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Isabel Hospice

Key facts & achievements

Local Care for Local People since 1982

Annual Review 2010/11


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Isabel Hospice Annual Review 2010/11

Who we are Isabel Hospice is a registered charity which provides free care and support for patients and their families living with cancer and other life-limiting illnesses throughout eastern Hertfordshire. The population we serve is almost 350,000 people. Care is based on the simple idea that patients are ordinary people living with physical, social, emotional and spiritual needs. The Hospice provides enormous support to families and friends, caring for the patients and all those around them. Founded in 1982, the Hospice provides a wide range of services including a 16 bed In-Patient Hospice in Welwyn Garden City, a Day Hospice caring for up to 45 patients each week plus 3 satellite Day Hospices, a Home Care Team providing support and nursing care in patients’ homes, a Family Support & Bereavement Service and a team of Allied Health Professionals (see page 20). A fully trained team of volunteers support our specialist medical and clinical teams, ensuring that patients and their families receive the best possible care and support. In addition, Isabel Hospice’s team of Community Nurse Specialists, who work closely with all local GPs, is available from the outset to give advice and support to patients and their families and to refer them to other appropriate services of the Hospice when necessary. All our services are free of charge, and the cost of providing these services is budgeted at around £4.5 million for 2011/2012. Of this, we need to raise around £3 million from charitable sources including the contribution from trading profits. > Find out more at www.isabelhospice.org.uk

Our Mission • To maximize the quality of life of those living with cancer and other life-limiting illnesses. • To provide high quality specialist palliative care, including support for those who are in the terminal phase of their illness. • To support the families and carers of patients, and to continue such support into bereavement.

A message from our Chairman of Trustees The word “Hospice” is often understood to mean a building where only one thing happens but this year’s Report explains how Isabel Hospice is so much more than that, and that our care extends into our community in so many different ways. For example, we were able to improve the quality of life of our patients Margaret, and Richard, both in their own homes, through services that people do not always associate with the word “Hospice.” The work we are doing in schools to raise young people’s awareness of Hospice care and the ways it can help living with a debilitating illness is another example of how a community-based charity can make a difference. None of our work would be possible without your support, or without the hard work and dedication of our staff and volunteers. Together they ensured that we weathered the “perfect storm” in 2010-2011 – strong winds blowing at us from all directions and making it one of the most challenging years in our history. We have contended with uncertainty over future NHS commissioning plans; the ongoing planning work for the new hospital site in Welwyn Garden City and our place in it; the continuing economic downturn and its impact on disposable incomes; and most importantly, the everincreasing demand for our service from the community it is our privilege to serve.

Despite all these pressures I am delighted to report that we have accomplished, or are close to implementing, many of the key aims which we set out in last year’s Report and which you can read about on Page 40. As a result of this considerable progress, we were able to care for around 3500 patients, carers and families last year – the highest number we have ever reached. Perhaps more revealingly, we provided care and support to some 80% of all those who died from cancer last year in the areas of East Hertfordshire, Broxbourne and Welwyn Hatfield. We have also been able to report an operating surplus of £912,000, thanks to significant legacy income, which has allowed us to make prudent transfers to replenish our depleted reserves and for future development including the costs we will inevitably incur through the re-development of the QEII Hospital site and our part in it. I wish to thank all our amazing staff and volunteers as well as my fellow Trustees for all that they have done during the year for Isabel Hospice and the community it serves. Above all, and as we look forward to our 30th Anniversary next year I wish to thank you, our supporters, for helping us make the Hospice so much more than a building. Mike Freeman, Chairman of Trustees


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Isabel Hospice Annual Review 2010/11

Day Hospice All our Day Hospices provide a unique and holistic service to patients and their families. They have their own relaxed and informal atmosphere which patients appreciate. The Day Hospices are staffed by experienced palliative care nurses, working alongside Doctors, Family Support workers, and Allied Health Professionals (see page 20). Trained volunteers are crucial to the running of our Day Hospice care and we are grateful for all the hours they give, working in partnership with patients, family members and our medical staff. The Day Hospice in Welwyn Garden City is the hub of the service. However, we also have three satellite Day Hospice facilities, extending our specialist care into the community in Bishop’s Stortford (Thorley), Hoddesdon and Waltham Cross. Local people benefit from their local accessibility, as it reduces travelling for our more poorly patients. The aim is to help support patients living at home by offering them easy access to medical, nursing, psychosocial and spiritual care at the centres. For most of our very sick patients it provides a social experience in which they can receive medical care and advice as well as choose from a range of activities. ih

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An Easter bo nnet competition at the Day Hospice brought a smile to the faces of patients an d volunteers al ike.

Talking to other patients and gaining support and friendship is a very important aspect of the day. We also know that the role of caring can be exhausting; carers value the chance to have a break, knowing that their family member is being well cared for. The range of services offered is testament to the staff creativity and the increasing numbers of volunteers who provide support, complementary therapy and creative activities such as silk painting, pottery, card making, gardening, music, group relaxation, discussions and board games. The key to the success of Day Care is the vibrant mix of staff, volunteers, patients and families coming together in a unique way. Patients are given choice and treated with respect and dignity.

£397,000

£192

is the cost of providing our extensive Day Hospice services across eastern Hertfordshire

is the average cost for a patient to attend one of our Day Hospices

2,071 attendances across our four Day Hospice facilities


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Isabel Hospice Annual Review 2010/11

Day Hospice Highlights of the year:

• The Benefits Advisor now attends the Day Hospice and the satellite Day Hospices on a regular basis.

• We have started a new forum for patients that have been discharged from Day Hospice. They meet on a monthly basis and through the forum, we are able to monitor their symptoms and therefore get the most appropriate care for them as soon as possible. • At Christmas the staff and volunteers put on a mini cabaret performance for the patients/carers. • A pilot study was undertaken regarding the therapeutic value of expressive writing with selected patients. From this we are planning to work with the University of Hertfordshire to undertake another piece of research around the therapeutic benefits of expressive writing.

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• The Pets as Therapy dogs attend the Day Hospice and the satellite hospices on a regular basis. • The Art Therapist attends the Day Hospice and runs group work art therapy. • Student District Nurses are spending time at the Day Hospice or one of the satellite units as part of their training. Elaine said “Time spen t doing arts & crafts at th e Day Hospic e in Thorle y is time I don ’t spend th inking about my ill ness. I get totally absorbed an d am produ cing things I neve r felt myself capable of” .


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Isabel Hospice Annual Review 2010/11

In-Patient Unit The Isabel Hospice In-Patient Unit (IPU) is a 16 bed short stay unit providing specialist palliative care for patients with cancer and other life-limiting illnesses. Patients are admitted for various reasons: some may come for care when they have distressing symptoms which cannot be managed at home, whilst for others it is a safe haven where they can be cared for in the last days of their life. Providing high quality holistic care for our patients is the main priority of the team. Holistic care means we do not simply care for a patient’s physical needs but also for their psychological, spiritual and social needs. We provide care for the patient but also support and care for their close family/friends, including children and young people. We are proud to have a committed team of health and social care professionals, all of whom are highly trained in specialist palliative care. Medical care, under the guidance of the Medical Director, is provided by a team of Doctors, Nurses, Health Care Assistants and our Allied Health Professionals which is made up of our Physiotherapist and Therapy Assistant, Occupational Therapist and Lymphoedema Therapist. ih

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Whilst at the In-Patient Unit, Sue sipped champagn e in the lounge after she launched the bo ok that she had written for her family and friends .

Patients and their families have access to the Family Support Team, which consists of staff and volunteers specially trained in counselling, family work and pastoral care, providing support for both the patient and family whilst they are at IPU and into bereavement. The team are trained to listen and to be alongside the patient and to give support in the final days and hours.

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We are very fortunate to have a team of specially trained volunteers who support our medical team. Patient Care volunteers work alongside the nursing staff providing personal care to patients. Volunteers also provide a range of complementary therapies under the supervision of the Hospice Therapist, as well as running art and music sessions. Other volunteers support us with reception, flower arranging, gardening and administrative duties.

is how much it costs to run our In-Patient Unit for the year

332

11 days

32%

ÂŁ380

admissions to our In-Patient Unit

is the average time a patient stays at our In-Patient Unit

of our patients are discharged to home

is the average cost of providing 24 hours care per patient at the In-Patient Unit


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Isabel Hospice Annual Review 2010/11

In-Patient Unit Highlights of the year: • We have been able to care for more patients and their families than we did last year. • We have offered more short stay admissions than last year for treatments such as blood transfusions, drainage of ascites and bisphosphonate treatment. • Our Care Review Co-ordinator works closely with patients, families and the Community Team to help the patients spend their last days in the place of their choice. • We were able to help more patients and family members via our 24 hour Advice Line, based at the In-Patient Unit than in any other year.

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• Following the introduction of 7 day working for Isabel Hospice Community Nurses, the Advice Line calls received at the In-Patient Unit can be referred, where appropriate, to the Nurse on-call in the community. • A Department of Health grant has enabled us to improve and update communal areas, such as the Cosy Kitchen where patients’ families can make simple meals and hot drinks, and the relatives’ overnight accommodation to enable them to stay near their loved one in the last days of their life. • The progress we have made in ensuring all our patients have a clear plan of care.

John was a real character and settled into the Hospice, making it his home from home.


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Isabel Hospice Annual Review 2010/11

Family Support Our Family Support Team offers individual, family and group support to patients and their relatives, both during the illness and into bereavement. This may take the form of practical, psychosocial and/or spiritual support. The Team has two Social Workers, a Bereavement Coordinator, one Counsellor, an Art Therapist and the Chaplaincy Team, made up of a Chaplain and Pastoral Care Worker. Our team of trained volunteers, working under the supervision of the Bereavement Co-ordinator, provide bereavement support to adult relatives. We also have a specialised Childhood Bereavement Service (CATS – Children and Teenage Support) which is available to any bereaved child in eastern Hertfordshire.

• Providing training about the work of Family Support both in-house and to external agencies and the production of a multi faith reference document and training tool. • Increased attendance at our regular days for carers, in our Day Hospice facilities where volunteers offer a range of complementary therapies as well as art and craft activities. • Bringing our Chaplaincy Team to full strength with the induction of the Rev Fionnaigh Reid culminating in a successful Annual Service of Thanksgiving. • The first Family Fun Day for bereaved families held in conjunction with, and part sponsored by the Clayton Centre.

Highlights of the year:

• The piloting of an Art Therapy group at the Day Hospice.

• Enhancing the children’s service with the addition of a Service Users’ Forum (to be repeated this summer) and the first CATS re-union.

• Productive collaborative working relationship with the Citizens Advice Bureau in the provision of benefits advice for our patients and their families.

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Children w ho are bein g cared for b y Family Support oft en produce artwork in memory of the loved o ne they hav e lost.

136

143

622

845

children were supported

individuals were helped with their finances by our Benefits Advisor

patients and family members were supported by our Palliative Social Workers

individual counselling sessions delivered by our Bereavement Team


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Isabel Hospice Annual Review 2010/11

Community Nursing and Hospice at Home Our Community Nurse Specialists and Hospice at Home Team work together to ensure that the patient is able to remain in their own home, for as long as they can, if that is their wish. Our Palliative Care Consultant works alongside them to offer both out-patient appointments at our Day Hospice and In-Patient Unit as well as home visits. The Community Nurse Specialists and Hospice at Home Nurses are all registered nurses with additional specialist skills and knowledge in palliative care and oncology. Their passion is to meet the needs of both the patient and the family by caring for them in their own homes. They care for patients with a range of life-limiting conditions, not exclusively those with cancer. Home may be what we traditionally think of as ‘home’ in terms of a house or flat, but in addition, the team also provide care to

patients in residential homes and specialist units that support those with dementia and learning disabilities. We also have one dedicated Nurse Specialist providing care for patients in nursing homes, as well as offering advice about care and specialist education to staff. The whole team meet regularly with GPs, District Nurses, Community Matrons and Practice Nurses to address pain and symptom management for the patients. Patients can also receive financial advice from the Hospice’s Benefits Adviser.

“I know I won’t get better but at the moment I am on a plateau. Who knows what the future brings but without the help of Isabel Hospice I know life would be a lot worse”. Read Margaret’s full story on page 18.

1,214 patients and family members received a home visit

6,958 home visits were made by nursing staff

8.4% of Hospice patients had a non-cancer diagnosis

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Isabel Hospice Annual Review 2010/11

Community Nursing and Hospice at Home Highlights of the year: • The Community Nurse Specialists have assessed and looked after 1,166 patients with an average of 70 patient referrals per month over the past year. • The success of 7 day working which means that patients at home receive care when they need it. • Our aim of increasing services to non-cancer patients continues, and specific education programmes have increased the skills of our team. Links have been forged with the renal, cardiac and respiratory health care providers and the Community Mental Health Service.

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• The Community Nurse Specialists have a significant role in the increased Gold Standard Framework meetings where the Primary Care Team work together to enhance the care of patients under their care. This has a significant benefit of shared learning and identifying the patients within each GP practice who may benefit from Isabel Hospice services. • Night services have also been maintained for end-of lifecare as we know that this is one of the most vulnerable times for patients and their families. We offer this care alongside other community services such as Marie Curie Night Nursing Service and the overnight District Nursing Service for eastern Hertfordshire. Rod wanted to be at home on the day of his Golden Wedding Anniversary for the special sea bass meal his wife cooked for them. Hospice at Home made his dream a reality.


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Isabel Hospice Annual Review 2010/11

Margaret is visited at home and can also see Dr Amsler at the Hospices In-Patient Unit in Welwyn Garde n City.

Margaret’s Story When Margaret (pictured right) from Bishop’s Stortford was discharged by her oncologist last September, he told her there was nothing more he could do for her. The treatment she had been receiving since her cancer diagnosis in 2008 and the sessions of chemotherapy she had endured were no longer effective, and Margaret and her husband Terry left the hospital at a complete loss as to where to turn. Since then, Isabel Hospice has given Margaret a quality of life she never thought possible. “I visited my GP at the South Street Surgery in Bishop’s Stortford in turmoil, not knowing what to do. They referred me to Isabel Hospice and I can’t tell you what a difference that has made to my life. Up until then, I was visiting the hospital every few days to have the fluid that was building up in my body drained. I was carrying between 5-7 litres of it, making breathing, walking, eating and everything so difficult. My life was a real misery at that point. Then I saw the Isabel Hospice Community Palliative Care Consultant, Dr Pia Amsler, and she arranged for me to have a procedure at hospital that enabled me to drain the fluid myself at home. I was a bit nervous at first as it seemed rather ih

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complicated, but I soon got the hang of it, and now my life is completely different. Every few days I do the procedure at home. Some days I am even well enough to drive myself to the Hospice’s Day Centre at the Barnabas Centre in Thorley for a massage, and I feel so much happier in myself. I can’t thank Dr Amsler and the Hospice’s Community Nurse Specialists, Caroline and Sharon enough. They have given me my quality of life back. I know there is help and advice at the end of a telephone line at any time, day or night, which is something that gives me great comfort and peace of mind. I know I won’t get better but at the moment I am on a plateau. Who knows what the future brings but without the support and care of Isabel Hospice I know life would be far worse than it is now.”


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Isabel Hospice Annual Review 2010/11

Our Physiotherapy Team, Lymphoedema and Occupational Therapists

Allied Health

These three services make up our Allied Health Professional Team. They care for patients in partnership both at the In-Patient Unit, any of the four Day Hospices as well as in patients’ own homes. Patients are seen following a referral from the Community Nurse Specialist Team, our In-Patient Unit (IPU) and Day Hospice nursing staff. We know that this service makes a real difference to the lives of our patients, as we have received feedback from families who talk of our care “making this time easier” and they tell us how grateful they are that we have been able to relieve the pain of their loved one. Physiotherapy sessions enable our patients to gain confidence and build strength in their own movements and bodies. This in turn improves the quality of the lives of our patients and their families and carers. They are able to receive treatment at our In-Patient Unit, where we have a small gym, at the Day Hospice facilities as well as in their own homes.

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If they so wish, they are also able to participate in group exercise sessions at our Day Hospice at Hall Grove which also provides friendship, support and camaraderie between patients. These group sessions complement the one-to-one sessions offered to patients and have led to us being able to follow up on many of our patients on a more regular basis.

Laurie joked she should be wearing the Tour de France yellow jersey when she worked on the physio bike at our In-Patient Unit, before she was discharged to go home.

Occupational Therapy helps patients to achieve as full a life as possible despite their illness. Our aim is to help patients feel ‘like people’ rather than being defined by their illness, and help them to regain some sort of control over their lives through their everyday actions and routines. Individual and group sessions are available as well as some adapted Tai Chi sessions which encourage normal breathing, help with increased balance and stamina, and provide an alternative form of relaxation, so increasing concentration and focus.

1,281

631

463

Physio sessions were given throughout the year

Lymphoedema sessions were given

Occupational Therapy sessions helped patients to achieve as full a life as possible


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Isabel Hospice Annual Review 2010/11

Allied Health As all patients are individuals, and therefore have individual requirements, our Occupational Therapist also works with other organisations such as REMAP, a charity who design specific one-off pieces of equipment to provide individual solutions to patients’ mobility problems. REMAP are a countrywide charity organisation of retired engineers. This partnership has provided many patients with quick and cost-effective solutions such as ramps and dressing aids.

Highlights of the year:

Our Lymphoedema Therapist works with patients who have secondary lymphoedema (a chronic condition that is caused by the accumulation of fluid in the tissue spaces resulting in a swelling commonly affecting the arms and legs, but can affect any part of the body) which occurs as the result of surgery or the treatment of cancer.

• Our ever popular exercise class.

Lymphoedema or oedema can have a great physical or psychological impact as the increased limb size can affect mobility and reflect on body image. Caring and managing oedema build up can greatly improve the patients’ quality of life, improving mobility and body image.

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• Our on-going relationship with professionals outside Isabel Hospice to enhance the care of our patients and their families. • That more patients than ever are requesting to come to the gym sessions at the In-Patient Unit.

• That we deliver our services where it is best for the patient, whether that be in their home, at our In-Patient Unit or any of our Day Hospice facilities.

rred was first refe When Richard pist ra he T a m oede to our Lymph d an rd gs were ha er. his feet and le nc ca s hi of e result t swollen as th en mme of treatm After a progra d ol s back into hi he can now fit ay and throw aw rs pe size 11 slip the size 13’s. full story on See Richard’s page 46.


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Isabel Hospice Annual Review 2010/11

Special Projects Schools

Transfer between services

Isabel Hospice has always valued the support it receives from, and gives to, local schools in eastern Hertfordshire. The decision was made to forge closer links and raise awareness about our service, by offering to contribute to the Personal Health & Social Education/Social and Emotional Aspects of Learning (PHSE/ SEAL) and Citizenship Curriculum currently taught in local schools.

When patients transfer between services and carers, it can be particularly stressful and bewildering. The Project Worker, in her Care Review role, is there to facilitate staff and family meetings and contact external service providers such as District Nurses or Adult Care Services.

We have worked closely with numerous schools and delivered programmes for them both in their school and at the Hospice. We have built good relationships with the PHSE Lead for Hertfordshire and this has enabled us to work with teachers in the area to support them in subjects around loss, body image following illness and realising the importance of fundraising for a charity. We have widened this relationship now to junior schools and colleges and have attended many assemblies. This in turn has inspired many pupils to fundraise for the Hospice which is fantastic and has built strong links between the Hospice and local schools which is greatly appreciated.

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Many patients who are admitted into the In-Patient Unit for symptom control are anxious about leaving, whether this is to go home or to a nursing home. They may wish to go home, but need reassurance that support will be there for them when they do. Our Occupational Therapist and Physiotherapy Team work together with other Hospice staff to help achieve this for the patient. On occasions a patient may go home for an afternoon to see how they manage and following this, they are more confident about the possibility of actually achieving their goal of returning home.

Hospice Nurse Wendy speaks at both primary and secondary school assemblies. She adapts her talks about Hospice end-of-life care to ensure that they are appropriate to the age of the pupils.


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Isabel Hospice Annual Review 2010/11

Education & Training In order to maintain and develop specialist palliative care services, Isabel Hospice continues to place education, and staff development at the heart of its philosophy.

• Our non-cancer end-of-life education programme continues to be supported by Herts PVI Workforce Development Partnership.

Our training and education programme encompasses a variety of mandatory, clinical and non-clinical topics aimed to support life-long learning for all staff and volunteers. We strive to disseminate knowledge and skills to colleagues working throughout our catchment area in a variety of health and social care settings.

• We have completed the end-of-life non-cancer respiratory education programme.

Over the past year we have delivered training to nursing and residential homes, adult care services, staff, schools, teachers, volunteers, complementary therapists, pulmonary rehabilitation teams, Primary Care Trust staff and acute hospital generalist staff.

Highlights of the year: • Our advance care planning and Advice Line collaborative teaching projects . • We have been working alongside the Mount Vernon Cancer Network delivering communication skills training and psychological skills assessment courses. ih

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As part of th e Advance Care Planning ed ucation pro gramme across Hert fordshire, Is abel Hospice wo rked in par tnership with Easaliquam Praesent t & North N HS Trust, Gardenfelis. lobortis Etiam House Hospice an ca d key re p semperro dolor viderssitin de veloping “a message in amet nequeafacilisis bottle”. Th is is a small plastic connisi dapibus. Donec tainer whic be stored in h can e patie felis, fringillath sed, holdin g key inform nts’ fridge ation about volutpat ac, volutpat their end-o fvitae, libero.life wishes.

• We have been planning for a multi-disciplinary end-of-life neurological disease programme for 2011/2012 with the aim of improving the access and care pathway/ referral criteria for patients with life-limiting neurological conditions. • The department has worked to develop clinical competencies which will provide the foundations for a competency based education. • Four members of staff have completed the Preparing to Teach in the Life Long Learning Sector teaching certificate and deliver both internal and external education sessions. • The Lecturer Practitioner is completing the Diploma in Teaching in the Life Long Learning Sector.

4

34

178

staff completed the Preparing to Teach in the Lifelong Learning Sector

micro teaching sessions were held throughout the Hospice service

external teaching sessions took place


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Isabel Hospice Annual Review 2010/11

Fundraising Providing the services that you have read about in this review cost the charity over £4 million, of which the Primary Care Trust contributed nearly £1.5 million, leaving our Fundraising and Trading Company to raise the remainder. We could not achieve this amazing figure without the continued loyalty of our supporters. This year we have felt, due to the uncertain economic climate, that each day had to be approached with caution. However, our local supporters have kept us close to their hearts with their continued support, and we thank them. The Fundraising Department operates on a value for money philosophy and seeks fundraising opportunities wherever we can. We have received valued support through our local and corporate supporters, and whilst income is necessary to us, it is not always about the money! It is also about creating opportunities which could include offers of help, advice, skills and gifts in kind or discounts. Our supporters will often take the approach of how they can best work the mighty £ itself and turn it into something more valuable than its pure monetary value. Our professional team of ih

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From the Para medic Piranhas at H atfield Swim Centre to the jungle of Bor neo, our diverse fundra ising activities boug ht in the £££s.

fundraisers, both paid and voluntary, are always on hand to help and advise. Our income is raised through many means and varies from the ingenious and creative right through to the simple, quick, easy and traditional. New projects for fundraising this year have been our Open Challenges. These are popular projects that can be in locations such as Borneo, Sahara or perhaps Scotland! We endeavour to choose projects that will involve and assist the local community in the challenge location. We are also offering more physical challenges that will test your personal limits whilst raising vital income. For those that like a more relaxed pace we have teas in gardens, picnics, art displays, golf and much more. Our supporters have also organised glamorous balls and dances, race nights, quiz nights, trampoline bounces, jazz nights, skydives, darts, swims, runs and walks to name but a few. We launched our own corporate networking event called The 3rd Thursday (www.the3rdthursday.com). We realised there was a need for business networking with heart and the lunches have gone from strength to strength.

£42,000

£78,000

£30,000

is the amount donated in memory of loved ones at our 2010 Lights of Love ceremonies

was raised on Gift Aid alone

was made from our Make A Will Week


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Isabel Hospice Annual Review 2010/11

Fundraising Over the last couple of years many grant making trusts and foundations have reported a huge increase in the number of applications received from charities but have had less money to distribute. However, over this period Isabel Hospice has actually seen an increase in the value of grants received, and we are extremely grateful to all the organisations who have supported our work. In particular we would like to thank those who continue to support us year on year, as we very much value the relationships that we have built with them. Legacy income by its nature is an unknown factor each year, however, the generosity of our supporters in remembering us in their Wills is always appreciated. We realise that many of our supporters may not currently be in a financial position to help as much as they would wish during their lifetime, so gifts in Wills are always received with gratitude. We welcome 2011/12 with a little apprehension, unsure what it will bring as the financial climate settles. We will count on you, our loyal supporters, to help us raise as much money as we can, so that we can continue to serve our local community with vital end-of-life care.

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Our deepest and most sincere thanks go to all our patients, donors, supporters and volunteers. You are an inspiration to us all and without you, Isabel Hospice would not be the charity it is today.

Highlights of the year: • Expanding our fundraising into centrally organised overseas challenges. • Increasing the support of corporate and local businesses. • Running a successful Make A Will Week in conjunction and with support of local solicitors. • Launch of Networking with Heart The 3rd Thursday in Bishop’s Stortford. • An increase of 9.5% donation income from last year. • £78,000 raised from Gift Aid.

Every penny counts whether it comes from collections outside supermarkets or sponsored bouncy cas tle bounces – we need you r support!


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Isabel Hospice Annual Review 2010/11

£1.7m

Our Shops & Lottery

is the amount for which donated goods were sold

The Isabel Hospice Trading Company is made up of two key areas, our charity shops and our weekly Lottery.

Shops

Lottery

We now have 11 shops located in towns across our catchment area (and run four more in conjunction with Grove House Hospice in St Albans). These shops are supported by our warehouse and furniture storage area at our Head Office in Welwyn Garden City.

The weekly Lottery draw which started in 1995 raises around £240,000 each year towards the cost of our patient care. Each ticket costs £1 with the top prize each week being £1,000. Signing up for the Lottery on an annual standing order basis provides the Hospice with a vital form of regular guaranteed income. This income enables us to plan ahead for future projects and gives us a more stable financial base.

Each shop is staffed by a manager and up to 40 volunteers a week. All our shops have a real community feel about them, as they are run by the local community, for the local community. They rely on a constant supply of high quality donations and the goodwill and continuous hard work of the volunteers and staff. The continuing challenging financial climate has made it more important than ever to make the most of the donations that we receive. To this end, we have been delighted to continue to work with prestigious auction house Sworders, to make sure we are able to maximum the money raised from collectable and antique donated item. ih

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Are you a former Lottery member? If you are unsure or if you wish to sign up, don’t miss the chance of winning our top prize of £1,000. Ring the Lottery Office today on 01707 382594 where our Lottery Team will be more than happy to advise you.

400 volunteers help across our shops and in our warehouse We rely on good qualit y donations to keep our shops stocked. You can dona te to our shops in: Bisho p’s Stortford, Buntingfor d, Cheshunt, Cuffley, Ha tfield, Hatfield galleria, Hertford, Hoddesdon , Waltham Cross, Ware or Welwyn Garden City.

£240,000 was raised from sales of our weekly Lottery tickets


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Isabel Hospice Annual Review 2010/11

Trading Highlights of the year: • Sales have risen – Once again we have been able to increase the retail sales and profitability of our shops. You can see further details in our Treasurer’s Report on pages 38/39. • Gift Aid in Shops – Throughout 2010 we researched, planned and trained our staff and volunteers to start rolling out this initiative incorporating our 11 charity shops. A new till system has been installed to enable us to carry out this initiative. Our new scheme is an opportunity to claim even more Gift Aid back from the HM Revenue & Customs because when you donate a bag of items to our shop the monetary proceeds from this can now also be Gift Aided, at no additional cost to you. • The John Lewis Golden Jubilee Trust project – A Visual Merchandiser from the Oxford Street branch has been on secondment to Isabel Hospice to help with the opening of the Hatfield galleria shop (April 9th 2011) as well as working on other projects throughout our 11 shops using her expertise and donated merchandising items from John Lewis stores.

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• Sworders Fine Art Auctioneers – Sworders have continued to be extremely generous to the Hospice, both with their time and their expertise. They have visited the Hospice regularly to advise on valuations of antique and collectable items, and have sold key pieces at auction for the Hospice at 0% commission. • Godshaws the Jewellers have continued to train our staff and volunteers, free of charge, to enable them to identify precious metals and stones when items are donated to the shops. • eBay – We have continued to list and sell donated items on the on-line auction site eBay. This has enabled us to reach a wider audience for collectable and specialist items

Shop volunteer, Pam said the reta il Gift Aid scheme is very exciting and will mean we will be able to make even more from every item donated. For example if you donate a leather jacket, sign our Gift Aid declaration and we then sell it for £30, we can claim an extra 25% at no extra cost to you, making you r donation of the jacket worth £37.50 to the Hospice.


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Isabel Hospice Annual Review 2010/11

Highlights of the year:

Volunteers Our volunteers bring a diversity of skills and personalities to Isabel Hospice, and help us to deliver the very special levels of service that we so pride ourselves on. Their value to the Hospice is so much more than the financial face value that their donated skills give to our patients, their families and indeed our staff. Not only does the 40,000+ hours per year donated by them enable us to keep our running costs down, they also bring many positive intangible benefits to the Hospice, which strengthens our organisation and its links with our local community. They help us to put life into the days of those who are terminally ill by providing empathy, care, enthusiasm and personal attention within our huge collective desire to make a real difference to end-of-life care. Volunteering is a win-win activity and individuals grow in confidence, competencies and skills. After extensive induction we offer ongoing training and learning, flexible times and involvement as part of a team. As new opportunities and challenges arise for individuals and the organisation itself, we adapt to changes and needs, with the patients and families foremost in our hearts and minds. ih

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• We have been able to maintain a seamless service of support to our In-Patient Unit, with 9 volunteers each day, as well as providing support for Day Hospice staff throughout the year at all four Day Hospice sites. • We have continued to arranged transport for all patients to and from their homes to both our Day Hospices and to our In-Patient Unit where appropriate. This kind of activity is the keystone of what we do and is achieved by lots of goodwill amongst volunteers. • All Isabel Hospice receptionists in all locations have received computer training and are using IT to speed communication and improve the flow of relevant information.

240 Our Pets as Therapy Dogs (P.A.T.) dogs often bring back memories of the pets our patients have had in their life and this can bring them a lot of happiness.

volunteers support our Hospice In-Patient care

55 flower arrangers and cake makers add that special touch

• We have introduced an out of office hours call handling procedure for the Hospice, so that until 9pm on weekdays all calls are answered personally. • We have introduced an employee volunteering scheme with a local company, giving us extra help two mornings each week at the In-Patient Unit.

40,000+

• We have recruited over 40 new volunteers to Isabel Hospice to help with administration as well as three Pets As Therapy Dogs, (P.A.T. dogs) to enhance patient care.

hours per year are volunteered for the Hospice by around 900 individuals

om Employees fr to Roche helped en rd ga e th tidy up nt ie at -P In r at ou Unit.


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Isabel Hospice Annual Review 2010/11

Treasurer’s Report

Financial highlights of the year ended 31 March 2011

We started the year facing another budget deficit if we were to maintain services and income projections were not exceeded. In common with many other charities, we focused on reducing costs and maximising income; neither easy in the economic environment. However by the end of the first half of the year, general income was on target and costs were below budget, and the gap was bridged by legacy income. Subsequently we have received additional legacies that have turned a predicted deficit into a surplus, allowing us to replenish our reserves to more comfortable levels and to face the coming year with cautious confidence.

– Gift Aided profits from trading £626,000 (£663,000), down 5% – investment income £16,000 (£25,000) • Legacies £1,873,000 (£388,000), up 382% • Total resources expended £4,690,000 (£4,483,000), up 4% Although trading profits were down, turnover was up 4% and increased costs attributable to investment in skills and systems, which will bring increased returns in the future. When the trading company’s gross figures are added in, the consolidated results show an overall operating surplus of £912,000 (deficit £402,000).

I report the following highlights for the year: • Total incoming resources £5,627,000 (2010: £4,117,000), up 37% • Incoming resources excluding legacies £3,754,000 (£3,729,000), up 1% – contract income £1,655,000 (£1,699,000), down 3% – donations £838,000 (£765,000), up 10% – fundraising events £619,000 (£577,000), up 7%

For every £1 of the resources spent, 86p was on patient services, bringing care and support to over 1,000 people every month of the year.

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We are truly grateful to all our supporters who have contributed to this financial performance, especially those no longer with us, who remembered Isabel Hospice in their Wills. Chris Bird, Honorary Treasurer Full, statutory Audited Accounts prepared and signed by Nicholsons, Chartered Accountants of Welwyn are available on request from the Company Secretary at Isabel Hospice, Head Office, 61 Bridge Road East, Welwyn Garden City, Herts. AL7 1JR. Tel: 01707 382500.

Where our money came from

How our money was spent

Investment Income <1% Management & Admin 2% Other NHS Contracts 3% Family Support 8% Event Income 11% Day Care 8% Shops & Lottery 11% Fundraising and Publicity 11% Donations 15% Home Care 23% Main NHS Contracts 26% In-Patient Care 48% Legacies & Other Exceptionals 33%


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Isabel Hospice Annual Review 2010/11

Key Achievements We set out last year with a number of key aims and plans. We have made the following progress: • We have reinforced our Community Nursing Team with the introduction of 7 day working and the addition of a Community Consultant in Palliative Care. • We have refined our Hospice at Home service so that there is closer integration across our services, and introduced support workers to respond more quickly to nursing needs at weekends and Bank Holidays. • We have continued the development of our service for non-cancer patients and are implementing changes to our Day Hospice so that we can reach more patients at an earlier stage in their illness. This includes greater use of our satellite Day Hospices to minimise travelling for our patients. • We continue to work pro-actively with GPs, both in the day-to-day care of patients and in longer term planning of services.

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• We continue to work closely with other health agencies, including District Nurses, Marie Curie Cancer Care, Acute Hospitals and the Mount Vernon Cancer Network. • We have set challenging budgets to ensure that we always live within our means and therefore give continuing sustainable care. • We have enhanced our fundraising capability and have secured the support of a number of major business names in our community. • We have improved our communications to ensure maximum awareness of what our Hospice is able to offer including the use of Facebook and Twitter.

Gifts in kind are just as important to us as monetary dona tions. We were delighted when a team of 12 volunteers from RB S Nat West Bank cleaned and re-pa inted the exterior of our sm all mobile Community Nurses’ offi ce in Standon and decorate d the inside including insulating the floor and re-carpeting it. The nu rses based there care for patients in Bishop’s Stortford, Sawbridgew orth and the surrounding villages.


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Isabel Hospice Annual Review 2010/11

These two strands will then be drawn together to form an integrated strategy based on a central ‘hub’ into which Community and Day Hospice services will connect.

Aims & Plans for 2011/12 Changes in our local population and an increasing focus on choice in place of care, mean that there is a growing demand for our community services to support patients to live and die at home. Whilst the services we currently provide are well evaluated by service users, we need to ensure that the care we provide in the future best meets the needs of our population. We will continue with the ethos that Isabel Hospice is rooted in the community and will develop our services to meet their changing needs, including: • Continuing to improve the quality of care to more patients, including those with a non-cancer diagnosis, in all settings. • Enabling more patients to live and die in the place of their choice. • Developing the use of end-of-life care tools: Standards Framework w Liverpool Care Pathway w Advanced Care Planning Find out more at www.isabelhospice.org.uk Like us on facebook

• Enabling our patients to be admitted into the In-Patient Unit 7 days a week. • Developing education and training to support other providers of care for the less complex palliative and end-of-life patients.

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We will then develop our plans in conjunction with our commissioning colleagues in the NHS, in particular our local GPs, and will redouble our efforts to raise the necessary funds to staff the services and provide the necessary physical and technological infrastructure on a cost-effective basis. High quality patient care will remain, as always, our highest priority.

In addition, two important pieces of strategic planning have recently started. A major consultation exercise to determine the future nature of our services in the community and at our Day Hospice. We have held focus groups with local stakeholders – service users, health and social care professionals from the NHS and local authorities. Work relating to the re-development of the QEII Hospital which will determine the future nature of our services delivered from a centrally positioned building.

w Gold

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• Continuing to evaluate and develop our Hospice at Home service.

Our Community Nurse Specialist with a responsibility for Nursing Homes has been training and mentoring staff in many nursing homes in palliative end-of-life care. This enables as many of our patients as possible to stay in the place of their choice. Welwyn Hatfield MP Grant Shapps presented training certificates to a local nursing home, on behalf of the Hospice.


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Isabel Hospice Annual Review 2010/11

Thank you! 106 Jack FM Albert Hunt Trust Aldwickbury Park Golf Club All our patients and their families who gave permission for their photographs to be used in this Review Andrea Madgwick Annandale Charitable Trust Anthony Hamilton Axis Magazine Barnes & Partners Beatrice Laing Trust Bernard Pearce & Co Big Lottery Fund Bishop’s Stortford Chamber of Commerce Bishop’s Stortford Golf Club Bishop’s Stortford Rugby Club Bleriot Construction Ltd Borough of Broxbourne Breeze & Wyles Brignalls Balderston Warren Brookmans Park Golf Club Carol Newland Caron Keating Foundation Cathedral & Abbey Church of St Alban Children in Need Childwick Trust Chris Lane Clayson Williams Charitable Trust Coopers of Stortford CP Enterprises Crane & Staples Curwens Cyril Shack Trust Daniel Robinson & Sons

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We could not operate without all of our volunteers who enable us to care for patients and their families and to raise funds for us in our offices, in local groups and in shops. We are also grateful to all those other individuals and organisations, too numerous to mention, who have supported us during the year. We would like to make special mention of the following organisations and trusts: David Webster Charitable Trust Dean Capon Department of Health Duffield Harrison East Herts District Council Eisai Europe Ltd Everyone Active Ewart Price Finesse Leisure Fishers Outdoor Leisure Follett Trust Freemasons Grand Charity Gayle Holliday Garden House Solicitors Garfield Weston Foundation Gina Bridgman GlaxoSmithKline Godfrey Skinner Gordon Morrison Charitable Trust Graham Rowlandson Foundation Haileybury College Hanbury Manor Harlow Health Centres Trust Ltd Hatfield galleria Hedley Foundation Help the Hospices Hertford Offset Hertfordshire Community Foundation Hertfordshire County Council Hertfordshire Life Hertfordshire Mercury Herts & Essex Observer Hospice Aid UK HRJ Law Ian Hudson

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Isabel Hospice Fundraising Support Groups – Bishop’s Stortford, Broxbourne & Hoddesdon, Hertford, North Mymms, Ware, Welwyn Garden City, Isabel Hospice Special Events Committee James Tudor Foundation Jeremy Waldron John Lewis Welwyn Garden City Jules Thorn Charitable Trust Kevin Budd King William IV pub (Hoddesdon)! Knebworth Lodge Leach Homes Lindsey Peters of Rosemary Conley Longmores Lussmanns - Bishop’s Stortford Male & Wagland Marketing Kinetics Marks & Spencer Mary Gethin Matthew Wyatt at the Bishop’s Stortford Flyer Morgan Sindall Morrisons Mr H Productions Mr E Carter Ocado Paradise Wildlife Park Partybuds Pellys Solicitors Ltd Peter & Rosey Wilkerson Peter Bussey Pexhurst Pitney Bowes Limited Pothecary Witham Weld Price Bailey

Provincial Grand Lodge of Hertfordshire Ramblers Worldwide Holidays Reynolds Johns Partnership Richard Bloom Roche Rotary Clubs across our catchment area Sainsbury Simon Gibson Charitable Trust Stanley de Leon Sue Gager Sylvia Adams Charitable Trust Tees Law Tesco The Barn Theatre The Best of Bishop’s Stortford The Best of Hertford The Lemon Tree The Welwyn Hatfield Times Tom Beldon Valeside Catering Van Hage Great Amwell Veolia Water Vintners Gifts Charity Ward Times – Hertford Welwyn Hatfield Community Housing Trust Welwyn Hatfield Conservative Association WGC Lodge 5748 WGC Golf Club Whiskers LLP

Our Trustees Trustees 1984 Dr Richard Dent 2002 Michael Freeman (Chairman since 2006) 2002 Jill Geall 2002 Charles Lewis 2005 Christopher Garrett

Michael Freeman (Chairman since 2006)

Christopher Bird

Christine Brown

Dr Anthea Cecil

Ann Collins

Sophie Cowan

Dr Richard Dent

Marlene Duke

Christopher Garrett

Jill Geall

Angela Lever

Charles Lewis

John Morris

Barbara Newman

Geoffrey Perrin (Deputy Chairman)

2005 Dr Anthea Cecil 2006 Sophie Cowan 2006 Geoff Perrin 2006 Christopher Bird 2008 Christine Brown 2009 Ann Collins 2010 Marlene Duke 2010 Angela Lever 2010 John Morris 2010 Barbara Newman


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Isabel Hospice Annual Review 2010/11

A Regular Gift

Richard’s Story

Regular Giving is precious to us

When Richard (41) was first referred to the Isabel Hospice Lymphoedema Therapist his feet and legs were extremely hard and swollen as result of his cancer. He could no longer even wear his normal size 11 slippers and had to wear a size 13. This meant his ability to move about was minimal, his lower back was affected and he was in a lot of pain and discomfort. Paul Riley, the Lymphoedema Therapist explained: “Richard was referred to me by one of our Bishop’s Stortford Community Nurse Specialists. We planned a treatment programme which would result in the softening and reduction of the oedema build up in this body. Richard, who had previously lived in his own home, moved back into the family home for support from his family during all his treatments. His mum Sheila gave exemplary support and

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was a key part in the continued daily care. I saw Richard once a week, and there was always a welcoming cup of tea. Being a keen sportsman we would have interesting conversations whilst treatment was carried out, mainly about rugby, cricket and golf of which I knew nothing; but I do now! It has been a privilege and a pleasure to meet Richard and his family and to see the benefits achieved with full collective support from medical and family members. Gradually, and with ongoing medication, an improvement was seen and Richard was delighted to throw away his super size slippers!”

To provide this service annually costs £4.5 million. To achieve this we rely heavily on the generosity of our supporters. By making a regular donation you can help us to be there for more people who need our care and support. This also means we can plan for the future with greater confidence. Ensuring the security of the Hospice means we will be there for future generations. Your Regular Gift will enable us to continue to help those living with cancer and other life-limiting illnesses.

!

It’s the small things that count… I can get back into my slippers now

Every day of every week of the year, Isabel Hospice provides specialist care for patients and their families living with cancer and other illnesses.

A regular gift Please enter your full name and HOME* address

STANDING ORDER FORM Please cut out and return to: Fundraising, Isabel Hospice, 61 Bridge Road East, Welwyn Garden City, Herts AL7 1JR Please pay Isabel Hospice £................................ monthly / quarterly / yearly until further notice and debit my Account No: ................................................. Bank sort code: Starting on**:

__ / __ /__ DD / MM / YY

**(please allow one month from today)

To the manager (bank name and address): . ...................................................... ........................................................................................................................................ ........................................................................................................................................ ............................................................................. Post code: ..................................... Signed: ......................................................................................................................... Date: ............................................................................................................................. Recipient Bank Details: Pay Co-operative Bank (08-02-28) for the credit of Isabel Hospice Account No. 65424870

GIFT AID DECLARATION

First Name: . ..................................................................................................................................................................

I would like Isabel Hospice to treat all donations that I make from the date of this declaration until I notify you otherwise as Gift Aid donations. I pay tax on earned or unearned income and will have paid sufficient tax to cover the tax reclaimable on my donation(s) to Isabel Hospice.

Surname: .......................................................................................................................................................................

Signed: ......................................................................................................................................

Address: .........................................................................................................................................................................

Date: ..........................................................................................................................................

.......................................................................... Post code: .........................................................................................

(to find out more about Gift Aid go to our website www.isabelhospice.org.uk

Title: Mr/Mrs/Miss/Ms/Other (circle relevant title)

Telephone: . ................................................................................................................................................................... Mobile: ...........................................................................................................................................................................

To the bank: If this standing order is rejected, please return it to Isabel Hospice, 61 Bridge Road East, Welwyn Garden City, Herts AL7 1JR.

E-mail: ............................................................................................................................................................................

o

If you would like us to contact you via email please tick here q

Isabel Hospice is registered under the Data Protection Act 1988. Your details will not be disclosed to any third party.

*By entering your HOME address you enable us to claim Gift Aid, we CANNOT claim Gift Aid with any other address.

I would like to receive information about Isabel Hospice.

‘Thank you’


Patrons 1983 1983 1983 1983 1986 1993 1995 1997 1998 1999 2000 2000 2001 2001 2003 2004 2004 2004 2005 2005 2006 2006 2007 2007 2009

Dr Carmel Coulter FRCS, FRCR Donald Seymour Kim Wilde Marty Wilde Mr Basil Collins CBE Bob Wilson OBE Richard Walduck OBE JP DL Barry Norman CBE Frederick Forsyth CBE Michael Goulding OBE James Barham Terry Mitchinson Ronald Maddox PRI Hon RWS FCSD Mark Prisk MP Oliver Heald MP The Most Hon. The Marquess of Salisbury Lady Salisbury Sir Philip Mawer Grant Shapps MP Charles Walker MP Susan Warren David Williams Bryan Norman Lady Parkinson DL The Rt. Rev. Alan Smith, Bishop of St. Albans

Life Presidents

Senior Management Team

Barbara Doherty MBE, Chairman of Trustees 1991–2003

Helen Dodd Director of Hospice Services

John Lockhart, Chairman of Trustees 2003–2006

Nigel Furlong Director of Finance & Administration Lisa Seccombe Director of Fundraising & Public Relations Matt Seccombe Director of Trading Dr Dee Traue (from May 2010) Medical Director – Consultant in Palliative Care Sue Balcombe Head of Human Resources Pauline Willson Deputy Director of Hospice Services

Isabel Hospice Registered Office: 61 Bridge Road East, Welwyn Garden City, Herts AL7 1JR Tel: 01707 382500 Registered Company Number (England & Wales) 3056823. Registered Charity No. 1046826

www.isabelhospice.org.uk


Isabel Hospice Annual Report 2010 2011