“You gave him his life
Read on page 6 how our brand new Frailty Service is already changing lives.
So much has changed since our last edition of Open House. In November, we wrote to you with the news of our exciting New Chapter, the Frailty Service. On the 2nd January, after months of detailed research and planning, the service went live.
In this special edition of Open House, you will read about the monumental impact the first three months of the Frailty Service have had on the lives of almost 100 patients who were previously unable to access our services.
We said we would avoid emergency admissions to the local hospital. We said we would prioritise long-term health conditions and bring them into our palliative care services. And that is what we have done, with some outstanding results. We have exceeded our own expectations and are incredibly proud to be leading the way for Hospices. This November, we will be presenting our model of care at the Hospice UK National Conference for other Hospices to follow in the future.
We are overwhelmed by the positive response from patients, their families and fellow healthcare professionals from across the system. This only confirms the need for the Frailty Service and tells me that we have a lot more to do in the future.
Our ambition was always to support people earlier on in their journey. We are already planning our next steps to strengthen links in the community, through extended Community Hubs, Wellbeing Cafés and continuing to work with GPs and local healthcare providers to enable us to support patients to live well in our community and avoid potential crisis.
We can’t and won’t stop now. This year we expect to treat an additional 515 frailty patients whilst running our already established services.
We will continue to grow and innovate in response to the need of our community and we hope you continue to support us as we venture on the next stage of what is an exciting and life-changing journey.
Lisa Lisa Hunt Chief Executive Officer Garden House Hospice Carelisa.hunt@ghhospicecare.org.uk
Frailty Nurse Jenny Hadley and Rehabilitation and Wellbeing Service Manager Lucy Heaps have been at the forefront of delivering the Frailty Service. Here, they reflect on their highlights, three months in:
After 13 years on A&E I was rather thick-skinned, but I’m a nurse at heart and I want to help people – and that is happening! My job is first about identifying people who have come into hospital and then talking to them, explaining how we can help at the Hospice. I find that they are all so grateful to have someone relate to them, many are left bewildered and overwhelmed having called 111 and not expecting to end up in A&E, and their lives are spent bouncing around from GP, to A&E and 111 – it’s frustrating. Being able to redirect them to services where people will talk to them in a way they understand is really positive.
I’ve had some of my nicest moments of nursing talking to these patients, one highlight was visiting a patient in the Hospice and he took my hands and said ‘thank you so much for sending me here’.
Most days I can think to myself ‘I’ve done a good thing’.
The launch of our Frailty Service has revolutionised our approach, making us more adaptable across the Hospice Inpatient Unit, Community Frailty Service, and Day Services. This shift means we’re not just focused on one area at one time, but are spreading our expertise where it’s needed most, across our working week.
The focus of the Occupational Therapists and Physiotherapists in the Rehab and Wellbeing team is on empowering the individual to actively participate in their day to day lives.
We work closely with patients to understand their needs and goals, we tailor our support to help them regain or maintain their strength and confidence, we support them to remain connected to their local community.
It’s incredibly rewarding to guide someone from a place of isolation to a position where they’re fully supported.
On 2nd January our service began. We said we would provide equal access to our care, supporting patients living with frailty earlier on in their journey, enabling them to live and die well whilst avoiding admissions to hospital, easing pressure on the NHS during winter. We are proud to say we have delivered.
Over a short period of time, we have evidenced how valuable our support and expertise are to both patients and professionals in the local hospital and the community. Here are some figures from the first three months of the Frailty Service.
4 newly recruited Frailty Specialist Nurses
80% patients discharged from the Frailty Service within 8 days
frailty patients identified in the local hospital by Jenny our Frailty Nurse
66 cared for at home by our Community teams
27 cared for in our Inpatient Unit
57% of patients were transferred from Emergency Departments, preventing admissions to hospital wards
774
Starting this new service has had a positive effect on our already established specialist palliative and end of life care services. Over the last three months we have also increased our IPU and Community admissions by over 68%.
total bed days saved in our local hospital
Reducing inpatient stays at the local hospital has freed up 110 beds to be used during winter
51%
non-cancer patients from Jan-Mar 2024
compared to 30% in the previous 9 months.
We have supported more patients with Cardiovascular disease, Renal failure and Respiratory conditions like COPD.
We identified a need, we innovated a new service, we addressed inequalities and we are making a difference to people’s lives. We have supported 93 new frailty patients, but we know there are many, many more. This is just the tip of the iceberg.
‘You gave him his life back again’
Grandfather of five and former civil engineer, Anuraja, was transferred to the Hospice after a fall inside his home and a call to 111 resulted in a hospital admission. The 81-year-old had been previously diagnosed with an optic nerve tumour which affects his eyesight and hormone imbalance, and years of steroid treatments led to the weakening of his leg and hip muscles, affecting his mobility and leaving him housebound.
Due to Anuraja’s increasing frailty, doctors at the hospital didn’t think there was much they could do to help or treat him. So, when our Frailty Nurse Jenny suggested he might benefit from receiving care on our Inpatient Unit (IPU), Anuraja’s wife Rukmal became concerned about his future.
“When he first came in here, he couldn’t lift his head up and he was always sitting in bed. I was worried he might die here,” Rukmal said. “I got frightened in the beginning. You think of ‘hospice’ as the end of life.
“But after we arrived, I learned more about what Garden House Hospice Care does. I read about life-limiting illnesses, but trying to rehabilitate people, which reassured me. Then he got better.
“After about two or three days, the big change came. His face was very fresh, his speech improved and he started walking little by little. The staff really had patience with him and they were kind; nothing was too much and the service was coming from their heart.
“I can’t explain in words how pleased we are. You gave him his life back again.”
Ten days after arriving on our Inpatient Unit, Anuraja was discharged from the Hospice, returning to his home in Stevenage
where our Rehab and Wellbeing team have provided specialist equipment and suggested exercises to help him maintain his independence as much as possible.
Our Physiotherapist, Althea, went to visit Anuraja a few days after he arrived home to review his mobility and function in his own environment. She credited his positive attitude and willingness to engage in the exercises aiding with his recovery, saying:
“Anuraja has made real progress since we first met him on the IPU. He’s really motivated and a joy to work with, and is taking responsibility to improve his own mobility. I am confident he’ll get up to his optimal functional ability and, with ongoing support from our community nurses, will be able to live well with his long-term conditions.”
Anuraja’s story is just one success of our new Frailty Service, highlighting how powerful the impact of collaboration in care across hospice teams and with our colleagues at the local hospital can be. Patients wishes, needs and aspirations are our priority, and to see Anuraja come through the whole new service from the hospital, to IPU, to the community with the support of Rehab and Wellbeing along the way is incredible. It is what this service is all about.
Three months into our pioneering service the headline is clear: it’s needed and it works. That said, we have learned plenty already and what we have delivered so far is only the start of our plans.
Let us tell you more about what is next. We will:
Our partnership with the local hospital is working brilliantly and we have welcomed patients to the Hospice services from A&E and wards within the hospital. This year we will be present at more meetings attended by clinicians working in a range of other services across our community, so that we can be in their minds for their patients too. We are also exploring how we can transfer suitable patients from the ‘emergency stack’ – people waiting for urgent care.
We will offer a range of treatments at the Hospice, including those that sometimes would lead to an admission at hospital but could be a ‘day’ admission elsewhere. The idea is that it may prevent admissions in the first place, or help with the transition from hospital to our Inpatient Unit, knowing those treatments are available with us instead.
Our hugely popular hubs are a great way of identifying patients and supporting them to stay well, for example, we know anecdotally that people who attend our hubs feel they see their GP less. As well as opening more hubs so attendees can reap the benefits from the social and physical activities, we will make sure there’s smooth access to the Hospice for those who need our services.
Barbara, who has Motor Neurone Disease, and her husband Richard are regulars at our Letchworth Community Hub. However, a recent decline in Barbara’s symptoms meant they were unable to attend for a short period. It was a difficult adjustment for the couple.
Richard said: “Think of the words in the song Green, Green Grass of Home: ‘I awake and look around me, at four grey walls that surround me’. That’s exactly how it was. We couldn’t go anywhere.
“I used to drive us here, but because of Barbara’s condition, I couldn’t get her into the car anymore. It became too dangerous. We couldn’t get here for six weeks and it was horrible.”
We are aware transport is a barrier for people like Richard and Barbara. Fortunately, we have a solution. Letchworth Garden City Heritage Foundation generously donated a minibus to the Hospice at the end of 2023, which we now use to offer a safe, accessible, reliable and affordable transport option.
“The minibus is a lifesaver,” Richard continued. “It’s the best thing that’s happened to us and we’ll keep coming as long as we’ve got it!”
Our Wellbeing Hubs run weekly across Hitchin, Stevenage, Letchworth and Royston and are the highlight of hundreds of people’s weeks. Find your local hub: www.ghhospicecare.org.uk/community-hubs
Are you forgetful?
Are you worried about your memory?
Are you caring for a loved one who is?
Drop in for a cuppa, a chat, information and support at the Healthy Memory Café, held every Thursday 10am-12noon at the Hospice.
Find out more: ghhospicecare.org. uk/dementia-care
Last November we launched an appeal to raise the £300,000 we needed to fund the first three months of the Frailty Service. One way individuals and organisations could help us was by becoming a Founder of the Frailty Service, which meant making a minimum donation of £5,000. We are extremely grateful to those who have supported us in this way, including long-term hospice supporter, Lady Dixon.
What compelled you to become a Founder?
I could see the tremendous benefits for people being looked after in the local area, in a hospice community that they have heard of, or perhaps even visited, as opposed to being stuck in a hospital.
I could see how those who aren’t in need of huge amounts of hospital treatment could benefit from having somewhere safe that they know, where their family could be around them, where they could go to get everything they need to feel better.
It just sounded like the most amazing ‘new invention’ and a wonderful next progression for hospices.
Having heard from patients who have benefitted from the Frailty Service in recent BBC coverage, how does it feel to know that you’ve contributed significantly to launching a groundbreaking new service?
It’s really nice to know that myself and other people have been able to help in
setting this up. I was so pleased to hear from patients who’ve been able to come into the Hospice, and get the help they needed short-term, or even a bit longer.
Who knows, one day I may need the service, or somebody else I know – the facility is now there locally.
What is it about the Frailty Service that resonates with you most strongly?
The fact that you’re not just a number in a hospital. It’s very personalised help for patients, in a far more family-orientated situation – it’s important to know that it’s a close community.
What would you say to somebody who is considering donating to the fundraising appeal?
If you can, that would be wonderful. People are now benefitting from the service that started from 2nd January. It’s just the thing we need.
Meet our full list of Founders on the ‘Our People’ section of our website.
The Frailty Service was launched without any financial support from the NHS – instead, the £300,000 it cost was raised entirely by our community. From individuals donating during the Big Give, trusts providing grants, companies pledging gifts and community organisations clubbing together to make a donation, we have been overwhelmed by the wealth of support from everyone who has made this service a possibility. Thank you.
Due to the success of our first three months, we will invest in the Frailty Service in 2024/25. It will become part of the ‘business as usual’ at Garden House Hospice Care and we will continue to develop the service with some exciting projects on the horizon. That means our annual running costs are rising, growing from £6.4m to £7.7m. Excluding the funding the NHS give us, we need to raise £15,300 day - up from £9,700 last year.
for our patients, their loved ones and for the wider community. We know this puts us under pressure to raise more money, but we will rise to the challenge and look forward to working with our community to make our vision a reality.”
Carla Pilsworth is our Director of Income Generation: “The outcome from our Frailty Service is so overwhelmingly positive it is now critical we merge this into the ‘day to day’ here at the Hospice. It has set us off in a positive direction for the future, which is the right move
Our Frailty Service is giving people their lives back, and with a regular donation, you will be too.
One way to support the Frailty Service and all the people benefitting from it is to set up a regular donation. You can choose a donation of any size to suit your budget and it means we can plan ahead with more confidence.
During the course of a year, just £4 per month could pay for a visit to someone’s home, identifying how we can help them and setting the plan in motion. £10 per month could pay for six whole hours of the care we give people with frailty on the Inpatient Unit.
To give someone like Anuraja their life back and find out more about making a regular gift, please visit: www.ghhospicecare.org.uk/make-a-regular-donation
As well as being the public face of the Hospice on the high street, our 12 shops, Depot and online platforms play an essential role in our community, promoting a healthy climate both socially and economically.
A third of our charitable income comes from trading, a valuable stream which supports the sustainability of our life-changing services. This income is something we must sustain, with over 50,000 hours of volunteer time in trading alone to help us meet our target.
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“We’re so proud to have a presence in the community in every aspect of our services and believe our shops and Depot still have an important part to play in our local towns. They support sustainability, save tonnes from landfill each year and positively impact loneliness, physical and mental wellbeing through volunteering roles across Garden House Hospice Care.
David Cooper Deputy Director of Trading
“However, it’s a tough climate for charity shops. People are holding onto items for longer and we’ve seen a decrease in the quality of donations we receive, which affects the income we generate.
“As someone who sees the difference each donation makes here at the Hospice, I ask you to think of us next time you pull that jacket out the wardrobe that you no longer wear, or dust off the toy your toddler no longer plays with. These items really can change lives for the better when gifted to Garden House Hospice Care.”
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Did you know that a third of our charitable funding is made up from trading activities?
How do we make our trading income?
• Shops
• The Depot
• Online sales
• Upcycling
• House clearance
• Furniture collection
• Gift Aid
• Recycling rag
Do you have unwanted items you want to donate?
Visit The Depot, our one stop shop for donations, second-hand shopping, upcycling and online sales.
1 Protea Way, Letchworth, SG6 1JT