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Nightingale House Hospice Hospis Tŷ’r Eos

Annual Report 2012

Nightingale House Hospis Tŷ’r E

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Mission Statement To provide a specialist palliative care service for patients with specific life-limiting illness living within the catchment area of North East Wales and the border areas and to support their families in a caring environment. This will be undertaken by a specialist trained multi-disciplinary team who will provide symptom control, assessment, terminal care, and on going emotional support for relatives and carers, bereavement support, education and information.

Directors and Trustees Committee Members Mr M Edwards (President), Mrs E Griffiths (Chair), Dr N Braid (Vice-Chair), Mrs P Valentine (Company Secretary), Mr M H Phillips, Mrs A Wood, Mr A Morse, Mrs J Lowe, Mrs E Walker, Dr J Duguid, Mr N Davies, Mr C Burgoyne, Dr H Paterson (appointed June 2012), Mrs J Hinchcliffe (resigned February 2012). Acknowledgements and thanks to: Gareth Brooks, Icon Imagery and Posib. Wrexham Hospice and Cancer Support Centre Foundation Registered Charity Number 1035600 Company Number 02906838 (Registered in England & Wales).

Nightingale House Hospice Chester Road Wrexham LL11 2SJ

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Tel: 01978 316 800

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Contents Chair of the Board of Trustees


Chief Executive


Director of Nursing


Associate Medical Director


Director of Income Generation


Volunteer Liaison Manager


Finance Manager


Financial Reports


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Eluned Griffiths

Chair of the Board of Trustees Through the dedication, hard work and support of our staff and volunteers we continue to provide first class palliative care to those patients and their families who need it. During 2012, the economic recession continued and this has resulted in another challenging year for the Hospice. Even though we endeavour to control our running costs, these continue to rise with inflation whilst our statutory funding continues to fall in real terms. However, I am delighted to report that fundraising the income needed to maintain the Hospice’s high standard of specialist palliative care was successfully achieved. Through the dedication, hard work and support of our staff and volunteers we continue to provide first class palliative care to those patients and their families who need it. It is also important for the benefit of both patients and staff that Nightingale House is at the forefront of palliative care development.


This has been achieved by developing high levels of staff education and training and participation in relevant research projects. Nightingale House Hospice has managed to achieve its aims during 2012 due to the leadership and expertise of the management team(s) and dedication of all staff ensuring that departmental budgets were adhered to without compromising standards. Alongside this, the hard work and innovation of the income generation team resulted in an increase in the retail, recycling, third party events and lottery incomes, which more than compensated for the understandable recession linked decrease in corporate and ticketed events income.

Chair of the Board of Trustees Nightingale House Hospice

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Our volunteers, a group of people of all ages and skills, supported the Hospice by working with our patients, in the shops, the fundraising office and with every type of event from bag packing, street collection, lottery and many more too numerous to mention. The Welsh Government proposals for the delivery of end of life care plus the reorganisation within BCUHB will bring new challenges in the coming years. We, as a Board of Trustees, are not complacent and are already implementing a board development programme to further our knowledge and skills, as well as beginning strategic planning to ensure that we are ready to adapt to the changing circumstances we will face in the near future. At Nightingale House Hospice we are committed to continually improving the experience of patients with life threatening illnesses who come under our care and this will only be possible if we ensure there is good leadership and clear thinking in our planning for the future. On behalf of myself and my fellow trustees, I thank everyone involved in ensuring the Hospice achieved its income target and also our skilled and dedicated staff for continuing to deliver the high standard of care our community deserves and has come to expect.

‘ Our patients said . . .

"Compassionate, understanding staff who helped us through this situation"

August 2012

My second year as Chair has been made easier by the support, hard work and professionalism of my fellow trustees, staff, volunteers and supporters. My heartfelt thanks to you all.

Gave so much with genuine care and kindness

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Patient May 2011

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John Savage Chief Executive

I can report that we have had another successful year in terms of delivery of high quality care to patients, carers and families . . . When I sat down to write my report it was hard to believe that 12 months had come and gone in a flash and I now needed to give some thought to what was I going to say about 2012. However, that came very easily and I can report that we have had another successful year in terms of delivery of high quality care to patients, carers and families and all of it free at the point of delivery. This success has been achieved against continued financial uncertainty in the economy at both local and national level. This has put severe strain on our ability to raise funds from our traditional fundraising related activities. Our medium term planning of expanding fundraising activities like the lottery and shops has paid off and we have seen a significant increase in funding coming from these areas.

Success, for me, is not just about the level and quality of patient services delivered by the clinical team, but is also about the support from every department within the organisation including administration, catering, housekeeping facilities, shops and income generation in ensuring that those patient goals are met. Our success truly is a team effort and contributions have been made by all staff in ensuring that we kept within our budgeted expenditure levels in the delivery of those services during a very difficult financial period. Alongside the staff, we have our loyal army of volunteers who are an integral part of our success, working in all spheres of Hospice activities and without whom we could not deliver the services we do — a big thank you to them all.

he care during my stay has een exceptional in every way ith lots of TLC (tender loving are) compassion and humour

Patient, June 2011


Chief Executive Nightingale House Hospice

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However, none of this success would be possible without the support of the local community; in 2012 it cost ÂŁ2.49m to maintain services at the Hospice and only 23% of this came from statutory sources. The remainder came from the community we serve including individuals, groups and corporate supporters who all ensured we were able to deliver the services that are vital for the community we serve and we are eternally grateful for that continued support. It is also vital that we continue with initiatives to ensure that we can minimise costs of running the facilities and I am pleased to report that the photo voltaic solar panel project reported last year and installed in March has been a big success and has delivered over ÂŁ18,000 worth of savings in year one. We are continuing to look at a range of projects to ensure we can minimise costs and therefore ensure we can maximise expenditure on patient services. The next twelve months will be just as difficult, in terms of funding, as the last twelve months and therefore I urge all our supporters to help find ways to maximise their support to ensure we can continue with the services we offer.

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‘ Our patients said . . .

"The approach is totally holistic which is excellent."

May 2012

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Tracy Livingstone Director of Nursing

. . . our work continues through the dedication of our staff and volunteers and through your support of our work. Each year the annual report presents us with the challenge of summarising our activities within the nursing, physiotherapy, occupational therapy, social work and chaplaincy team along with the teams who support us in terms of housekeeping, catering and administrative support. This is always a challenge as there are so many things within a 12 month period that would be of value to share. Our services across all departments continue to focus on three main principles — high standards of care delivered to patients and families, exploring an evidence base for development of practice through involvement in appropriate research and ensuring quality delivery through a programme of planned audit and service evaluation.

Our in-patient unit nursing team continues to use this process of audit and service evaluation to improve and where necessary change practice, based on appropriate evidence. Ensuring change is implemented safely through the promotion of education, mentoring and coaching of our team. The team have also taken the lead on a number of regional audits when hospices across North Wales compare our practice, not only against National Standards, but against each other in a process of peer review of practice. At the end of the year our in-patient team were part of a national project, comparing patient dependency and nursing workload between 16 hospices and palliative care units. The results will be available in 2013 and will

he care during my stay has een exceptional in every way ith lots of TLC (tender loving are) compassion and humour

Patient, June 2011


Director of Nursing Nightingale House Hospice

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provide further information to inform our in-patient service delivery going forward. Our physiotherapists and occupational therapist have been involved in the national drive to improve rehabilitation services to cancer patients from diagnosis to end of life and addressing distressing symptoms that people may experience following treatments for cancer or the effects of the disease. Symptoms such as breathlessness, fatigue, anxiety, poor mobility and pain etc. can become extremely debilitating and affect quality of life. The emphasis of this work is on self help. This self help approach is also facilitated within our chaplaincy team, who provide education and support to patients and carers to develop their own resilience to cope with their diagnosis and condition. The chaplain has also undertaken a piece of academic research during the year to identify the most appropriate spiritual care assessment tool for use in a hospice environment Supporting resilience and emotional well-being in our patients crosses the professional boundaries of all team members; our social work team continue to support patients and families planning discharge home and also offer practical advice and support

‘ Our patients said . . .

"They gave me confidence and reassurance and were always willing to talk and help in my low moments. I cannot praise them too highly."

June 2012

while liaising with other external agencies. This involves developing therapeutic relationships with patients and families and for this reason we have taken the step of allocating specific ‘protected time’ for the social workers within both the ward environment and day unit.

Day unit and out-patients have had a year of consolidating the development of the Monday Programme reported during 2012, and continue to explore the delivery of outreach services within the catchment area. The year has been a year of challenges and achievements across all departments and teams but our work continues through the dedication of our staff and volunteers and through your support of our work. Thank you once again for your continued support and commitment to our services.

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Dr Nigel Martin

Associate Medical Director The team have looked after 222 admissions to the inpatient unit over the year, and 232 attendances to our Palliative Medical Outpatient Clinics. The year 2012 to 2013 has provided many new clinical challenges to the medical team. The team have looked after 222 admissions to the inpatient unit over the year, and 232 attendances to our palliative medical outpatient clinics. Patients are admitted to the inpatient unit for a number of reasons. Approximately 40% of people are admitted for symptom control and about 60% are admitted for terminal care in the last days or weeks of life. Of these people, 64% are admitted directly from their homes and 17% from the Wrexham Maelor Hospital. The remaining 19% come from community hospitals or cancer treatment centres. A growing trend is the gradual increase in nonmalignant conditions requiring admission to

the inpatient unit. These have been 7% of our admissions over the year, and are predominantly made up of neurodegenerative conditions, heart failure and pulmonary conditions. The in-patient unit is only one part of our medical responsibilities. As well as the above, we provide medical support and review to our Hospice day unit, which has had 1,108 attendances over the year and have provided support to the physiotherapy department and the bereavement team. Our medical team is currently made up of myself, as Associate Medical Director and our Speciality Doctor who works nine sessions a week. However, we have also developed very close links with the palliative medical team at Wrexham Maelor Hospital. The team who work with us on honorary

he care during my stay has een exceptional in every way ith lots of TLC (tender loving are) compassion and humour

Patient, June 2011


Associate Medical Director Nightingale House Hospice

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contracts, are led by Professor Matthew Makin who is also our visiting consultant in palliative medicine and part of our on-call team. The remainder of the team consists of a Specialist Registrar who is training to be a consultant and a Clinical Lecturer in palliative medicine. Additionally, we often have a Foundation Year One House Officer for four month attachments; these doctors are in their first year after qualifying and are still very much in a training role. The links we have forged with Betsi Cadwaladr University Health Board, both from the palliative medical and oncology points of view, have been, I feel, one of the great triumphs for the Hospice. Not only in providing experience and training to junior doctors, but in doing so ensuring the team as a whole is kept up to date and does not become medically isolated from mainstream medicine. One of the major advances has been the initiation of a ‘job swap’ between our speciality doctor and the Oncology Speciality Doctor who supports the Shooting Star Unit at the Wrexham Maelor Hospital. This swap occurs on one day each week. Not only has this cemented the links between the units, but has provided further experience to both doctors of each other’s speciality, which in turn benefits

‘ Our patients said . . .

"No room for improvement"

September 2012

our patients. This also has had the added and valuable benefit of providing a seamless service for our patients as they move between oncology and palliative medicine.

As I mentioned in the first paragraph, palliative medicine and hospice care is evolving. Not only are many people who suffer from cancer living longer with new therapies, often making cancer a more chronic condition, but there is also the acceptance that we can offer many other patients with nonmalignant conditions help, support and symptom management. To this end, it is becoming essential that we continue to foster close links with other medical specialities so that we may share in the patents’ care, and also to ensure we are medically abreast of current practice.

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Caroline Siddall

Director of Income Generation . . . the Ladies’ Midnight Walk is still our most successful event, generating an income in excess of £80,000 for 2012. Each year, as I write my annual report, I always reflect on the support we have had throughout the year and the success of our fundraising activities. Even during what has been a very difficult few years economically, our local community have continually supported us to ensure we can offer palliative care free of charge to those who need it, and we are grateful for that ongoing support. In total, our general fundraising including income from events organised by the hospice, the local community and general donations totalled approximately £1m of the £2.5m needed to run the Hospice for the year. This includes £25,000 raised by our regional Support Groups, many of whom have supported us since the founding of the Hospice, and includes money raised by our newest

support group Ffrindiau’r Hospis, Rhosddu, who formed during 2012. Although year on year the number of walkers is dwindling, the Ladies’ Midnight Walk is still our most successful event, generating an income in excess of £80,000 for 2012. The introduction of the 5p carrier bag levy in Wales proved beneficial for Nightingale House as both ASDA and Sainsbury’s very generously donated their contributions to us raising over £10,000 during the year. We are fortunate to receive excellent support from local businesses and during 2012 we had a donation from Redrow Homes to support our bed replacement programme. Local businesses such as EADS and Barclays organised fundraising events on our behalf to raise money for the Hospice.

he care during my stay has een exceptional in every way ith lots of TLC (tender loving are) compassion and humour

Patient, June 2011

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Director of Income Generation Nightingale House Hospice

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Not all of our support is received in the form of money. We utilised to the full, our donated car from Stoneacre Motor Group, Wrexham. This car is used by all staff and volunteers when working off site to reduce any travel costs. Radio-Active Communications very kindly donated the use of two way radios for all of our events for 2012, making us a large financial saving on hire costs. We are in the second year of a three year grant from BBC Children in Need to help fund Release, our child bereavement service. We also received a grant of £5,000 from the Marjorie Boddy Charitable Trust. Our retail business continued to grow and for 2012 has produced a profit of approximately £160,000. Our new shop on Rhosnesni Lane has certainly developed into a thriving furniture shop, far exceeding its anticipated profits. We have also benefitted in the development of our recycling income and this has risen from £50,000 in 2011 to £64,000 in 2012. During this year we have also started to claim gift aid on the sale of donated furniture and electrical goods in all of our shops. We are grateful for the support of the community who donated their unwanted clothing, bric-a-brac and

‘ Our patients said . . .

"Nothing is too much touble, whether it be cleaners, volunteers, cooks, nurses or doctors."

October 2012

furniture which allows us to keep our charity shops stocked. We also receive support from businesses such as Westbridge Furniture in Holywell who give us their continued support. With the continued support of an external canvassing company we have again increased our lottery membership and have returned a very healthy profit in excess of £400,000.

As we start each year, we are always conscious of how much of a challenge we face with our fundraising. However, each year we are overwhelmed by the support we receive from our community. On behalf of our patients, their families and staff I would like to thank you for your continuing support — without whom there would be no Hospice.

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Val Connelly

Volunteer Liaison Manager . . . we extend a warm welcome to all of our new volunteers. Their enthusiasm is infectious and breathes new life into the Hospice. Without our army of ever willing volunteers we could not run the Hospice and offer the range of services we do. During 2012, over 500 volunteers have contributed nearly 60,000 hours in support of our patients, their families and our staff. Volunteers work in every area of the Hospice including our inpatient unit, daycare, reception, helping in the kitchen, offering support with administration, working in our charity shops, tending our beautiful gardens and helping with our vast number of fundraising events and activities. We are very grateful for your continued support. Whilst the number of volunteers has remained fairly constant, we have seen volunteers both come and go during 2012. One of the many benefits of

volunteering is that people are able to develop new skills and this often leads to opportunities of permanent employment, whilst many of our students on the young person’s programme leave us as they enter further education. Our Young Person’s Volunteer Programme has continued to grow in popularity during 2012. We are able to offer young people over the age of 16 the opportunity to volunteer within the Hospice giving them an opportunity to work within a healthcare environment, adding strength to their CV’s and university applications as well as developing other core skills. During 2012 we have developed new volunteering roles in the kitchen and within daycare to reflect the

he care during my stay has een exceptional in every way ith lots of TLC (tender loving are) compassion and humour

Patient, June 2011

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Volunteer Liaison Manager Nightingale House Hospice

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changing needs of the Hospice. New volunteers bring additional skills and experiences to Nightingale House and we extend a warm welcome to all of our new volunteers. Their enthusiasm is infectious and breathes new life into the Hospice. During 2012 we launched a new volunteer recruitment programme which resulted in 220Â new volunteers working at least one hour for the Hospice. At the same time we have developed a new volunteer training and mentoring system to support all our volunteers. We recently successfully introduced our new text messaging system as both a time and cost efficient way of communicating with volunteers who are supporting Hospice fundraising events. We would like to thank all of our volunteers for donating their time so generously in support of Nightingale House Hospice.

‘ Our patients said . . .

"The care is 100%. What a lovely place."

February 2012

Statistics for 2012

rr504 Volunteers contributed 59,821 hours to Nightingale House.

rr52 Volunteers recruited on the Young Person's Volunteer Programme. rr220 Volunteers contributed hours for the first time.

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Neil Williams Finance Manager

How funds are utilised on the provision of patient care Income 2012

Alternative Therapies 3%

Other Restricted 2% 2%

Day Care 7% Education 2%

Local Health Board 13%

Neil Williams

Social Workers 5%

Welsh Government 4%

Lottery 24%

Group Income £3.55 million

Shops / recycling 16%

Inpatients 59%

Donations 19%

Medical 14%

Occupational Therapy 3%

£ Events 7%

Legacies 12%

Physiotherapy 7%

Investments 1%

Statistics for 2012 rr £6,800 will fund the Hospice for 1 day rr ££406,000 was raised by Lottery rr 46% increase in amount raised by Lottery rr 24% of total income comes from Lottery rr 71 days of patient care funded by Lottery rr ££176,000 —— the amount raised by the Hospice charity shops rr 6% increase in sales through charity shops


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rr ££3.55 million total group income for the year rr 13%——amount of income received from Local Health Board rr ££681,000 was raised from donations rr 118 days of patient care funded by donations rr ££242,000 was raised from Hospice fundraising events rr 42 days of patient care funded by fundraising events

Finance Manager Nightingale House Hospice

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Neil Williams

rs 5%

Unrestricted Funds

Restricted Funds



Year ended Year ended 31 December 31 December 2012 2011 £


INCOMING RESOURCES Incoming resources from generating funds Voluntary income — Grants and donations Activities for generating funds Investment income Incoming resources from charitable activities Other incoming resources – profit on disposal of fixed assets Total incoming resources

1,587,309 1,654,382 53,233

22,694 -

1,610,003 1,654,382 53,233

1,358,202 1,541,738 36,023













391,915 979,093 6,429 1,931,431 8,338 (3,219) 3,313,987

3,067 1,924 143,230 148,221

394,982 981,017 6,429 2,074,661 8,338 (3,219) 3,462,208

391,849 867,750 6,361 2,028,246 7,676 3,301,882

153,487 5,180

(61,729) (5,180)

Resources expended Cost of generating funds Fundraising costs of Hospice Commercial trading operations Investment management costs Charitable activities Governance costs Other Total resources expended Net incoming / (outgoing) resources before transfers and other recognised gains and losses Transfer between funds Unrealised gains/(losses) on investment assets Realised (losses)/gains on investment assets Net movement in funds Total funds at 1 January 2012 Total funds as at 31 December 2012

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95,021 (8,434) 245,254 3,005,204 3,250,458

(66,909) 2,111,229 2,044,320

91,758 -

(1,910) -



(8,434) 178,345 5,116,433 5,294,778

41,873 (68,708) 5,185,141 5,116,433

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Financial Reports CONSOLIDATED BALANCE SHEET As at 31 December 2012. Group 2012

Group 2011



FIXED ASSETS Tangible assets Investments

3,106,235 1,163,539 4,269,774

3,121,737 1,048,699 4,170,436

24,720 149,176 1,172,740 1,346,636

152,426 23,831 98,376 961,209 1,235,842

CURRENT ASSETS Investments Stock Debtors Cash at bank and in hand

Creditors — amounts falling due within one year NET CURRENT ASSETS

(309,397) 1,037,239

Total assets less current liabilities


Provisions for liabilities and charges


(277,345) 958,497 5,128,933 (12,500)



Unrestricted funds



Restricted funds







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Financial Reports Nightingale House Hospice

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Annual Report 2012  
Annual Report 2012  

Nightingale House Hospice Annual Report 2012