This is What it Takes is the theme of this year’s Hospice Care Week (October 5-11.) Medical director Dr Corinna Midgley and palliative care consultant Dr Pia Amsler from Saint Francis Hospice – which cares for people from Havering, Barking and Dagenham and Redbridge – share their thoughts on what makes the charity such an integral part of the community and one we must never take for granted.
Everyone’s life matters and hospice care is about helping people to live as well as they can and when the time comes, to help people to die as well as they can.
So what does the hospice offer that hospitals and other healthcare organisations don’t?
“We work very closely with all our community and hospital colleagues but we are able to add a wealth of experience in looking after people with advanced illness, to focus on the issues at hand and issues ahead, both for the person and those who care for them,” said Dr Midgley.
“Our aim is to support people to live as well as possible despite their difficulties.”
Over this past year, Saint Francis Hospice, Havering-atte-Bower, has cared for 1,674 people living in Havering, Redbridge, Barking and Dagenham, Brentwood and West Essex.
The community services, who deliver 85 per cent of the care, and the hospice ward have been busier than ever since March, reflecting the higher need for support of people with advanced illness during the pandemic.
“A good third of our hospice admissions have come from hospital, with issues requiring more time and focus than the hospital is able to give,” said Dr Midgley.
“Usually for complex symptom issues and debility, but there may be very challenging social issues or severe spiritual or psychological suffering too.
“We can take the time to deal with these challenges in a professional but more homely environment.”
One of the biggest challenges the hospice faces is meeting increasing demand.
“We have a huge amount of need in our community,” said Dr Midgley.
“Over this past 10 years referrals have doubled, without expansion in staff size. Care has generally become more complex.
“Our care was once just cancer care, but now we support people with a much wider range of advanced life-limiting conditions, more people have multiple conditions, and more people are having treatments which in themselves are more complex and bring challenges.
Healthcare professionals in the community rely heavily on the hospice’s expertise and the hospice supports them through education.
“Our Pepperell Education Centre delivers high quality training courses so we are empowering GPs, district nurses, healthcare assistants and care home workers to feel confident and competent to deal with end of life care patients so we only need to help them with the most complex cases, “ said Dr Amsler.”
When the country went into lockdown, the hospice played a crucial role in relieving the pressure off NHS frontline services, and continues to do so.
“We have ensured that we step forward in these difficult times, to lift some pressure off the hospitals, ” said Dr Midgley.
“For example more hospice ward interventions like blood transfusions - short sharp interventions that can make a big difference to people.”
The charity has maintained essential visiting all the way through the pandemic for those in crisis and for those who are dying, but has also had to step up the manning of its 24-hour advice line to meet the demand for advice and support to GPs, district nurses and others.
OrangeLine, its confidential telephone service, has expanded to keep connected to people who have re-stabilised but who remain vulnerable and who would normally come to the outpatient groups.
Volunteers have worked tirelessly alongside staff to keep contact going, and to ensure people are supported to come back to Saint Francis nurses if things are changing.
But with the charity receiving less than a quarter of its funding from the government and relying on donations to cover the rest of the running costs, Dr Amsler urged people not to take the hospice for granted.
“We are filling gaps that are not currently filled by other services but we are so established in the community that we could be taken for granted,” said Dr Amsler.
“There is a clear expectation that life will carry on as it is but the charity is struggling and unless something changes and people support us more, our valuable service could be at risk.”
Case study - Peter Yallop
Peter Yallop has been struggling with ill health for more than 40 years and when his GP suggested Saint Francis Hospice could help him and his wife Linda, they had no idea it would also bring them joy, new friends, and ease mental health challenges that seemed insurmountable.
Pete needs 24-hour care after a rare skin condition led to a range of health problems including arthritis, epilepsy and being partially sighted.
“If it wasn’t for the hospice I’d feel so alone,” said Linda.
“Recently Pete was in so much pain and we were unable to get through to the doctors.
“I was desperate. I called the hospice’s 24-hour helpline, and within an hour, Pete’s prescription was ready. I’ve even called at 2am and there was someone at the end of the phone to give advice.”
Before lockdown, Linda and Pete, who are both 69 and live in Collier Row, loved attending the day services at Pemberton Place where they enjoyed meeting people and taking part in art and craft therapy sessions.
And while the services are currently on hold, Linda still keeps in touch with a friend she made at Pemberton Place. Linda has also been having regular counselling from Briony Townshend, from the family support team, to help her to cope with the challenges she faces as Pete’s full-time carer.
“I get good and bad days and it really helps that I can chat with Briony and offload — that way I am not bottling up my feelings,” said Linda.
“There are things I can say to Briony that I can’t say to my family because even though they are really supportive, I know they would be upset.”
Briony was also able to advocate on Linda’s behalf so the three hours of respite she received a week for carers to come in and assist with Pete’s needs was increased to 14.
Linda isn’t able to make the most of it yet, but she is looking forward to the time when she can do daily errands as well as spend some time with friends and family and catch up on some much needed sleep.
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