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 in-

patient 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• 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

• In-patient beds

• Community services

• Day care services

• Enhanced service efficiencies

Transforming end of life care

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

Community HUB

Psychological Therapies Counselling Music/Art

Oncological Outreach Therapies

Additional Services: Hairdresser Bathing Chiropody Beauty treatments

Drop In Centre Resource / Information Welfare Advice Computer access Clinical Nurse Specialist avaialbe Duty Clinical Nurse Specialist available

Cafe Light refreshments Volunteer run

Base for: Doctors CNSs OT Physio Counsellors Admin

Outpatient Consultants clinics Nurse led clinics Therapist clinics

Carers Group

Therapeutic Models Educational programmes Complementary therapies Art / music therapies

Respite 5 days a week Focus to keep patients at home

Focus work for non-cancer patient care bundles

Medical Interventions: - blood transfusions - intravenous therapy

Education delivery to HCPs

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