Annual Review 2015 - 2016
“It takes special, dedicated and outstanding people to create such a calm and positive environment.� Total support for patients and families Clinical - Financial - Practical - Emotional - Spiritual
An exciting year Sarah Brocklebank Chief Executive
August 2016
Welcome I am pleased to be able to share with you our latest Annual Review, which I hope you find interesting and informative. It details all of the important information about our services, achievements, income and expenditure over the last financial year (April 2015-March 2016).
patients within this Review, to illustrate the positive impact which our services have had on their lives.
2015/16 has been another busy and successful year, which has seen us conclude the successful implementation of our 2013-2016 strategy.
If you would like more information about our work, please refer to our Annual Report from the Trustees, see our new Three-Year Strategy Report, or do get in touch.
In 2015/16 we built on the transfer of the Beacon Service to Phyllis Tuckwell to create Phyllis Tuckwell Hospice Care – a united organisation which operates from two sites. Our successful marketing and awareness campaign has used a range of media, with patient stories at its heart, to convey this new combined service to our community.
Thank you for your support! Page
Chief Executive message
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To unite our nursing teams and provide an improved service to patients, we created a Single Point of Access for all of our Hospice Care at Home (HCAH) services, at the Beacon Centre. We also introduced smart phones and tablets for the Community team, to enable more efficient and effective remote working. These developments have helped us to grow our services that are delivered away from the Hospice and Beacon Centre, and consequently last year our Community team were able to care for over 1,500 patients at home, while our Hospice Care at Home nurses looked after over 500 patients during their last weeks of life.
Putting the Patient First
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Our Services in 2015/16
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Achievements in 2015/16
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Patient Stories ...because every day is precious
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Income Generation
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Our Fundraising Promise
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We have also extended our therapy sessions to include pottery, poetry, creative writing and horticulture, and our new exercise classes have been a great success in helping patients build muscle strength and stamina, as well as forging strong friendships within the group.
Financial Summary
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Plans 2016/17
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Trustees, Officers & Contacts
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We have included stories from two of our 2
Contents
Putting the Patient First Phyllis Tuckwell Hospice Care (PTHC) is the only adult Hospice Care service supporting patients and families who are living with a terminal illness, across the whole of West Surrey and part of North East Hampshire. We offer our care at the Hospice, at the Beacon Centre and at home, across a catchment area of around 550,000 residents. Our care helps patients manage their pain and improves quality of life for both them and their families.
Our care extends across a wide area
Seeking Hospice Care isn’t about giving up hope or hastening death, but rather a way to get the most appropriate care in the last phase of life... …because every day is precious. We are one of the larger Hospice Care services in the South East, with 18 beds and a growing community team and, last year, we cared for around 2,000 patients and their families living with a terminal illness, enabling them to live their lives to the full.
Our mission is to care compassionately for people living with a terminal illness, and those closest to them, so that they are able to live their life to the full and their ending is peaceful. 3
Our Services in 2015/16 We offer In-Patient services, through our 18-bed In-Patient Unit (IPU), and Community Services through our Clinical Nurse Specialists, Day Services, Out-Patient appointments and our expanding Hospice Care at Home team, which means patients and carers have a choice about where and how they want to receive care and treatment. All our services are provided to ensure the majority of our terminally ill patients spend their remaining days at the place of their choice. Our services extend beyond the patient, to their relatives, carers and friends through our pre- and post-bereavement services.
Overall patients supported 2015/16 was a big year of change with the integration of the former Beacon Service and refurbishment of the IPU, so we were pleased that we received 1,514 new patient referrals across all our services – just 18 patients less than in 2014/15.
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At the Hospice and Beacon Centre Referrals to PTHC during the year were stable as the Beacon Service was integrated into PTHC. This comes on the back of a year-on-year growth to Phyllis Tuckwell Hospice for the last four years (total increase of 13%). We expect referrals to PTHC to continue to increase year-on-year now that we have completed a major period of transition. A major refurbishment of the IPU in 2015/16 necessitated the closure of some beds over a four-month period to allow the work to be completed. Despite this, the number of
admissions has been fairly consistent year-on-year. There has been a small increase in the number of non-cancer patients supported, reflecting our deliberate focus on increasing support for all patients regardless of their diagnosis. Occupancy levels dropped over the summer months but have increased since, back to similar levels to 2014/15, and there has been an increase in the number of patients admitted for End of Life (EoL) care, particularly from one of our acute hospitals.
In 2015/16, our Day Services at both the Hospice and Beacon Centre saw a 3%
increase in contacts, with a marked increase in the amount of face-to-face support. We are currently undertaking a review of Day Services, to ensure they meet the needs of patients, families and referrers, as we are finding that patient preferences are changing and some find the different group activities better suit their needs than more traditional Out-Patient appointments.
An expansion to our Bereavement team means that we have been able to support a significantly increased number of people (+62%). As well as one-to-one sessions, we now offer many types of support groups to different groups, including children & teenagers, which have been very positively received.
At home and in the community Despite the organisational changes to our Community team due to the integration of the Beacon Service, we have supported over 1,500 patients and their families this year. Effective working and communication with our community partners has resulted in strong referrals from GPs and community nurses, and our links with local hospitals have also remained strong. We have introduced a telephone triage system for all new community patients in order to ascertain their needs and wishes, and have found this a very effective way of utilising our resources to ensure home visits are targeted appropriately.
Working in partnership with the NHS, the HCAH service is now an established provider of EoL care in the community. We have expanded the team to include a Social Work Advisor, who has proven invaluable in facilitating patients’ discharge home from hospital and arranging care
packages, enabling patients to be looked after and die at home.
This has also reduced the number of unscheduled admissions to hospital and enabled patients to remain at home for EoL care.
Hospice Home Support Our Hospice Home Support service continues to grow and develop. This year we supported 138 patients (+35%), providing more befriending and practical support for patients.
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Achievements in 2015/16 The Beacon Service
The Beacon Service was successfully transferred to Phyllis Tuckwell Hospice (PTH) on 1st April 2015 and we have worked hard to create one united organisation, operating across two sites in Guildford and Farnham, providing an integrated EoL service right across our catchment area. Our combined organisation has been renamed Phyllis Tuckwell Hospice Care to reflect the increasing amount of services now delivered outside of the In-Patient Unit (IPU).
Community
All of our community staff now have smart phones and tablets, enabling them to work efficiently and effectively without the need to return to Guildford or Farnham to update their patient records.
GPs
We have inducted an additional GP to our first on-call rota, to help provide additional medical cover out-of-hours, and are committed to increasing our medical team to enable routine weekend admissions.
New Services
We have developed new services, such as our Open House sessions, to encourage patients to access EoL support earlier.
Just drop in...
to find out more about Hospice Care
Hospice Care at Home (HCAH)
Therapies
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Branding
PTHC is now our recognised brand and better describes our full range of integrated services. All literature has been updated, and our marketing campaign, through a range of media including radio, newspapers, magazines and social media has been very successful in raising awareness of our service. Patient stories have been at the heart of our campaign and have proven to be a very powerful way of explaining how our work makes a difference to our patients and their families.
Partnerships
We continue to work closely with all CCGs to inform and influence the development of EoL services in our catchment area and are also working more closely with our neighbouring hospices, in particular Woking & Sam Beare Hospice and Thames Valley Hospice, in order to identify synergies and opportunities for partnership working.
Education & Training
We continue to provide a wide and varied education and training programme for Care Homes, GP practices and community nurses with consistently positive feedback, and the continued professional development of our own clinical team.
All HCAH services are now coordinated from a dedicated Single Point of Access, at the Beacon Centre, providing a clear and coordinated service. We have also expanded the team, enabling us to care for more patients at home.
We have invested in additional Occupational Therapy, Complementary Therapy and Child & Family Support clinicians in the Guildford & Waverley CCG area, to ensure an equality of access to all of our services for patients throughout our catchment area. 7
which he is facing. ““It’s helped meeting others who understand, understand,” he says. He is also helped by Hospice Home Support, our service which matches patients with volunteers who then visit them once a week, helping them around the house, taking them out for a few hours, or simply just having a cup of tea and a chat.
Patient Stories: Robert Stevens One day, when out in the garden, Robert fell over. The handle of the rake he was using jabbed into his stomach, bruising the area and leaving it sore. Worried that he might have internal injuries, Robert took himself to A&E. Scans, however, showed a tumour on his kidney. Robert had cancer. Two weeks later the tumour had been removed and Robert returned home to his wife and two sons. He underwent chemotherapy and had regular scans, but two years later an invasive secondary cancer developed in his liver and bones. When Robert was referred to Phyllis Tuckwell, he was unenthusiastic. “Hospice means end of But when I got here it was quite the opposite. life – that was all I could think,” he remembers. “But opposite.” Instead of the drab building he had imagined, Robert found the large, bright Dove Lounge, where Day Hospice is held. Through its glass doors he could see the Hospice gardens, and opposite was a quiet room where patients and families could talk with Doctors, Nurses, Therapists or Counsellors, and another for art, pottery and creative writing classes.
As well as social and psychological support, Robert has also been helped physically, through complementary therapies, such as aromatherapy and head, neck and back massages, which have eased his discomfort. He has been visited at home by a PTHC Occupational Therapist, who has assessed his need for specialised equipment to help improve his safety and maintain his independence, and has arranged for the provision of a profiling bed and equipment to enable him to use his bath safely and independently. Our Clinical Nurses Specialists (CNSs) keep in contact with Robert’s GP and local hospital, ensuring that everyone involved in his care is kept up-to-date with his condition and medication, with the aim of keeping him out of hospital and ultimately giving him the ability to choose where he wants to die, when the time comes. In addition to all of this, the range of activities which we offer have given Robert a creative outlet for his emotions, helping him to relax and find peace. He attends both Brush with Art and our new pottery classes, which enable him to express his feelings creatively and feel proud of the work he produces. He also attends our Social and Therapeutic Horticulture sessions, during which patients can plant flowers and herbs, making planters, for example, which they can then take home.
“Thanks to Phyllis Tuckwell, I wake up every day and think ‘I’ve got today’ rather than ‘when is it going to happen?’” he says. “They’ve helped me to look forwards instead of backwards, and make the most of the time I have left. It’s a place of happiness. You feel cared for here.”
Robert visits Day Hospice once a week, and is driven there and back by a PTHC Volunteer. He has had hypnotherapy, and he and his wife have also had counselling, which have helped them come to terms with Robert’s illness. We are also helping Robert’s sons, Anthony and Michael, through counselling, social work advice and support groups, and knowing that they are not alone has been a comfort to them. “It’s like a big umbrella that goes over the whole family,” Robert explains. 8
Robert has found friendship at Day Hospice, where he has met others who share the difficulties
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Patient Stories: Derek Dougherty When he discovered a hard lump on his chest, Derek was immediately referred to a specialist, who confirmed that he had bone marrow cancer. He was immediately put onto an intense course of chemotherapy, followed four months later by a stem cell replacement. The operation was successful, but the chemotherapy had left him in a lot of pain. “One of the drugs they use in chemotherapy destroys nerves, which then re-grow, but this causes a lot of pain,” Derek explains. “When you touch your body, it feels numb.” Derek experienced this numb feeling from the waist down and, as his nerves began to grow back, the pain started. “It feels like being beaten on the soles of your feet and then asked to walk over pebbles. Then there’s burning in your toes, along with prickling sensations and electric shocks which go down your legs and into your feet. These pains don’t go away, they never allow you to rest.” The pain kept Derek awake at night, and he struggled to sleep. He found walking very painful, and standing still even worse. The only comfortable position for him was to sit with his legs raised. Derek was referred to Phyllis Tuckwell, and was visited by Dr Paul van den Bosch, who recommended a different drug and also spoke to the Physiotherapy team about alternative methods of pain relief, including acupuncture.
Income Generation The “cost of raising funds” increased by 6% but we generated 18% more income than last year. Retail Activity 2015/2016
We continued to refurbish some of the older stores and opened a new furniture showroom in Guildford High Street to enhance the retail estate. At 1st April 2016 PTHC had 19 shops.
“I didn’t really think it would work,” Derek confesses. “I thought ‘you can’t just stick a needle in there and it will make any difference’. But it has.” Since starting the acupuncture, Derek has been able to reduce the painkilling drugs he takes and can now work a full day, when six weeks ago he could only manage four hours at most. “Before it was a painful experience just to go across the road, but now I can walk for half an hour,” he smiles. “Some days my feet and legs become painful, but I can tolerate that discomfort, and then I can go and relax in the evening. I couldn’t do that before. Before, it was all night long; I couldn’t sleep.” “I didn’t realise this was available at Phyllis Tuckwell,” he says. “It’s frightening when the doctors say you’re on the maximum painkillers and there’s nothing more they can offer. And then for someone to come up and say ‘let’s try this’, and it helps, it’s absolutely phenomenal. It’s allowed me to have a normal life again. It wasn’t easy to hide the pain all day from the people I work with, or from my wife. But she’s got her life back too now. It’s not just my life that this has affected, it’s affected the lives of everyone who cares about me.”
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“My home had become a prison. I thought maybe the cancer should have taken me away, I just couldn’t see a future. I could quite happily have had my feet cut off, it was that painful. But these six weeks have made a massive difference. Every day is about living, it’s not about anything else.”
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Successfully delivered income generation targets for 2015/16
We developed existing fundraising events (e.g. Dash of Colour) and introduced new corporate partnerships with key local businesses.
We carried out a review of In Memory Giving and achieved impressive corresponding growth in income lines. Growth in digital engagement resulted in increased use of digital marketing and online and SMS giving. We developed the use of social media to support our own and community events and improved graphic design across all of our communication.
We rolled out ‘Mission & Money’ training sessions to all staff to highlight the important link between fulfilling our mission and the need for increased funds. This has enabled us to include an increasing number of patient testimonials in our marketing & communications materials across all media.
Our Fundraising Promise Our fundraising promise to you. Over the past couple of years there have been a lot of stories in the media about the way some charities are raising money. At Phyllis Tuckwell, we hugely value our supporters. We get around 20% NHS/Government funding so our work is reliant on voluntary donations, which means we do have to ask for money. When we do, we always try to ask responsibly and respectfully. • • • • • •
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We will never share or sell personal details to another organisation for their own marketing purposes. We don’t swap lists containing our donors’ details with any other charities. All our communications with supporters offer the opportunity to easily opt out of future contact. We do not use the telephone to ‘cold call’. We are especially careful and sensitive when engaging with vulnerable people, the elderly or those affected by illness. We are members of the Fundraising Standards Board and ‘Our Fundraising Promise’ to donors is easy to find on our website – www.pth.org.uk
Please contact us if you have a question about these issues. If you wish to stop or adjust the frequency or type of communications you receive from Phyllis Tuckwell, you can call us on 01252 729446 or email us at fundraising@pth.org.uk.
Financial Summary 2015/16 Income and expenditure
Total PTHC income for the year ended 31 March 2016 was £9.77 million, compared with £7.34m in the previous year, an increase of £2.4 million. Whilst much of this was due to the transfer of the Community Care Contract connected with the Beacon Service, there were also significant increases year-on-year in every other income line, particularly patient related donations (+38%), legacies (+32%), fundraising (+19%), gifts (+14%) and retail (+10%) and lottery (+10%). The transfer of the Beacon Service to Phyllis Tuckwell Hospice Care on 1 April 2015 had a significant effect on PTHC’s finances, however the grant payment traditionally made for the services provided by Phyllis Tuckwell Hospice (prior to the integration of the Beacon Service) received no inflation uplift nor any other increase, thereby representing a real decrease in overall NHS percentage contribution for that part of our service. The transfer of the former Beacon Service to PTHC, under NHS Contract, was cost neutral to PTHC, as the additional income received reflected the additional costs incurred by taking on this service. The combined effect was that during 2015/16 we received 22% of our total income from the NHS, compared to 11% the previous year, which is still less than the national average of 33%. Total expenditure for the year was £8.77m; up £1.6m (22%) in 2015/16. The biggest increase in expenditure was due to a 31% growth in our charitable expenditure year-on-year, due in part to the transfer of the Beacon Service to Phyllis Tuckwell Hospice Care but also due to the investment of Phyllis Tuckwell’s own charitable funds in our clinical services. The “cost of raising funds” was up 6% on 2014/15 yet delivered an 18% increase in income year-on-year. Net income, after movements in investments, for 2015/16 was £349,000. We have maintained a strong financial position as a result of the extraordinary generosity of our loyal supporters, to whom we are extremely grateful. With this firm foundation we are confident that we demonstrate a high quality, cost-effective service which, with sustainable future funding, will improve EoL care in West Surrey and North East Hampshire, continuing to serve the needs of patients and families and to enhance the support we offer. 13
Our Current Trustees, Officers and Contacts
Plans for 2016/17 2016/17 is the first year of our next three year plan, during which time we aim to: 1. Review and develop two-site/locality working to maintain a seamless service for patients and their families across the whole catchment area.
5. Review the findings and recommendations from our market research to ensure that the language we use to describe our services is appropriate for our patients, families, supporters, staff and volunteers.
2. Build on our IPU nursing and medical teams so that we can begin to routinely admit to the IPU on weekends and bank holidays.
6. Deliver an ambitious income generation plan for 2016/17 and lay the foundations for the successful delivery of the 2016-19 income generation strategy.
3. Investigate and implement the appropriate technology to support the delivery of high quality and effective community and In-Patient EoL services.
4. Create an education team, headed by a full time Education Manager, to consolidate our existing education and training activities, and develop courses for new external audiences.
7. Continuously review our recruitment and retention activities and undertake innovative ways to differentiate PTHC as a local employer of choice.
8. Carry out a staff and volunteer survey to assess and review the PTHC climate and culture – what we do well, what we could do better and develop plans as required.
In our three year strategy, we have set ourselves four strategic priorities:
Strategic Priority 1: Strategic Priority 2: We will provide - and be able to demonstrate - high We will empower others to provide high quality EoL quality EoL care services to patients and families in care and be seen as an authoritative voice at the West Surrey and part of North East Hampshire. decision-making table.
Strategic Priority 3: Strategic Priority 4: We will generate sufficient funds to enable us to deliver our clinical services and demonstrate that we are good stewards of the money donated to us.
We will remain an independent organisation and demonstrate organisational efficiency and effectiveness.
For more details of our plans for these three years, please ask for a copy of our Three-Year Strategy (2016-19) document. 14
President
Contacts
Mr E C Tuckwell
Medical Director
Board of Trustees Alan Brooks (Chairman) Michael Maher (Vice Chairman) John Wenger (Treasurer) Professor Michael Bailey Fran Campion-Smith Veronica Carter David Eyre-Brook Helen Franklin Richard Holway Ken Kent Ian Trotter
Chief Executive Sarah Brocklebank
01252 729402 sarah.brocklebank@pth.org.uk
Cate Seton-Jones 01252 729401 cate.seton-jones@pth.org.uk
Director of Patient Services Clodagh Sowton 01252 729403 clodagh.sowton@pth.org.uk
Director of Estates & IT Paul Batten 01252 729407 paul.batten@pth.org.uk
Director of Finance & Business Development Mark Beale 01252 729436 mark.beale@pth.org.uk
Director of Marketing & Communications
Tony Carpenter 01252 729476 tony.carpenter@pth.org.uk
Director of HR & Voluntary Services Jaci Curtis-Donnelly 01252 729441 jaci.curtis-donnelly@pth.org.uk
Director of Income Generation Peter Foxton 01252 729449 peter.foxton@pth.org.uk
Tuckwell Chase Lottery Manager Susan Wade 01252 728411 office@tclottery.org.uk
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Thank you for your
support!
www.pth.org.uk Tel: 01252 729400 Phyllis Tuckwell, Waverley Lane, Farnham, Surrey, GU9 8BL
Phyllis Tuckwell Memorial Hospice Ltd. Limited by Guarantee. Incorporated in England and Wales. Registered No. 1063033 Registered Charity No. 264501 Copyright ©PTH 2016
September 2016
The Beacon Centre, Gill Avenue, Guildford, Surrey, GU4 8WW