do nothing – would result in longer waiting lists and an
increase in hospital admissions
• Develop Woking Hospice site – cost approximately £4.5m –
access to land denied, option not feasible
• Search for a green-field site and build a new hospice
approximate cost £12m – timescale 6 -10 years
• Re-design an existing building – costs approximately £6.3m
– timescale 3 years
Strategic choice
• Preferred option is to re-design an existing building to
house a new hospice facility including a 20 bed in-patient
unit
• Appropriate building identified in Goldsworth Park,
Woking
• Loan of up to £6m to acquire and re-design building
granted by Woking Borough Council to be repaid over 50
years
• Loan unlocks Hospice plans and allows speedy
implementation of Hospice strategy in all key care
services areas
Transforming end of life care
• In-patient beds
• Community services
• Day care services
• Enhanced service efficiencies
In-patient beds
• We need to keep 20 beds open
• 20 beds on one site will improve delivery of service:
• Ensure consistency
• Enable prioritising patients with greatest need
• Serve patients with complex needs better
• Improve delivery of patient care
• Ensure high quality care
• Cost savings – reinvesting in services
Community services
• We will be able to support an increasing number of people
in their communities and in their homes
• Continue to develop a responsive service that meet the
needs of the community to enable them to stay at home
• Improved facilities from which the teams delivering this
service can be housed
• Improved capacity to deliver education
Oncological Outreach
Therapies
Psychological
Therapies
Counselling
Music/Art
Cafe
Light refreshments
Volunteer run
Education
delivery to HCPs
Carers Group
Medical Interventions:
- blood transfusions
- intravenous therapy
Drop In Centre
Resource / Information
Welfare Advice
Computer access
Clinical Nurse Specialist
avaialbe
Community
HUB
Therapeutic Models
Educational programmes
Complementary therapies
Art / music therapies
Respite
5 days a week
Focus to keep
patients at home
Duty Clinical Nurse Specialist
available
Outpatient
Focus work for
non-cancer
patient care
bundles
Additional Services:
Hairdresser
Bathing
Chiropody
Beauty treatments
Consultants clinics
Nurse led clinics
Therapist clinics
Base for:
Doctors
CNSs
OT
Physio
Counsellors
Admin
Enhanced service efficiency
• Repatriate our Counselling services
• Space for equipment storage
• Inadequate parking facilities for our visitors which has caused
distress to patients and their families at times
• Administration and Fundraising departments back under one
roof with the rest of the services
Conclusion
• We will implement our plans and will provide regular
progress updates
• We will continue to work to improve our services
• The re-location of beds from both Hospices will not
happen until 2016
• Through our care provision we are aware of the close
bonds between people and communities to both
in-patient facilities
• We will work hard to ensure the transition is managed as
sensitively as possible