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Annual Report | 2010/2011

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Annual Report 2010/2011

Chairman’s Report GrahamYardley Chairman


espite some uncertainties about our future funding, and the retirement of Margaret Evans our Chief Executive, Bolton Hospice has continued to do what we do best – looking after patients with life limiting illnesses. But we are not only a provider of care for the people of Bolton, we are a significant instrument for social cohesion; we help individuals, and families of individuals, diagnosed with terminal illnesses to come to terms with death, and dying can never be under-estimated.

Next year we are celebrating our 20th Anniversary, and there is no doubt that we have made immense progress in the last twenty years, with the quality of care we provide, and the professionalism of those providing that care. And there is little doubt that over the next five years that Bolton Hospice, and the hospice movement generally, will see enormous changes in the way in which it is funded. There will also be changes in the way we progress generally to provide palliative care in the community. In 2010, the Coalition Government announced the Palliative Care Funding Review to look into the state funding of hospice and palliative care services in England. In the final report published in July of this year, the review tried to describe which palliative care services should be state funded and which services should continue to be funded by charities. The review’s recommendations had three key aims: • To create a fair and transparent funding system

• To deliver better outcomes for patients • To provide better value for the NHS The great conundrum is how this will affect hospices. 97% of hospices including our own, do not receive all the funding they need for the NHS services we provide, and the latest proposals would guarantee funding regardless of where patients live. It is also likely that there will be some incentivising of the provision of palliative care, which it is claimed leads to better outcomes for patients, supports choice, and is the most cost effective way of using NHS resources. The current funding process in which we receive about 33% of our requirements from the Primary Care Trust was going to change anyway with the abolition of the PCTs in 2013, and it is expected that the current level of funding will continue after that, via the local GP Consortia, but there are certainly no guarantees on this. The added uncertainty is that the Palliative Care Funding Review is unlikely to kick in until 2016, after a pilot scheme has been in place before full implementation. The difficult period will be in the transition from the current funding system, due to change anyway, to the new system in a few years time. The pressure on hospices will continue with an ageing population, and the fact that it is estimated that almost 100,000 terminally ill people in the country do not get proper palliative care. We accept and acknowledge that our hospice is unable, for reasons of space, to increase the number of beds for our in-patients, and therefore we need to move forward with increased vigour to expand our Hospice at Home Service. There will be some obstacles

15 3

No praise is too high for the dedication of our staff, and the numerous letters, cards and comments of the families of patients in the hospice is testimony to this.

Annual Report 2010/2011

to this expansion, and clearly there will be cost implications, but our nurses need to get to patients’ homes at any time day or night and stay there as long as needed to provide specialised palliative care. We need to be better at getting our efforts and resources on taking care and services to people’s homes in the community.Yes there is a cost, but if we don’t do it, other organisations will. So all this is in the future, and although this Annual Report is intended to look back at the year, I thought it important to highlight the challenges that lie ahead. At the start of this Report, I did say that our Chief Executive Margaret Evans retires on the 16 October 2011, and I would like to pay tribute to the immense contribution that Margaret has made to Bolton Hospice. Margaret had worked in a number of very senior positions at the Royal Bolton Hospital before she was appointed as Chief Executive here, and it was an inspired appointment, and very quickly she set about introducing a much more professional management style, introducing proper procedures for the way in which the hospice was to be run. Eventually, once she had assessed the staffing structure, Margaret changed the structure, and was never afraid to adapt the staffing structure to accommodate changing needs. Her approachable style has endeared her to all of her team, both clinical and non-clinical, and she will be greatly missed. At the time of writing this Report, a recruitment process is underway to appoint a replacement for Margaret, no easy task, but I will update all members at our AGM in late October. It is no coincidence that the quality of our staff, both clinical and non-clinical, reflects Margaret’s influence and style. No praise is too high for the dedication of our staff, and the numerous

letters, cards and comments of the families of patients in the hospice is testimony to this. It is truly heartening when I meet with those family members and hear of their effusive comments about the care from our staff. Our Fundraising team have had a difficult year, mainly because of unfortunate sickness levels. Our new Fundraising Manager, Alice Edmond joined us at the beginning of 2011, and she has brought much needed professionalism in managing the Fundraising Department. The Midnight Memories Walk is our major event, and I am amazed at the numbers of ladies wanting to participate in this event, more often than not in memory of a relative or loved one who has died in the hospice. The success of our six hospice shops is astounding, and no praise is too high for the volunteers who work in those shops to make them the success that they are under the management of Cathy and Denise. Many hospices have seen a decline in the numbers of members in their lottery, but Steve Holt and his team have bucked the trend, and have increased numbers of members in the last year. I never tire in these annual reports to make reference to our volunteers, an ‘army’ of over 600 at the time of writing. No praise is too high for the contribution they make to the hospice. Finally, may I thank the Trustees for their support and diligence through the year. Earlier this year, four new Trustees were appointed, Karen Elliott, Margaret Ranyard, Traci Berry, and Andy Morgan. The contribution they have all made to the Board and various sub-committees on which they serve has been outstanding, and I greatly value this.

GrahamYardley Chairman 5

The care that is offered to patients, their families and friends, at such a difficult time in their lives is unequalled and must always be maintained.

Annual Report 2010/2011

Chief Executive’s Report Margaret Evans Chief Executive


y Annual Report for 2010/2011 is the last one I shall write as Chief Executive of Bolton Hospice, as I am leaving the Hospice in October 2011.

I shall miss the people I work with immensely, both staff and volunteers, but it is time to take a little more time to relax and do other things. I feel hugely privileged to have held the Chief Executive’s position in such a wonderful organisation for 11 years. The care that is offered to patients, their families and friends, at such a difficult time in their lives is unequalled and must always be maintained. It is truly a team effort and our success is built on that teamwork. Everyone is vital to the success of the organisation. We all rely on fundraising to bring in the money and they rely on clinical and support staff to provide a high quality standard of care to support them in raising those funds.

The past 11 years have been successful ones here at Bolton Hospice, full of changes and challenges which we have met with enthusiasm and success. There are many more challenges ahead, principally in relation to our funding from the NHS, which constitutes a third of our income. It is time for someone else to meet those challenges and I am sure that, with the support of the Trustees, staff and volunteers, the Hospice will continue to go from strength to strength. Thank you to everyone – staff, volunteers, patients, carers and supporters – for making my time at Bolton Hospice so rewarding and fulfilling. I could not have had a better job and that is because of you.

Margaret Evans Chief Executive


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Annual Report 2010/2011

Medical Director’s Report Dr Barbara Downes Medical Director


e live in an ever changing world and the Hospice provides services within an ever changing health care economy.This has always been true but it feels especially so this year. Nationally there has been a major review of how palliative care services are funded which will, if the recommendations are implemented, have a big impact up on how we operate. Locally there are changes within commissioning and health care provision. Hospital and community services have integrated into one organisation – the Bolton Foundation NHS Trust. Internal to the Hospice we now face the change and upheaval of Margaret Evans’s retirement, and I would like to pay tribute to her wisdom and steady leadership over the years, she will be a hard act to follow. This year we have continued to review and adapt our services to the needs and expectations of patients and carers. The ward functions at capacity, and Bolton Hospice Support Services offer a flexible service to day and out patients; we now have a dedicated lymphoedema clinic, our bereavement support systems have been strengthened, we are addressing our need of an upgraded IT system, we continue to educate and train our staff, we seek and respond to feedback from our patients and families.

Change is also a fact of life for our medical team. Other than myself, Dr Lieth the other consultant and Dr Rink a local General Practitioner, all of our doctors are in training either to be consultants or general practitioners. They spend six months with us gaining experience, learning skills which they will take with them into their future careers. Training is a vital part of our work and it gives me great satisfaction to know that we can influence the care of patients indirectly by passing on our skills and providing a model of good care. Change creates both challenges and opportunities but whilst we cope with change we need to maintain our focus on our core purpose which is of course patient care. Despite the challenges our work goes on to maintain and improve our quality service and I thank all who contribute, staff, volunteers, fundraisers and supporters.

Dr Barbara Downes Medical Director


Clinical Nurse Manager’s Report Jill Entwistle Clinical Nurse Manager


uality is at the centre of all we aim to achieve for our patients and those who are close to them. Over the last year we have continued to strive towards our services meeting the highest standards and pride ourselves that all aspects of the patient’s physical, social, emotional and spiritual needs are addressed and met along with those of their carers. We continue to assess the effectiveness of our services through Audit and Satisfaction Surveys and where possible, involve those who have access to Hospice Care to shape future developments.This approach was used during the recent refurbishment and restructure of Bolton Hospice Support Services now providing flexible services within modern facilities allowing patients and carers to access a variety of different services dependent upon need and choice.

We have continued to submit evidence of our compliance with Essential Standards of Quality and Safety to the Care Quality Commission. We also provide data for The Department of Health Quality Markers and measures for End of Life Care. These include usage of the Liverpool Care Pathway for the Dying, Advanced Care Planning, Communication Skills Training and Bereavement and Spiritual Care. This year has seen us produce our first Bolton Hospice Quality Accounts, allowing us to demonstrate to service users what we, as an organisation, are


doing well, where improvements can be made and what quality priorities we need to set for 2011/2012. Caring for families during illness is a challenging and rewarding role which requires both knowledge and compassion. This year has seen the appointment of Siân Russell to the newly developed post of Hospice Educator. This is an exciting opportunity not only for us within the Hospice but for all those delivering End of Life Care within Bolton as we endeavour to ensure we have the relevant knowledge, skills and attitude for our roles. This post will require her to develop, plan and co-ordinate the educational needs of all the staff and volunteers within the Hospice, whilst enhancing links within Bolton’s wider Healthcare Community. Staff have worked very hard this year to increase public and professional awareness of the work that takes place within the Hospice in an attempt to dispel misconceptions that we are solely about dying. As treatments for diseases continue to be developed and improved upon, people are living longer with illness. Much of our work now focuses on supporting these patients and their families to live well and this is achieved through the Hospice and by collaboration with other care providers within Bolton and neighbouring localities. Under the umbrella of the St. Christopher’s Project, local primary school children, college students and adults have spent time with Day Therapy patients producing together a wealth of art and literacy work. Feedback from all parties involved is very encouraging and I feel sure that we shall continue to offer further opportunities

Annual Report 2010/2011

Promotion of our services will remain paramount as we venture into a new and challenging Health Service. to local organisations. We also took part in the national initiative Dying Matters Week held in May 2011 and promoted Carers’ Week throughout the organisation. Promotion of our services will remain paramount as we venture into a new and challenging Health Service. People within Bolton will have greater choice in who delivers their care and in which setting; and we are well placed to offer Palliative and End of Life Care services to those facing a difficult and frightening time in their lives. Staff have included separate reports for the services they manage and I would like to take this opportunity to thank them for all their hard work, commitment and drive to deliver and improve upon Hospice Services within Bolton.

Jill Entwistle Clinical Nurse Manager



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Bolton Hospice Support Services


Lynn Halliwell Senior Sister BHSS

010/2011 has seen a new look to our Day Therapy Services as well as the whole unit having been refurbished to a high standard. The name has also changed – we are now called Bolton Hospice Support Services (BHSS).

We currently run three traditional day therapy days – Wednesday is a drop-in for younger patients. This is an informal day when patients come and go at their own convenience and a buffet lunch is served. Monday is an optional day where patients will attend for blood transfusions. We also hold a nurse-led lymphoedema clinic monthly and nurse-led outpatient attendance to provide additional support to patients and families between their medical outpatient appointments. The team, working alongside Physiotherapists and Occupational Therapy, have successfully run a series of education sessions for patients; this is to be extended to any outpatients and also in-patients who it is thought may benefit from certain sessions. The BHSS team remain enthusiastic and are generating new ideas; we continue to be involved with audit.

Our Complementary Therapists remain busy and dedicate one day a week to the in-patient unit. They also offer treatments to carers for both outpatients and in-patients. They will also offer treatments to bereaved relatives if needed. Creative Therapy has seen the completion of two projects working with local school children who have visited the Hospice, chatting and developing relationships with patients. The children have gained some insight into the work of the Hospice. Just recently we have run sessions with college students who have shown patients how to produce art or written work by using IPads. Hair and Image is continuing to promote the service working with outpatients, in-patients and carers. User views have been sought to ensure we are providing a suitable service for patients. In the next 12 months we aim to continue to develop the Image side of the service to meet patient needs.

Lynn Halliwell Senior Sister BHSS

Nutrition has been taken forward by involving volunteers and creating new documentation. This has enabled staff to ensure that patients are having appropriate diet and fluids whilst attending BHSS.


Annual Report 2010/2011

Inpatient Unit Bridget Harrison Senior Sister Inpatient Unit


he inpatient unit continues to flourish. Our aim is to provide the very best care for our patients and their loved ones with dignity and compassion. We work hard as a team to ensure that symptoms are assessed and addressed, along with any other problems, as soon as possible.The team consists of nurses, doctors, physiotherapists, occupational therapists, social workers, chaplaincy, complementary therapists and catering staff all working together to provide holistic care.

We now have a new nursing structure in place with myself as Senior Sister, and Lisa Tate and Elaine Morley as Junior Sisters.This seems to be working well.We have undergone changes due to staff leaving. Kate Hadfield, a Senior Staff Nurse has taken up a post as a Macmillan nurse at Royal Bolton Hospital and we wish her well.We have welcomed new staff who bring skills and experience we can benefit from.This is also a good opportunity for existing staff to take on new roles and responsibilities and share their knowledge. We hold regular meetings to enable all staff to air their views and discussion can take place. Ideas can be taken forward from these meetings to improve patient care. We have recently had a visit from four nurses from Taiwan which proved to be very interesting and challenging, we all learned a great deal from one another!

There are regular monthly bereavement support sessions held on the inpatient unit which have greatly benefited patients and carers. It is a good opportunity for informal discussion to take place with support from experienced nurses.We have a little thought tree where anyone can leave messages, this has been especially helpful to children who often find it difficult to express their feelings.We also now have a children’s area in the lounge. Staff work closely with Mark Brackley, our Chaplain, to ensure time is given to patient and carer well-being and preferred priority of care is addressed.This is essential to ensure we work with patients and families in fulfilling wishes and needs particularly ensuring that patients are cared for at the end of life in the place of their choice if possible. We are about to commence a system of hourly rounding which will target our most vulnerable patients who cannot easily ask for help.This will consist of regular, documented checks on those patients to ensure that their needs are addressed.This will include pain and symptom assessment, adequate food and drink, comfort, positioning, toileting, support and reassurance. Hopefully, this will help prevent falls, reduce the risk of pressure ulcers and minimise distress.This means that we, as nurses, are anticipating the needs of this particular group of patients to improve their care.

Sister Bridget Harrison Senior Sister Inpatient Unit 17

Hospice at Home Melanie Blain Senior Sister Hospice at Home


s a Senior Sister at Bolton Hospice I have predominantly worked within the Inpatient Unit. In November 2010 the reorganisation of the nursing structure gave me a fantastic opportunity to develop and lead the Hospice at Home service.

The Hospice at Home team comprises myself and two motivated and committed Senior Staff nurses Barbara McCavery and Dawn Raby. In addition Senior Staff Nurses continue to rotate through from the Inpatient Unit for their experience and development within this service. As a team we firmly believe that Hospice at Home is a valuable service. Since Hospice at Home was first introduced 14 years ago, the service has gradually evolved. The most recent and significant initiative is the introduction of a Senior Sister within the team to lead and to facilitate cohesive working. It is therefore possibly my biggest challenge and our task as a team to take this service forward. Our vision is that all patients will receive excellent and seamless end of life care in their own homes, with their families and carers being well supported through this difficult and emotional time in their lives. By raising the profile of the services Hospice at Home can provide to the people of Bolton and health care professionals I am confident we will see the service flourish.


Hospice at Home is a seven day a week service currently operating between the hours of 8.30am and 4.30pm. As a team we would like to review our working hours to enable us to work more flexibly to meet the changing needs of patients, families and carers. Bolton is a large area and we have at the moment the capacity to care for and support up to five patients and their families each day. We would very much like to see an increase in the number of patients we care for as we feel strongly that we do make a difference not only to the care given but to the support patients, families and their carers receive. We would anticipate an increase in our staffing numbers to accommodate an increase in referrals but what an amazing achievement this would be! Referrals are made by health care professionals with a request to share care at the end of life. Very often these patients have already been commenced on the Liverpool Care Pathway following the standards set within the Gold Standards Framework .We would very much like to see referrals being made sooner, to give us the opportunity to build a rapport with patient’s families and carers. Other services that can be provided include transitional care following discharge from the Hospice or Hospital and we can give support at home until a package of care can be established. More recently we have shared observational and support visits with the District Nurses, which have proved to be effective and worked well. Following a holistic assessment of the patient,

Annual Report 2010/2011

family and carers we are able to involve other members of the wider multi-disciplinary team in the plan of care where appropriate. This is truly collaborative working at its best. If you were to ask us what difference does Hospice at Home make our first answer would be supportive care. It is the essence of good palliative care and what makes Hospice at Home such an exceptional service. To have both the knowledge and skills in end of life care and be able to transfer these to enable a person to die with peace and dignity in their preferred place of care is beyond doubt a privilege for us and a service which should be available to all.

Melanie Blain Senior Sister Hospice at Home


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The Palliative Care Therapy Team Jacqui White PCT Team Leader


ur team provides occupational therapy and physiotherapy to patients at the Hospice and to those referred to our service in the community. Therecently highlight ofemployed the Up until we were yearBolton was winning thenow by NHS PCT, we are employed by BoltonTeam NHS Foundation Outstanding Award, Trust and have practising privileges a proud moment for at the Hospice.

the service.


Even though the last 12 months have been unsettling for the team going through the merger of NHS Bolton PCT with Royal Bolton Hospitals NHS Foundation Trust to form Bolton NHS Foundation Trust, which occurred on 1st July 2011, this has not dampened our enthusiasm to continue with service development work, generate new ideas and be positive about the future of the service. The team worked hard to achieve last year’s

Annual Report 2010/2011

objectives, some of the work continues into this year and they strive to provide the best for their patients. The following captures some of the work that has occurred over the last 12 months: Many of our patients suffer from fatigue, breathlessness and/or anxiety and to help deliver a more consistent approach to the treatment of such symptoms we have produced and implemented therapy treatment programmes that can be tailored to suit individual needs. Much of our work involves educating the patient and/or carer about what they can do to help manage their situation and what services/ support is available to enable them to make informed decisions about their future care.

staff; we said a sad farewell to Jen Dunn our Band 6 physiotherapist, who left to further her career, and welcomed Lyndsey Cantillon who has settled in well. The highlight of the year was winning the Outstanding Team Award at the NHS Bolton PCT Provider Celebration Event, a proud moment for the service. If you wish to learn more about the service please do not hesitate to contact me at the Hospice.

Jacqui White PCT Team Leader

The day unit in Bolton Hospice Support Services (BHSS) provides the ideal opportunity for such education, therefore two members of the team – Debra Jones and Rob Hodgkiss – have worked hard with staff from BHSS to produce the patient education programme, presently being rolled out within the service. As well as providing occupational therapy and physiotherapy within the Hospice we have also contributed to Hospice projects such as improving nutritional care for patients and basic lymphoedema management, and continue to contribute to key meetings; quality and audit, management, clinical governance, and health and safety.

The highlight of the year was winning the Outstanding Team Award, a proud moment for the service.

As well as a change in employer and in management last year we also had a change in


Education Siân Russell Hospice Educator


commenced the role of Hospice Educator on 31st January this year.

Prior to this, I have worked as a senior staff nurse at Bolton Hospice for the past nine years, gaining experience across all departments and teams. This post has given me an invaluable opportunity to develop and further my interest in the training and development of others. My initial and ongoing remit is to develop, plan and co-ordinate the educational needs of all staff within the hospice. This huge undertaking has required significant support, thought and time and has, for obvious reasons, started small with a view to growing and developing with time. I have found the past few months to be both challenging and extremely rewarding. The opportunity to take ownership of this new and exciting role has been a wonderful opportunity for me both personally and professionally. I feel I have achieved a great deal within this period and have invested much time, thought and enthusiasm into laying the foundations for a much more diverse and strategic view of education within the hospice in the future. Bolton Hospice has committed to regular education for its staff for many years and this post has allowed me to build on this success. We hold weekly education sessions, recently being available to district nursing staff also, which continue to be a success.


These important and time protected sessions are essential in addressing current issues and looking at the best evidence based practice for our patients. I have launched a leadership and management programme for Hospice staff and am responsible for ensuring all staff are up to date with all mandatory training. I have recently facilitated two study days for all clinical staff which addressed two very current and important subjects – advance care planning and working with children. The days were really successful in addressing these difficult topics and raising staff confidence and knowledge. I now intend to build on the success of this by organising similar education days for all our non-clinical staff, concentrating on building confidence in communication skills. I am really proud of all the work, planning and ideas that go into making these days so beneficial and hope to ensure they are an annual event for all our staff. This post has given me an invaluable opportunity to begin to look at education across the whole organisation. There is much that can be achieved in the future when considering how education can be developed here at Bolton Hospice and I am very proud to be a part of that.

Siân Russell Hospice Educator Annual Report 2010/2011

Social Work Teresa Morris Head Of Service


his year has been an eventful one for the specialist palliative care social work service which has been working through various major developments in social care and also through the implementation of the new Social Care Framework, ‘Supporting people to Live and Die well’ which was launched in July 2010.

This framework recognises the central role social care has to play in palliative care and provides a structure to enable social care to be involved in end of life initiatives as well as ensuring that end of life care is embedded in developments in social care.Work has therefore been in progress within social care in Bolton to ensure the key messages in the framework are incorporated into new developments around personalisation and reablement. Partnership working is a major factor in this work particularly in areas such as education and training. It is very encouraging however that Bolton are already committed to partnership working in end of life care as the specialist social work service based at Bolton Hospice has been in existence since 1998 and is well established as an integral element of the palliative care team. The wider changes in social care have been considerable due to the implementation of Self Directed Support.This has led to a complete restructure of Care management services and the specialist palliative care social workers will have a change to their management arrangements.These changes will have no impact on the work they do with Hospice inpatients but it will mean they are working with people with palliative care needs who

may not be known to the Hospice itself.They will therefore accept referrals on people who may be in hospitals such as The Christie or alternatively may be living in their own home but not known to the palliative care team.The specialist palliative care social work service will be targeted at the most vulnerable people who will benefit most from their expertise and their links with other specialist workers in palliative care. Other end of life work will be shared across the service dependent on the needs of the individual and the response required. The specialist palliative care social workers will continue to have access to a menu of resources within social care which includes reablement and a personal budget if needed.They will continue to provide extensive support to patients and their carers and will also share their expertise with other workers by acting as an educative and consultative resource around end of life care. Improvements to facilitate the delivery of quality end of life care within Bolton Adult Services include; • Improving the accessibility of the specialist palliative care social workers to the most vulnerable people with palliative care needs and their carers. • Developing End of Life Care Champions across the service • Developing champions in NHS Fully Funded Continuing Health Care • Developing partnerships for education and training. All these improvements should ensure the right level of expertise is shared across the service to support and educate staff working with people at the end of their life which should result in improvements in the quality of service delivered to people at the end of their life.

Teresa Morris Head Of Service 25

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Chaplaincy & The Bereavement Service Mark Brackley Chaplain and Bereavement Support Co-ordinator Chaplaincy It is often stated that time flies when you are having fun, I can’t believe another year has already gone by, so I must be enjoying my job as Chaplain and Bereavement Support Coordinator at Bolton Hospice. Recently I had a compliment paid to me by a regular user of BHSS; he told another staff member that he had known me for two years and I had never once mentioned God to him and yet he had told me things he had not told anyone. This man is a regular at one of the services we provide. The Chaplaincy is there for the patients, their family, their friends, the staff and the volunteers. Those who access Chaplaincy set the agenda, no one will be told what to do or think. There is a Prayer and Refection Room in the centre of the Hospice where worship, meditation and/or prayer regularly take place. Within this space the Memorial Books are kept, containing the names of those who have died, there are also scriptures, pictures and artefacts from the world’s major faiths. There is a space with teddy bears and bubbles for children who may like to talk to the bears or blow a few bubbles. There is the Tree of Life where anyone can choose a label and write on it a name, a thought, a prayer or a memory and hang it on the tree. Christian Bibles, New Testaments and Hymn Books may be borrowed from this room.


I give holding crosses to patients who are anxious, lonely or just like something to hold. These have been donated by individuals and churches in the area which has been a lovely gift, and well used. We are looking at the other faiths present in the area and in the Hospice to see if there is an equivalent item from their traditions that might bring comfort. The pastoral team is growing and we have had students on placement from the Inter Faith Chaplaincy Course run from Bolton University, together with visits from other chaplains, the diocesan healing advisors, local clergy and Bishops. Voluntary Chaplains from the World’s major faiths are willing to come in to see patients who share their faith and the patients are encouraged to invite their own faith leader to visit. Chaplaincy Services are offered throughout the Hospice to inpatients, day therapy patients, drop-in patients, to those being cared for by Hospice at Home and to outpatients. We hold three services a year at St Andrew and St George Church to remember those who have died in recent months and the families and friends are invited to attend. We also have two Light Up A Life Services at Christmas Time, one at the Hospice the other at St Peter’s Bolton, during which lights are lit in the trees to remember loved ones who have died. The Bishop of Bolton joined us again for the Carol Service in Bolton Hospice Support Services on Christmas Eve and will be with us again this coming year.

Annual Report 2010/2011

The Bereavement Service The service is for anyone who has been affected by the death of a loved one who has had a link with Bolton Hospice. We accept that bereavement is a natural process that everybody has to go through when someone they have a connection with dies. Because it is a natural process it does not mean that it will be easy. It is not and we recognise this and offer support for those who find their bereavement hard. Our mission statement is: “We allow the bereaved the space, time and opportunity to tell their story as many times as they need, without judgement, without advice and without pre-conceptions.We give the bereaved the opportunity to be heard and to give a voice to their grief.”

The service is staffed by experienced volunteers and support is offered to suit the different needs of the bereaved. We offer the supporters regular training and a forum to raise issues of interest to them. The Bereavement Link Nurses and the Spirituality Link Nurses are very involved in supporting patients and families. They offer regular open sessions where books, forms, and art can be looked at and there is an opportunity to discuss issues, interests and worries further, if that is what those attending would like. We have offered training to clinical staff on working with the young. The Bereavement Link nurses have worked very hard this year at offering support and they have produced a ‘Grief Relief Kit’ to be used with children and young people.


‘The Grief Relief Kit’ contains: Tissues: For when you need a good cry (and it is alright to cry). Chocolate: For when you feel you need a treat. Thyme Seeds: To grow – remember seeds need time to grow as you need time to grieve. Notebook: To jot down your thoughts and worries and maybe share when you feel able. Snuggle Dog Key Ring: To tell thoughts to and store things in. Stone Bag: To help you share your feeling. Rough Stone: For the rough times you have been through. Smooth Stone: For the comfortable times. Rose Quartz Gem: To remember the good times and the love that you shared. A Hug Card: Hugs can be good and it is alright to ask for one from a trusted adult. When a person makes contact with the Hospice and asks for some support they are invited into a session where they can contribute and discuss what might be helpful for them. It may mean spending time together, one-to-one with a member of staff or trained volunteer, on the telephone or at the Hospice.

have lost close family members, we understand that losing a friend, or relative other than parent or spouse can be devastating. There are no stipulations or expectations. Those attending do not have to have a religious affiliation and nothing will be expected of them, except to be themselves. There is no charge for the services offered. There is no right or wrong way to grieve, nor is there a time limit that goes with it. Each person deals with their grief in their own way. Here at the Hospice we try to see the person behind the pain. We will always reach out to support them on their journey through grief.

We offer one-to-one support, a group that meets once a month for an hour and a half in the afternoon, and drop-in sessions that are open to anyone accessing the service. The dropin is held in Bolton Hospice Support Services from 6pm – 7.30pm on the second and fourth Monday of every month. The drop-in offers opportunities to sit and watch TV, to do memory work, to talk with others about related topics and to know people are there for the bereaved.

Both services have not remained static and are growing and developing to meets the needs of the people we are there to support. We can only do this with the trust and co-operation of the people we meet so we listen, and are enriched by the contacts we make and the people we meet.

Once again we stress that the Bereavement Support service is open for all those who have a connection with a former patient of the Hospice. It is not just a service for those who

Chaplain and Bereavement


Mark Brackley

Support Coordinator

Annual Report 2010/2011

Catering and Housekeeping Sue Gooden Catering & Housekeeping Manager


utritional care has taken some big steps forward over the past 12 months. This has been a multi-disciplinary approach including the Occupational Therapists, Senior Nursing Staff, the Catering Team, the Clinical Support Nurses and the Volunteer Co-ordinator.

The menu choice available for inpatients and outpatients has been changed to ensure we are meeting our patients’ needs. One such change is for our Wednesday outpatients where we now offer a buffet lunch instead of a hot three course meal. We have also introduced protected meal times. This is to ensure our patients are ready for their meal; we welcome close family members to dine with them or use the dining rooms available. We have also introduced an excellent system for recording nutritional intake that is kept in the Care Plans. There are verbal and written handovers throughout the teams and we also carry out annual surveys to further hear the views of our patients and put forward recommendations for change, in line with the views expressed. The Housekeeping team continue to strive to keep the Hospice clean and tidy in all areas and have strict controls in place in patient areas to ensure we comply with all aspects of Infection Control, which keeps the environment safe for everyone.

There has been a change in the structure over the last year which is working very well for the team as we have more flexibility thus allowing us to take on extra tasks. We now clean one of our charity shops once a month and we are able to be more responsive to the needs of the hospice through working flexibly. The Housekeeping Manager sits on the Infection Control team alongside the Nursing Team and Volunteer Co-ordinator.

Sue Gooden Catering and Housekeeping Manager

We have introduced an excellent system for recording nutritional intake. 31

Next year is the 20th anniversary of Bolton Hospice and a number of our volunteers will be celebrating twenty years of volunteering with us.

Annual Report 2010/2011

Voluntary Services Alison Brown Volunteer Co-ordinator/ Health & Safety Co-ordinator


uring 2010/2011 our volunteer team has continued to provide support to a wide range of Hospice services, proving yet again how vital a part of the Hospice they are.

One theme this year for our volunteers in patient care roles has been nutritional care for patients. Our ward volunteers are supported by meal time co-ordinators from the nursing team and have all had an opportunity to attend training highlighting how meal times can be enhanced and what support can be offered to patients who might benefit from additional help. The gardens continue to be a source of pleasure to patients and families. These are maintained by a small team of dedicated volunteer gardeners who work hard to develop planting schemes that will provide colour and shape that can be viewed from patients’ rooms. A new herb bed provides herbs for use by the catering team and also provides a sensory experience that can be enjoyed by patients. We recently entered the Britain in Bloom competition and as I write this we are awaiting the results. Fresh flowers within the Hospice also provide enjoyment and our ‘flower ladies‘ provide arrangements of fresh blooms three times a week for patients rooms, lounges and reception areas. There are plenty of opportunities for volunteers to help with fundraising – whether

in our six charity shops, promoting the Hospice lottery, or helping at events such as the Midnight Memories Walk, the Christmas fair or bag packing sessions at local supermarkets. Our fundraising team is keen to hear from anyone who might be interested in helping us on a regular or occasional basis at fundraising events in and around Bolton. Next year is the 20th anniversary of Bolton Hospice and a number of our volunteers will be celebrating twenty years of volunteering with us. We award certificates annually to celebrate 5, 10 and 15 years voluntary service for the Hospice and will now be adding a new 20 year certificate. We are also awarding thank you certificates to our student volunteers who have completed one and two years of volunteering, usually whilst studying for GCSEs and A-levels – quite an achievement, and one we are very appreciative of. So with our 20th anniversary just around the corner, a big thank you to all our volunteers who freely give their time and ability. We hope that you will continue to do so for the next twenty years.

Alison Brown Volunteer Co-ordinator/ Health & Safety Co-ordinator 33

Fundraising Alice Atkinson Fundraising Manager


joined the Hospice in January 2011 and was immediately impressed and heartened by the level of support that local people offer the Hospice, not just through their own fundraising and donations, but through the giving of their time as volunteers.

and Morecambe Bay Walk – also continue to be well-supported.

2010/2011 has certainly been a challenging year for the fundraising department, with external influences such as the continuing recession and competition from new local charities and internal factors such as staff changes and absence having an effect on the department’s activities.

We have recently welcomed a new member of staff to the team – Aanika Dhillon has taken up the position of Community Fundraiser and will lead on generating income from individuals, groups and companies. Aanika will also work closely with volunteers across the borough to grow support for the Hospice within the local community.

Having said that, the income generated by the fundraising department - which includes shops, lottery, community fundraising and events – in 2010/2011 was in excess of £2.3 million; a marked achievement in such a challenging environment. We were very fortunate to receive a grant for £180,000 from the Department of Health for a full refurbishment of our Day Therapy Unit, now known as Bolton Hospice Support Services. The Midnight Memories Walk continues to be one of the team’s biggest successes, generating income in excess of £196,000 in 2010 – our biggest fundraising event by a considerable margin. Perennial favourites in our events calendar – the Ladies ‘Pink’ Lunch, Golf Day, Summer Fair


Our challenge events have proved very popular this year, including our first ever Santa Dash and an overseas challenge which saw 20 supporters undertake a 10 day trek through the mountains of Nepal raising an incredible £33,000!

Our fundraising growth areas include increasing income from trusts, companies and legacies, where we will be focussing more of our efforts this coming year. We have lots of exciting plans for our 20th anniversary fundraising and will be working closely with the Bolton News in a public appeal to generate income to extend our Hospice at Home service and raise awareness of the care that we can provide for local people who choose to spend their final days at home. We have recently re-designed our website to provide greater functionality and improve usability and we are soon to launch our new supporter newsletter, so look out for it landing on your doorsteps in March 2012!

Annual Report 2010/2011

Our constant challenge is to find new and engaging fundraising events and activities that will capture the public’s imagination and ensure that they continue to enjoy supporting us – not an easy task but one the team approach with enthusiasm and creativity. I would like to take this opportunity to thank all the Hospice staff, volunteers and supporters for giving me such a warm welcome to Bolton Hospice. Finally, to all those who support us in so many ways, thank you for continuing to do so. We simply wouldn’t be able to provide our services without you helping us to achieve our very challenging fundraising targets.

Alice Atkinson Fundraising Manager

Our constant challenge is to find new and engaging fundraising events and activities that will capture the public’s imagination.


Bolton Hospice Shops Cathy Wright Shops Manager


olton Hospice shops are continuing to go from strength to strength and in 2010/2011 saw an increase in profit on the previous year.This publication always gives me the opportunity to thank the people of Bolton who make this mission possible for us.

First a special thank you to our shop volunteers; considering we only trade in second hand goods and the average price of our goods is ÂŁ2.50, there is an enormous amount of effort that goes into a well-stocked productive shop floor. Our volunteers work tirelessly to continually be the best and provide a nice environment for our customers. Which leads me to thank our customers, over the years I have got to know a lot of our Hospice shop customers and I am always grateful for the feedback they give us. Their input has been invaluable to the success of the shops and led them to spend more!

A massive thank you to everyone who has donated to Bolton Hospice shops – it is a continuous task to replenish our stock and we are always searching for new initiatives to keep donations flowing at a steady pace! All the hard work in 2010/2011 paid off and the shops secured over a third of a million pounds in profits for Hospice funds - a tremendous achievement and a big thank you to all involved. This year has seen changes within our shops team; Sam Ionn, who I am sure many of you will know, reduced his hours to work over three days, which created a vacancy for another caretaker. Duncan Podmore, a volunteer at our Westhoughton shop since 2009, joined the team in January and works over four days. Duncan has brought new ideas and initiatives to the Hospice shops and he is extremely keen to promote house collections. Sam and Duncan make a great team and they are always happy to collect your unwanted goods.

Last, but by no means least, the Bolton public who continue to donate goods to our shops. Where would we be without these donations?!

Denise Cockerill, Shops Assistant Manager has been successful in the implementation of Gift Aid at our shop in Astley Bridge, with the volunteers at the shop embracing the scheme,

Useful Contact Numbers

Bolton Hospice Shops:

Main Hospice Reception Tel: (01204) 663066 Fax: (01204) 663060

Chorley Old Road (01204) 496660 Astley Bridge (01204) 304991 Little Lever (01204) 861074 Tonge Moor Road (01204) 521610 Horwich (01204) 699299 Westhoughton (01942) 810090

Fundraising Department Tel: (01204) 663055 Fax: (01204) 663050 Lottery Department Tel: (01204) 663077 Fax: (01204) 663050

shop may re-ignite Saturday afternoon shopping in Horwich! By the end of summer 2011 we are also hoping to extend the opening times at our Westhoughton shop to Wednesday and Saturday afternoons – so if you are interested in becoming a shop volunteer, please do not hesitate to contact me. Finally I would just like to add that I am very proud to be part of the Hospice shop team and I am constantly in awe of the people of Bolton and what they do to help us achieve our goals. This of course stems from the excellent work of the Hospice team, which I find heart-warming and very rewarding to be part of. Thank you and here’s to another good year! turning it into a successful income generator. We are confident that it will raise an extra £3,000 over the coming year so next time you’re in the Astley Bridge shop please ask to sign up to Gift Aid and we can claim an extra 25p in £1 on your donations that sell. The Astley Bridge shop also celebrated 20 years of trading this year; we held a bit of a ‘Do’ for our volunteers here at the Hospice and celebrated with a lovely buffet and birthday cake. Amongst those in attendance were three existing volunteers from 20 years ago who still work at the shop – it was a splendid afternoon, enjoyed by all! In April of this year we decided to open our Horwich shop on a Saturday afternoon. We were a little unsure at first as to whether it would be viable, especially with the shopping centre at Middlebrook so close, though we needn’t have worried - our customers are flocking in and trading is good! Who knows, our

Find your nearest Bolton Hospice charity shop, arrange a house collection or find out more about becoming a shop volunteer by visiting our website at or calling 01204 663063.

Cathy Wright Shops Manager

I am constantly in awe of the people of Bolton and what they do to help us achieve our goals. 37

Lottery Report Steve Holt Lottery Development Manager


ur Lottery continues to create new milestones for income generation to the Hospice.The

past 12 months have not only seen us for the 1st time ever donate over ÂŁ200,000 profit back to the Hospice during a calendar year, but also pass the ÂŁ3 million figure generated by our Lottery since its inception in 2001, whilst also paying out nearly ÂŁ750,000 plus a car in prizes to nearly 15,000 local people over the same period. A magnificent achievement by everyone concerned and one which we aim to build on for many years to come.

To help us to continue this upward trend and to look forward, we have organised significant development changes in the role that each member of the staff has within the team. We are now able to take payments via Direct Debit and Debit card over the telephone.This has had a knock on effect with our cash payers and we have streamlined how we collect from our agents.This also allows Louise, our Collector, to spend a little more time within the office contacting members informing them of our new payment schemes. We decided to promote our wedding favours even more this year and Carol, our Administration Assistant, has taken on this role attending more wedding fairs and developing extra gifts to take with her.This has seen a significant rise in interest and income, including a couple taking them all the way to Las Vegas for their wedding!

...we are confident that the lottery will continue to grow both its membership and its profitability.


Annual Report 2010/2011

Early in 2011 we decided to review the role of Val, our Canvasser, who had the challenging task of constantly recruiting new members whilst also looking at how we could re-organise our direct selling procedures within supermarkets, garden centres and other outlets.This was originally a job for Kerry, our Administrator, and myself to organise together with arranging volunteers to assist. After much thought, it was decided that Val’s role would be developed into Promotions Assistant. Her responsibilities now consist of generating sales through single tickets or scratch cards, whilst still recruiting for new members. She now co-ordinates direct selling venues and dates and arranges our team of wonderful volunteers to man these. Early signs are very encouraging with this new venture. This last but by no means least brings us to our Administrator Kerry, who has been with us for over 8 years having started as a volunteer in the fundraising department. It has been a pleasure seeing her take on new responsibilities which has allowed me to develop other sources of income generation within the Lottery department. Kerry has continued to develop the payment by Direct Debit system, whilst keeping the Lottery office ticking over day to day and taking on responsibility for the Lottery being marketed far and wide via social media networks such as Facebook & Twitter.

Scratch cards, bumper draws, play as you earn and our partnership scheme are just some of the developments we now have in place to increase our Lottery revenue in the future.The level of membership continues to grow, albeit very slowly, in spite of the economic downturn and thanks to these new changes in staff roles together with the new income streams that have been put in place, we are confident that our Hospice Lottery will continue to grow both its membership and its profitability. Special thanks to everyone who has helped over the past 12 months especially our wonderful team of Lottery volunteers who were extremely resilient during our Summer Sunshine Draw campaign, which again raised over £20,000. I’d also like to take this opportunity to thank Bolton Kia who not only continue to loan us a vehicle free of charge to help us promote our Lottery throughout the Bolton area, but Alex & Peter, together with their staff also join in with supporting us at various fundraising events. Finally, thanks again to all our members, agents, companies, partnerships and volunteers, for their continued support to the Hospice Lottery throughout 2010/2011.


Notes of the Summary Financial Statements 1. A grant of £180,241 was received from the Department of Health to refurbish the Support Services Building (formerly Day Therapy Unit) which is ten years old. This has allowed us to improve the facilities available to both patients and staff. 2. The contribution from Legacies was again substantial but it is not a source of income that can be relied upon. 3. The Trustees continued to take measures to increase the level of investment income by reallocating cash from bank deposits to longer term investments which offer higher rates of return. 4. The Trustees have identified a number of areas for review which may require substantial use of the reserves if they are found to require further development. These include clinical software, computer hardware replacement, computer management, training in nursing homes, hospice at home service, accommodation and parking and provision of medical services. This review was ongoing during 2010/11 and significant progress has been made in identifying the clinical software required to meet the future needs of the Hospice. 5. For the Hospice to be managed efficiently and to ensure the provision of uninterrupted services, the Trustees consider it essential to maintain funds available for that purpose. At the year end the General Reserve stood at £6.5m.


6. The Summary Financial Statements are not the statutory accounts but a summary of information relating to both the Statement of Financial Activities or the Balance Sheet. The full annual accounts have been audited by Moore & Smalley LLP and received an unqualified report. 7. These summarised accounts may not contain sufficient information to allow for a full understanding of the financial affairs of the charity. For further information, the full annual accounts, the Auditors’ report on those accounts and the Trustees’ annual report should be consulted. Copies of the full annual accounts, Auditors and Trustees reports can be obtained from Bolton Hospice. 8. Annual accounts were approved by the Trustees on the 10th August 2011. 9. Annual report and accounts for 31 March 2011 have been submitted to the Charity Commission and to the Registrar of Companies.

By order of the Trustees GrahamYardley Chairman Date: 05.07.2011

Annual Report 2010/2011

Summary Financial Statements Total costs for Bolton Hospice


The Bolton Primary Care Trust gave us


Leaving us to find


We received income from: Fundraising events, donations and appeals 572,891 Shops 328,435 Lottery 200,922 Legacies Unrestricted 449,573 Investment Income 171,492 Total income received


Which gave a net surplus of


Grant from the Department of Health


Gain in the value of our investments


Leaving an increase in our funds


The total funds of the Hospice at the 31.03.11


They were represented by: Funds restricted in their use Designated funds Information Technology Designated funds Investment Unrealised Surplus Buildings and equipment owned by the Hospice General reserve

162,462 39,425 608,737 2,685,446 6,521,220


Income By Source Legacies (17%)

Investment Income (6%)

Lottery (8%)

Shops (12%) Primary Care Trust (36%)

Fundraising (21%)


Notes of the Summary Financial Statements Auditor’s Statement to the Trustees of Bolton Hospice (Limited by Guarantee) We have examined the summary financial statements which comprise the summary of key figures and related notes 1 to 9. This report is made solely to the charitable company’s members, as a body, in accordance with the Accounting and Reporting by charities, a Statement of Recommended Practice 2005. Our audit work has been undertaken so that we might state to the company’s members those matters we are required to state to them in an auditor’s report and for no other purpose. To the fullest extent permitted by law, we do not accept or assume responsibility to anyone other than the charitable company and the charitable company’s members as a body, for our audit work, for this report, or for the opinions we have formed.

Respective Responsibilities of Trustees and Auditors The Trustees are responsible for preparing the summary financial statements in accordance with applicable United Kingdom Law and the recommendations of the SORP Accounting and Reporting by charities: a Statement of Recommended Practice. Our responsibility is to report to you our opinion on the consistency of the summary financial statements with the full financial statements and Trustees’ Annual Report. We also read the other information contained in the summary annual report and consider the implications for our report if we become aware of any apparent misstatements or material inconsistencies with the summary financial statements.


John Harrison Corporate Services Manager Basis of Opinion We conducted our work in accordance with Bulletin 2008/3 issued by the Auditing Practices Board.

Opinion In our opinion, the summary financial statements are consistent with the full financial statements and the Trustees’ Annual Report of Bolton Hospice (Limited with Guarantee) for the year ended 31st March 2011

Moore & Smalley LLP Statutory Auditor Winckley House Preston, Lancashire Date: 05.07.2011

Annual Report 2009/2010 2010/2011



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Annual Report 2010/2011

Bolton Hospice Annual Report 2010-2011  

Annual Report 2010 - 2011 for Bolton Hospice

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