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The Sue Ryder St John’s Hospice in Moggerhanger, Bedfordshire, has developed a high profile for its award-winning Partnership in Excellence Palliative Support (PEPS) service, which has most recently been nominated for an NHS Patient Safety Award. Jo Burnham (pictured below, far right, with St John's Hospice staff), Head of Stakeholder Relations for the National Council for Palliative Care, the lead charity of Dying Matters, visited St John’s to find out more.
Set across two floors in an extended and modernised Victorian building, St John's provides a range of specialist palliative care services including a lymphoedema clinic, a motor neurone disease service, complementary therapy, family support and chaplaincy support, and has become well known for its Partnership for Excellence in Palliative Support (PEPS) service. After a warm welcome, my visit began with an informative tour given by Pauline Carter, the hospice's Practice Educator. Pauline introduced me to her colleagues and showed me around the facility, including the relatives' lounge, the chapel, the 15-bed ward, the day treatment centre and the bright and airy dining area which overlooks immaculate gardens.
After my tour I met with Tracey Haddock, Team Leader of the PEPS service, and saw the nurses and support workers who provide invaluable telephone support to patients, carers and professionals as part of the service. This support is available 24 hours per day, every day of the year. While many local areas have established Electronic Palliative Care Co-ordination Systems (EPaCCS), set up to enable the recording and sharing of people’s care preferences and key details about their care at the end of life, I found out that PEPS has made further advances into improved palliative and end of life care. This includes supporting a nurse located in the local acute hospital, Bedford Hospital NHS Trust, to work with patients admitted to A&E who are identified as being on the PEPS register to establish their preferred place of care for end of life, thereby diverting people from unnecessary hospital admissions.
A hospital patient transport protocol has also been developed to ensure that patients identified as being at the end of life who prefer to return home/to a hospice for their last days are prioritised for transport to their preferred place of care within the first hour of formal discharge.
When not responding to A&E arrivals, the PEPS nurse liaises with hospital staff on the wards, raising awareness of the PEPS service, St John’s hospice wider services and palliative and end of life care generally. PEPS nurses are also involved in a project to improve anticipatory drug prescribing, ensuring patients have medication available for five days following discharge in order to avoid re-admission over weekend and Bank Holiday periods for medication.
I think the PEPS service developments are really impressive, and the hospice, along with local health and social care partners across Bedfordshire, really is making a difference for local residents and their families. PEPS were very open with me in acknowledging that enlightened local commissioners have been vital in driving forward Bedfordshire’s model for palliative and end of life care and that, following a recent feature about it on BBC Three Counties Radio, the PEPS service received phone calls from members of the public countrywide who lack support in their area.
Next on my schedule was to meet with Sarah Nash, Ward Sister of the hospice’s nursing team. I was very interested to hear how St John’s has successfully applied for funding to develop two Assistant Practitioner staff roles. These roles have provided a career development opportunity for two of the hospice’s Healthcare Assistants, who make up an integral part of the nursing team. It enables them to undertake a degree-level course over a two-year period which equips them to specialise to the level of a qualified nurse; the key difference being that, unlike a nurse, an Assistant Practitioner is not able to administer medication. This seems a great way to further train and skill-up experienced healthcare assistant staff who may not otherwise have the opportunity to develop their skills and could therefore chose to leave the sector. I am hopeful we will see hospices across the country able to access funding to support their Healthcare Assistants to develop in this way.
After an enjoyable break for lunch in the dining room with wider members of the hospice team, I met with Dominic Carter, Head of Clinical Services. Dominic explained that his role was to oversee the care services and told me more about what these involved. I had not realised that lymphodoema services were not as readily available across the UK as a whole, and heard that the demand for these services was huge despite the hospice being well resourced compared to many geographical areas. It was really good to hear about how the specialist motor neurone disease service was developing and how St John’s has been receiving growing numbers of referrals from wider non-cancer patients over recent years. Dominic was keen to talk about how the hospice involved patients and their carers in improving their services and suggested asking the monthly group that meets whether I can come along and visit them in the future – an experience I will find invaluable. I was overwhelmed by the ethos at St John’s of involving patients and their families: from inviting family members to stay, eat, sleep and shower at the hospice, to bringing in pets, which have so far included dogs and rabbits, to ensure that patients and their loved ones feel as comforted and looked after as possible. The team really go the extra mile.
I was really pleased to meet Jessica Wilson, Senior Fundraiser for the hospice. Jess wowed me with her enthusiasm and passion for working with colleagues and volunteers to help generate the £1.4 million that is needed each year, in addition to the statutory funding required, to deliver the services at St John’s. Their charity shop, which is located in the hospice, along with annual events such as the Summer Fete, the Lights of Love Christmas event and the Starlight Walk, make a huge contribution to their targets. Jess said she was always overwhelmed by the support they receive from individuals and families connected with the hospice as well as from the local community and businesses. Before I knew it, I had promised to join this year's Starlight Walk, which takes place on 13th September in Moggerhanger, to do my little bit to help the fundraising efforts!
After Jess, I met Donna Allison, a recent recruit to the St John’s Team, joining as Volunteer Coordinator in June this year. Donna again impressed me with her energy and enthusiasm. Before becoming a staff member she had volunteered for the hospice and, as the main Ambassador for their Starlight Walk, had helped raise over £100,000 - what an achievement! Donna explained that the hospice simply could not function without the support of its volunteers and that they currently have over 200 people volunteering. One lady, aged 80, has just retired from volunteering after 30 years at St John’s to spend time traveling with her husband in their motor home. I also learnt that a group of 18 bereavement volunteers support St John’s hospice to reach out to recently bereaved family members in the community. This forms part of the Family Support service, and bereavement volunteers receive specialist training from the local Cruse bereavement support charity to enable them to support families effectively.
I met up with Pauline again at the end of the afternoon and we talked about how St John’s approaches the learning and development of their staff. The team benefits from mandatory training, along with blended learning methods: classroom style and e-learning to support them with their wide-ranging training requirements. Pauline explained how she had recently been delivering the Quality End of Life Care for All (QELCA) course to senior nurses from acute, community and nursing/care home settings to support wider health and social care staff to deliver high quality care to patients and families at the end of life in non-hospice settings. Another exciting collaboration is the development of a palliative and end of life accredited university course, developed with the University of West London.
I could have listened and talked for hours more as the day’s schedule drew to a close. I came away feeling thoroughly impressed by the energy, commitment and compassion demonstrated by all the staff I met at St John's, and they made me feel so welcome throughout the day. May I say a huge thank you to everyone at the hospice, and to Pauline, who organised it all. I hope to be back to visit soon and look forward to seeing you all at the Starlight Walk in a few weeks!
More information about St John's Hospice can be found on the Sue Ryder website