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Quality Account 2014-2015
Collecting the ‘UKs Charity of the Year’ award. From the second right: Stephen Roberts, Chief Executive, Angela Webb, Chair, Kim Jones, Azey Siddiqui and Sharon Sandle
Contents
1. Quality Statement
01
2. Performance in 2014-2015
04
3. Priorities 2015-2016
24
4. Statements of Quality Assurance
27
5. Referral Criteria
29
Crosscare
North Devon Hospice Quality Account 2014-15
01
1. Quality Statement Dear colleagues, It is with great pleasure that I can share some exciting news with you. After a year of fundraising in the local community, I am pleased to let you know that the hospice’s new outreach centre, The Long House, is due to be completed in late summer. Sited adjacent to the Holsworthy Medical Centre, from this new hub we will be able to provide a range of specialist care and support services to patients and their families. It is a significant step forward in local care provision. I am looking forward to working more closely with local medical centres in the area and the community hospital. In addition to extending our care, our commitment to provide more care closer to home has been hailed on a national platform. In 2014, North Devon Hospice was named ‘The UK’s Charity of the Year’ at the Charity Times Awards. To be recognised on such a national platform and alongside large national charities is a real accolade. It was our commitment to care and our Hospice to Home service that were acknowledged at the ceremony. This award and the difference our hospice services have made is something we can all be very proud of. In the year ahead we remain committed to providing care and support closer to home. On behalf of my colleagues, we look forward to working closely with you to improve access to our services and to best support your patients and their families.
Murray Fletcher Medical Director and Consultant in Palliative Medicine murrayfletcher@northdevonhospice.org.uk Health Professionals Helpline 01271 347214
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for palliative care advice and information
1. Quality Statement
Kind regards,
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North Devon Hospice Quality Account 2014-15
Our Values Our doctors, nurses, counsellors, therapists and care teams can offer what is needed at such a difficult time in the life of a patient and their family. We provide free care and support to people who are faced with the impact of a life-limiting illness. We believe in: • Being there for all the family • Recognising and treating each person as an individual • The caring and clinical support that is provided 1. Quality Statement
• The sense of safety and support the hospice brings • The expertise of our professional teams.
being there for all the family
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www.northdevonhospice.org.uk
North Devon Hospice Quality Account 2014-15
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Mission Statement Our mission is to promote the relief of symptoms amongst people with life-limiting illnesses. We do this through offering: • Specialist palliative care for patients with an advanced, progressive illness and support for the adults and children who are close to the patient • Personal care to patients at the end-of-life and support to their families at home and in other settings • Supportive care to patients who have been diagnosed with a life-limiting illness and to the adults and children who are close to the patient • Advice, support and education provision to patients, families, communities, organisations and healthcare professionals who are responding to life-limiting illness, death and loss.
being there for all the family 1. Quality Statement
Health Professionals Helpline 01271 347214
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for palliative care advice and information
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North Devon Hospice Quality Account 2014-15
2. Performance in 2014-15 • We have recruited additional nurses and expanded our Hospice to Home team • We have worked proactively with other healthcare partners to improve end-of-life care • We have continued to build on our education and training programme, which now includes specialised training for care homes • We have continued to gather feedback on our services by joining the ‘I Want Great Care’ national survey programme
Overview of Clinical Governance 2. Performance in 2014-2015
Providing high quality, people focused care is incredibly important to us. We strive to maintain high standards of care through standard setting and regular audits.
being there for all the family
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www.northdevonhospice.org.uk
North Devon Hospice Quality Account 2014-15
Clinical Audits
Learning Points
• •
•
• • • • • • • • • •
• • •
•
Medicines Management Hand Hygiene Referral Response Time (Single Point of Access) Document Scanning Food and Nutrition Clinical Supervision Management of Terminal Agitation Effectiveness of Hyoscine in Reducing Secretions in Terminally Ill Patients Safe Disposal of Sharps Bed Rail Documentation South West Hospices’ Informatics Project: Medication Incidents, Falls and Pressure Ulcers South West Hospices’ Region Preferred Place of Care for Dying Hospice UK National Medication Incidents, Falls and Pressure Ulcers
Controlled Drugs Regulations Update Changes to the Care Quality Commission Inspection Mindfullness Session and the Introduction of the Crosscare Well-being Window Berwick Review Coroner’s Officer Presentation Falls Presentation highlighting the new NICE guidelines on Falls Management
• •
• • •
Significant Event Meetings •
Management of Respiratory Secretions Safeguarding Review Reflection on Complex Discharges from the Bedded Unit (Discussion with Community Multi-Disciplinary Team)
• •
Health Professionals Helpline 01271 347214
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2. Performance in 2014-2015
•
I Want Great Care Patient and Carers’ Focus Group Review Carers’ Support Needs Assessment Tool Controlled Drugs
05
for palliative care advice and information
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North Devon Hospice Quality Account 2014-15
Hospice Education We know that training and awareness can have a positive impact on the end-of-life care provided locally, that is why we continued to deliver a range of education courses for local health professionals.
Total number of healthcare professionals trained
655
Total number of care home staff who received tailored end-of-life care training specifically for care homes
367
In addition to our annual education programme, we began our pilot ‘Six Steps for Care Homes’ programme which supports care homes to become more confident and competent when providing end-of-life care for their residents; helping them to respond with sensitivity and compassion at a difficult time for residents and their families. The participating care homes are:
2. Performance in 2014-2015
• Eastleigh Nursing Home • Fremington Manor Nursing Home • Hatchmoor Nursing Home • Kenwith Castle • Swimbridge House Nursing Home • Tyspane Nursing Home
Book your place online www.northdevonhospice.org.uk
being there for all the family . www.northdevonhospice.org.uk
North Devon Hospice Quality Account 2014-15
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We received an average of 99% positive feedback from healthcare professionals who attended our courses.
Care Home Manager
Health Professionals Helpline 01271 347214
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for palliative care advice and information
2. Performance in 2014-2015
“Advance care planning is so important. There is not the opportunity to bring someone back and say - We’re sorry can we have another go”
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North Devon Hospice Quality Account 2014-15
Overview of our Caseload
During 2014-15 we cared for and supported thousands of people. Our care and support extends beyond our patients and reaches out to their family members, their carers and their children. We believe in being there for all the family. Every person we have supported was affected by a life-limiting illness and many people received more than one service. Not all of our patients have cancer, we also support people with other life-limiting illnesses such a MND and Liver Failure, among others.
2. Performance in 2014-2015
NEW REFERRALS AND RE-REFERRALS
933
Family Members/Carers
331
Patients
Total number of patients and carers supported
being there for all the family
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1,264
www.northdevonhospice.org.uk
North Devon Hospice Quality Account 2014-15
09
We care for patients who are 18 years old and over. There is a common misconception that we only care for older people, but some of our patients are in their 20s, 30s and 40s. Although the graph below indicates that a large proportion of our patients were aged 50 and over, it must also be highlighted that last year we cared for a number of younger patients, many of whom had their own families and young children.
PATIENTS AGE PROFILE 300
250
Number of patients
200
150
100
91-101
81-90
71-80
61-70
51-60
41-50
31-40
21-30
17-20
0-16
50
Patients age range
Health Professionals Helpline 01271 347214
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for palliative care advice and information
2. Performance in 2014-2015
“Many thanks for all the care and love you showed to my lovely daughter whilst she was with you’’
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North Devon Hospice Quality Account 2014-15
‘‘Where we die matters. Of the 636 patients who died last year, 83% achieved their preferred place of care. The majority of our patients were cared for at home, where they wanted to be.’’ Murray Fletcher, Consultant in Palliative Medicine
PLACE OF DEATH Home 300 Hospice 128 Acute Hospital 111 Care Home 64
2. Performance in 2014-2015
Community Hospital 30 Other
being there for all the family
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www.northdevonhospice.org.uk
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North Devon Hospice Quality Account 2014-15
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Community Clinical Nurse Specialist Palliative Care Service Our nurses supported 741 patients last year. The vast majority of their support was provided in the privacy and comfort of the patients own home. Our nurses travel the length and breadth of North Devon to visit patients and their families; last year they covered over 50,000 miles. This also included visiting people who are staying in care homes and hospitals. As with all of our services, our nurses work closely with local GP practices to ensure every patient receives joined up care and support at the right time.
LOCATION OF VISITS Home Location of visits
Hospice Hospital Care Home/ Nursing Home
0
500
1000
1500
2000
2500
3000
. www.northdevonhospice.org.uk beingHealth there for all the family Professionals Helpline 01271 347214 . for palliative care advice and information
2. Performance in 2014-2015
Number of patient visits
12
North Devon Hospice Quality Account 2014-15
The Hospice to Home Service
2. Performance in 2014-2015
Throughout last year, intervention by our Hospice to Home team alone prevented 269 avoidable admissions into hospital. Of these 269 cases, this equated to North Devon Hospice providing 1,973 days worth of care and support in people’s own homes. HOSPICE TO HOME REFERRALS Community Palliative Care Service (CPCS)
182
Hospice to Home (H2H)
319
Total number of referrals
being there for all the family
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www.northdevonhospice.org.uk
501
North Devon Hospice Quality Account 2014-15
13
PATIENTS’ PReFERRED PLACE OF CARE Home
90%
Hospice
8%
Care Home
2%
A significant number of our patients achieved their preferred place of care following intervention from our Hospice to Home service. Following a secondment to North Devon Hospice, as of 1st April 2015, the Community Palliative Care service merged with the Hospice to Home service. The strengthened Hospice to Home team continues to deliver round the clock care and support to people at the end of their life and for crisis intervention.
Make a referral
Health Professionals Helpline 01271 347214
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for palliative care advice and information
2. Performance in 2014-2015
• 9am-5pm call the Hospice to Home referral line 01271 347246 • Out of hours call the Northern Urgent Care Nursing Team 0845 504 9113
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North Devon Hospice Quality Account 2014-15
The Bedded Unit We cared for 144 patients on the Bedded Unit last year, some of whom were later re-admitted for further care, totalling 164 admissions. 90% had a cancer diagnosis, with the remaining 10% being referred for other life-limiting conditions such as MND and liver failure. As you will see from the pie chart below, a large proportion of patients were ‘at home’ before being admitted. This is representative of the extensive amount of care we were providing in people’s own homes. In addition to this, it is also indicative of the ongoing engagement with local healthcare partners.
patients Location before being admitted
2. Performance in 2014-2015
Patients own home
being there for all the family
.
119
Acute Hospital
40
Care Home/ Nursing Home
4
Community Hospital
1
www.northdevonhospice.org.uk
North Devon Hospice Quality Account 2014-15
15
DISCHARGES 122
Died Patient’s own home
26
Care Home or Nursing Home
11
Acute Hospital
1
Community Hospital
1
Total number of discharges
161
We have seen an increase in the number of specialist end-of-life care referrals to the Bedded Unit and this is reflected in the discharge data. These outcomes are directly linked to the activity of our other hospice services being delivered in the community. For example, early intervention by our Hospice to Home service meant a number of people were supported at home, with more specialised cases being referred to the Bedded Unit for additional care and support when it was needed most.
Health Professionals Helpline 01271 347214
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for palliative care advice and information
2. Performance in 2014-2015
A significant part of our work on the Bedded Unit includes offering support, guidance and understanding to family members and those who are close to our patients. We meet people at a difficult time in their life and the support given by our nurses and healthcare assistants continues to provide comfort to those they meet.
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North Devon Hospice Quality Account 2014-15
Occupational Therapy and Physiotherapy
Last year we continued to provide occupational therapy as part of our discharge planning process and to support existing patients to maintain a level of comfort and independence in their own homes. In addition to this, we continued to provide physiotherapy sessions for our patients throughout their journey.
2. Performance in 2014-2015
Home visits
Hospice visits
Total
Occupational Therapy
6
217 223
Physiotherapy
1
141 142
being there for all the family
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www.northdevonhospice.org.uk
North Devon Hospice Quality Account 2014-15
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Supportive Care Services We offer emotional and spiritual support to people who have been affected by a life-limiting illness. As well as supporting our patients along their journey, we also provide emotional and spiritual support to family members, including young children. Last year our Supportive Care services continued to be there for all the family, supporting 1,111 people.
“Thank you so much for helping me. You’ve made me feel much better about Grandad now’’
INDIVIDUALS SUPPORTED Patients
368
Family members
743
Total supported
.
2. Performance in 2014-2015
Health Professionals Helpline 01271 347214
1,111
for palliative care advice and information
18
North Devon Hospice Quality Account 2014-15
Our support can be available from the moment a person hears they, or their loved one, have been diagnosed with a life-limiting illness. Our support comes in a variety of forms, all of which aim to meet the needs of each person, at that specific time in their own journey. Last year, we provided pre-bereavement support, individual support and group sessions.
Pre-bereavement support
Face to face
Telephone support
2. Performance in 2014-2015
Family support 73 25 One-to-one support
685 305
Total instances of pre-bereavement support
758 330
being there for all the family
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www.northdevonhospice.org.uk
North Devon Hospice Quality Account 2014-15
19
individual bereavement support
Face to face
Telephone support
Family support 35 49 One-to-one support
Total instances of individual bereavement support
715 634
750
683
Last year we continued to provide a number of supportive ‘group’ sessions. Each group, as listed below, was tailored to the nature of why people were taking part. Our ‘It’s Friday’ sessions continue to be very popular as they enable patients and family members to visit the hospice in an informal way for support.
SUPPORTIVE GROUP SESSIONS 220
Carers group
170
‘It’s Friday’ drop in
607
Patients group
284
Total number of attendances
Health Professionals Helpline 01271 347214
1,281
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for palliative care advice and information
2. Performance in 2014-2015
Bereavement group
20
North Devon Hospice Quality Account 2014-15
Day Hospice
42 patients repeatedly attended Day Hospice throughout 2014-15, totalling 706 attendances. Of these 42 patients, 24% had a non-cancer diagnosis. Day Hospice is an ideal opportunity for patients to socialise in the comfort of a supportive environment, as well as accessing additional care and support at different times during their journey. During 2014-15 we offered a wider range of activities during Day Hospice, giving people more choice.
2. Performance in 2014-2015
“Day Hospice was somewhere my wife was always happy to visit�
being there for all the family
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www.northdevonhospice.org.uk
North Devon Hospice Quality Account 2014-15
21
Complementary Therapies During the last year, our complementary therapy groups and therapies were well received. 452 patients’ sessions were delivered and 234 family sessions. Group complementary therapy days continued to be popular last year. In response to a patient’s request, we held our first ‘men only’ pamper event for both patients and carers. At the pilot ‘Gents Event’ they could have a haircut, wet shave and access a range of complementary therapies. The feedback was positive and will lead to more group days of this nature in the future.
Group complementary therapy received by patients and family members ‘Look Good Feel Great’ Day
91
The ‘Carers Pamper Day’
51
The ‘Gents Event’ (pilot event following a request)
150
Total number of attendances
.
2. Performance in 2014-2015
Health Professionals Helpline 01271 347214
8
for palliative care advice and information
22
North Devon Hospice Quality Account 2014-15
We offer a range of complementary therapies to our patients and their carers. Studies indicate therapies can help to aid relaxation, sleep and enhance well-being. Attending therapies and group sessions also gives people an opportunity to access additional services in the comfort of a supportive environment.
2. Performance in 2014-2015
COMPLEmentary Therapy sessions Aromatherapy
223
Reflexology
102
Feldenkrais
77
Bowen therapy
76
Massage
33
Indian head massage
11
Reiki healing
8
Relaxation session
6
Total number of sessions provided
being there for all the family
.
www.northdevonhospice.org.uk
536
North Devon Hospice Quality Account 2014-15
Health Professionals Helpline 01271 347214
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for palliative care advice and information
2. Performance in 2014-2015
“After my massage my headache finally went. I’d had it for three weeks and no medication could touch it.’’
23
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North Devon Hospice Quality Account 2014-15
3. Priorities in 2015-2016 • To deliver care closer to home across North Devon through the further development of our Hospice to Home team and in the opening of The Long House outreach centre in Holsworthy • To increase the level of understanding, awareness of, and access to, our care and services for GPs and District Nurses • To increase end-of-life care skills and knowledge of healthcare partners across North Devon particularly in nursing and care homes.
being there for all the family
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www.northdevonhospice.org.uk
North Devon Hospice Quality Account 2014-15
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The Board of Trustees’ Commitment to Quality North Devon Hospice’s Board of Trustees is made up of professionals from a wide range of disciplines and experience; from clinical care to financial control to management. Together, they are responsible for ensuring our patients and their families are given the best possible care. The Board of Trustees have continued to maintain high quality standards of care whilst also expanding our care and support services and bringing care closer to people at home. The impact of our services was acknowledged at the national Charity Times award ceremony, where North Devon Hospice was named the ‘UK’s Charity of the Year.’ Statements of quality assurance from the Board of Trustees are available overleaf.
“Our Hospice to Home service was celebrated when we won the ‘UK Charity of the Year.’ We are a small local charity, so to be recognised on this national platform is a major achievement. To have our community services recognised in this way, well that is beyond words”
Health Professionals Helpline 01271 347214
3. Priorities in 2015-2016
CEO, Stephen Roberts
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for palliative care advice and information
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North Devon Hospice Quality Account 2014-15
Thank you Together we continue to make a difference throughout the community. Our community services continue to go from strength to strength, supporting more people to spend their final days at home. Thanks to the support of the local residents of Holsworthy and the surrounding area, over £75,000 has been raised towards the cost of building The Long House, our new outreach centre in Holsworthy. This year we are looking forward to delivering more care and support from this new hub. Providing high quality, people focused care continues to be our top priority and our care focus was celebrated at the Charity Times Awards this year when we were named ‘The UK’s Charity of the Year.’ It is an amazing accolade and one that we should all be very proud of. Every year we need to raise over £3.5 million from scratch to continue providing care and support to thousands of local people. Please help us to continue funding local care by making a regular donation or remembering us in your will. For more information contact Ali Hunt, Head of Fundraising: alihunt@northdevonhospice.org.uk / 01271 347206
Comments and Feedback
3. Priorities in 2015-2016
If you have any comments or questions about this Quality Account or our services in general, we are always grateful to have feedback. Please do not hesitate to contact us: Rachel McCarty Director of Care and Registered Manager North Devon Hospice Deer Park, Newport, Barnstaple North Devon EX32 0HU rachelmccarty@northdevonhospice.org.uk / 01271 347203
being there for all the family
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www.northdevonhospice.org.uk
North Devon Hospice Quality Account 2014-145
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4. Statements of Quality Assurance from the Board of Trustees In compliance with statutory regulations, North Devon Hospice’s Board of Trustees can confirm: 1.1 During 2014-2015 North Devon Hospice provided or sub-contracted no NHS Services directly. A grant was received from the Devon Primary Care Trust to provide palliative and end-of-life care. 1.2 During 2014-2015, no National Clinical Audits and no National Confidential Enquiries covered NHS services that North Devon Hospice provides. 1.3 The reports of seventeen clinical audits were reviewed by North Devon Hospice in 2014-2015 and North Devon Hospice will take action to continue improving the quality of healthcare provided. 1.4 The number of patients receiving NHS services provided or sub-contracted by North Devon Hospice in 2014-2015 that were recruited during that period to participate in research approved by a research ethics committee was zero. 1.5 North Devon Hospice’s income in 2014-2015 was not conditional on achieving quality improvement and innovation goals through the Care Quality Commission.
Health Professionals Helpline 01271 347214
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for palliative care advice and information
4. Statements of Quality Assurance
1.6 North Devon Hospice is required to register with the Care Quality Commission and its current registration status is active. North Devon Hospice has the following conditions on registration: to provide the regulated activities of diagnostic and screening procedures, transport services, triage and medical advice provided remotely, treatment of disease, disorder or injury with conditions and personal care as of 31st March 2015.
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North Devon Hospice Quality Account 2014-15
1.7 The Care Quality Commission has not taken enforcement action against North Devon Hospice during the reporting period of 2014-2015. 1.8 North Devon Hospice has not participated in any special reviews or investigations by the Care Quality Commission during the reporting period. 1.9 North Devon Hospice did not submit recordings during 2014-2015 to the Secondary Uses Service for inclusion in the Hospital Episode Statistics which are included in the latest publication data.
4. Statements of Quality Assurance
1.10 North Devon Hospice was not subject to the Payment by Results Clinical Coding Audit during 2014-2015 by the Audit Commission.
being there for all the family
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www.northdevonhospice.org.uk
North Devon Hospice Quality Account 2014-15
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How to make a referral If you have any questions about your referral, please call us. We respond to all clinical referrals within 24 hours and supportive care referrals within 5 working days.
Call us
01271 344248
Fax
01271 347218
Internal mail letter
CNS team
Watch this space! Following consultations with a number of North Devon based GP practices, we are working towards developing an online referral form.
5. Referral Criteria
Health Professionals Helpline 01271 347214
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for palliative care advice and information
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North Devon Hospice Quality Account 2014-15
Community Clinical Nurse Specialist Palliative Care Service To provide a specialist palliative care community nursing service for adult patients with complex problems associated with life-limiting illnesses, when the needs of the patient and family are unable to be met by the generalist palliative healthcare professionals in the care setting.
Available to people who • • •
Have an advanced, progressive illness or are on the Gold Standards Framework Need advice and care for pain management and other distressing symptoms Would benefit from holistic care, with any emotional and spiritual needs being addressed.
This includes • • • • •
Clinical Nurse Specialists providing advice and support to patients and families in the care setting of their choice The hospice multi-disciplinary team sharing care, information, advice and support with other health and social care professionals Telephone advice A named contact for each patient 24 hour advice line for local professional colleagues; provided by the hospice in-patient unit.
Referral
5. Referral Criteria
Write a letter or fax the ‘request for services’ referral form or call 01271 344248. Whilst healthcare professionals can request community nursing services, the patient’s GP must give their agreement on all occasions. Acceptance is reviewed during the daily (Monday to Friday) referral team meetings.
being there for all the family
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www.northdevonhospice.org.uk
North Devon Hospice Quality Account 2014-15
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The Bedded Unit (IPU) To provide specialist palliative care in-patient services for adult patients who have complex problems associated with life-limiting illnesses.
Available to people who • • •
Have an advanced progressive illness Need treatment for complex pain management or other distressing symptoms Have complex end-of-life care needs.
This includes • • • • •
24 hour care in a purpose built 7 bedded unit to help with the management of complex symptoms or in providing end-of-life care Allied Healthcare Professionals providing one-to-one and group sessions Consultant Outpatient Treatments and Consultant Domiciliary Appointments The hospice multi-disciplinary team sharing care, information, advice and support with other health and social care professionals A family room and overnight stay room for relatives.
Referral Write a letter or fax the ‘request for services’ referral form. In urgent and out-of-hours cases, call the Duty Medical Officer direct on 01271 347214. All requests must be with the explicit agreement of the GP and/or relevant hospital Consultant. Acceptance of admissions 24/7 as appropriate.
5. Referral Criteria
Health Professionals Helpline 01271 347214 . for palliative care advice and information
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North Devon Hospice Quality Account 2014-15
Supportive Care Services To provide a range of supportive care services, pre and post bereavement, to patients, carers and family members, including children.
Available to people who Are over 18 and have a life-limiting illness Or are adults or children deeply affected by that person’s illness Or are left bereaved as a result of that person’s death.
This includes •
• • •
Support groups for patients, for carers and also the bereaved, either one-to-one or in a group session Day Hospice ‘Look Good Feel Great’ sessions 'It’s Friday’ drop-in
• • • • • • •
Complementary therapies ‘Carers Pamper Day’ One-to-one bereavement support Support for children and their carers Pastoral and spiritual support Creative arts ‘One off’ events in response to client needs.
Referral
5. Referral Criteria
Completion of the ‘request for services’ referral form. Requests can be made from GPs, Consultants, Social Services, other hospices and other agencies. Requests are considered at any point in the patient’s/family’s journey and acceptance is reviewed during the daily (Monday to Friday) referral team meetings.
being there for all the family
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www.northdevonhospice.org.uk
North Devon Hospice Quality Account 2014-15
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Hospice to Home Service To support patients and their families living with a life-limiting illness, to provide care and support as a short-term intervention to help prevent a crisis escalating or to avoid an acute admission.
Available to people who Are over 18 and have a life-limiting illness Are known on the Gold Standards Framework register Have a care plan and risk assessment Require care to prevent admission to hospital or another care setting.
This includes • • • •
Hands on end-of-life care, palliative care and support in the community Crisis intervention to prevent an unplanned admission to hospital Skilled carers to provide round the clock care for those at the end of life, day or night To facilitate rapid discharge from hospital to their preferred place of care.
Referral Referrals are usually made by telephone between 8am and 8pm. Via the phone during office hours (Monday to Friday) by calling 01271 347246 or 347247. Out-of-hours contact via Community Nurses on 01392 823666. Referrals are accepted from all healthcare professionals. The service excludes routine packages of care and does not provide respite care.
5. Referral Criteria
Health Professionals Helpline 01271 347214 . for palliative care advice and information
h ls ion alt iona at e H ss ine 14 nform e l 2 i of elp 47 and r P H 1 3 vice 27 ad 01e care
Working in the homes of our patients across the community
iv iat all p r fo
Combe Martin
Working with GP practices & District Nurses
Woolacombe
Working with Nursing Homes & Residential Homes Working with Hospitals & Community Hospitals
Ilfracombe
N O R T H D E V O N
Braunton
Heanton
North Devon Hospice Deer Park
Chelfham
Barnstaple Instow
Landkey Swimbridge
Northam Abbotsham
Bideford
South Molton
Alverdiscott
Hartland Great Torrington
High Bickington
T orridge Chulmleigh
Bradworthy
Holsworthy
Shebbear Black Torrington Beaworthy
being there for all the family North Devon Hospice, Deer Park, Barnstaple, Devon EX32 0HU email: info@northdevonhospice.org.uk www.northdevonhospice.org.uk / 01271 344248 Registered charity no. 286554
Lynton