Recover, Regroup, Rebuild

RECOVER

REGROUP

Almost everything we do has an important, and often profound, impact on those we support, as well as on our wider community. 2021-22 saw us enter a second year of living with COVID, and of continuing to focus on providing care, support and guidance across our services.

CHAIRMAN’S WELCOME

In many ways, this second year was just as challenging as the first, however the year was also about recovering, regrouping and rebuilding. It was about continuing to take our services forward, and working with our patients, families, staff and volunteers to create the best possible space for our care and support that we could.

Although living alongside COVID did not get any easier, the systems, procedures and guidelines we put in place helped ensure that we continued to operate as smoothly as possible. It is safe to say, however, that not even the best procedures would work without the commitment and dedication of our incredible workforce. They continued to rise to the challenge, to put the needs of our patients, families and communities at the centre of their thinking, and they all ensured that we maintained, and also developed, our vital services.

Each of the staff, volunteers and supporters who is part of our Hospice community helps us deliver something very special, and it is undoubtedly teamwork that makes what we do possible. This sense of teams working together shone through in 2021-22, and as a direct result of this our impact was greater than ever.

It is a privilege to present this report, which highlights some of those key areas of impact throughout 2021-22, and details some of the key achievements from another incredibly busy year. Although staffing levels were often stretched, the team rose to the challenges they were faced with and, true to the very founding principles of the Hospice care movement, kept our patients and families at the very heart of the decision-making process.

Numbers and statistics are an important way for us to measure our reach, and help us track and monitor progress against objectives, and you will find these throughout this document, as well as in the year in numbers section. I’d encourage you to read the quotes in this report too however. These short quotes, from families, patients, our workforce and our supporters, highlight the personal, lived experience and impact of our services.

Whatever role you play in helping us deliver our services, I’d like to thank you for being part of our Hospice community.

David Dunsire Chairman

Our inpatient unit continued to be affected by COVID restrictions throughout 2021-22, with testing, Personal Protective Equipment (PPE), and tight infection control measures all in place.

OUR SERVICES

PPE equipment was in constant demand throughout the pandemic.

Despite this our dedicated team ensured the very best level of care and support to patients and families and, although restricted at times, we were able to maintain visiting throughout the pandemic. The team continued to be committed to ensuring our care was maintained at what was an incredibly challenging time for all, and over the course of the year we saw a 16% increase in the overall number of people referred to our clinical services compared with

In 2021-22 our inpatient unit consisted of two wards – Cedar and Pentland.

Some of the key achievements from the year included;

Supporting NHS Lothian throughout the winter months by moving a portion of our inpatient care team out into the community. This involved the temporary closure of Cedar Ward to enable staff to better support the growing need NHS Lothian required support with.

Nursing staff redeployed from the wards to increase our Hospice at Home services.

Average occupancy over the year was high at 86%

Visiting was maintained throughout the year, and services were largely maintained as normal. The team across the hospice worked hard to ensure measures were in place to allow safe visiting throughout the pandemic.

The whole experience has been overwhelmingly positive. From the moment I arrived I was treated like a person, not a patient. I made lots of friends and it was nice to meet new people that knew what I was going through in such a supportive environment.

COMMUNITY REACH

One of our key strategic objectives is to create a flexible model of care that shifts the balance from hospice building based care to community focussed care. Alongside this we will listen to the needs of our community and work with them to develop services that are right for them.

In 2021-22 we continued to develop our community services, which consisted of two multi professional “community hospice” teams in North East and North West Edinburgh, our Hospice at Home team, and our compassionate communities team. Our community hospice team saw a 74% increase in activity over the course of the year. Due to continued COVID restrictions the vast majority of the interactions which the community hospice team had with patients were either over the phone or virtual. We will continue to offer virtual and phone sessions, however we anticipate a move back to more face to face interactions with the easing of COVID restrictions.

Our Edinburgh Hospice at Home team was well established in 2021-22 and provided over 4,800 home visits. The capacity of the team was enhanced over the winter months by the redeployment of inpatient nursing staff to support NHS Lothian. This important team contribute to the prevention of hospital admissions and they also facilitated discharge from all inpatient settings. The team also carried out visits in order to bridge the gap before packages of social care commenced.

Part of the role of our community service is to enable people at the end of their lives to remain in their own homes. In 2021-22 some 260 people were supported in this way, an increase of over 40% as compared to the previous year and further evidence that the balance of care continues to shift towards increased community support. Importantly, this is driven by the needs and wishes of those we support.

COMPASSIONATE COMMUNITIES

Another important area of growth has been the growth of our Compassionate Communities team, who continued to develop networks with individuals, volunteers, carers, service providers and communities across North Edinburgh and East Lothian.

One of the key areas of focus for this team throughout the year was the creation of our new Compassionate Neighbours initiative. This approach works by enabling volunteers to offer their time, skills and company to local people who may be socially isolated, lonely, or have a life limiting condition. There have been some excellent successes to date and the quote opposite shows just how important the impact of this work can be.

Impact is not solely about numbers, however our Compassionate Neighbours teams have had a busy year, as highlighted below;

85 community members referred to the service and 67 matched with a volunteer compassionate neighbour

20 new volunteers recruited, which takes the total number of compassionate neighbours volunteers to 45

In total there were a staggering 888 contacts between compassionate neighbours and community members, helping us truly extend our reach and impact in the community.

Visits from my Compassionate Neighbour light up my week, I look forward to her next one the moment she leaves. She phones between visits, I struggle to hear on the phone now but just knowing she’s there, even for a moment, means the world to me.

The work carried out by our family support and counselling team has never been in greater demand, as the pandemic has sadly increased the need for bereavement support.

FAMILY SUPPORT

The number of sessions provided has increased year on year and throughout 2021-22 we continued to provide a mix of online and face to face support, a blend which we think will continue into the future and a development which helps those we support access our services in a way that suits them.

A total of 1392 sessions have been delivered to patients, carers, children and young people, and has included vital pre-bereavement work. Quotes like the one opposite highlight just how important these sessions are.

Recognising the vital importance of this work, the Hospice continued to invest in these services and in 2021-22 we brought in another counsellor to the team and also a second child and family practitioner. Overall, an increase in activity of 100% was seen across these services, which is a clear indication of how important these services are, and how integral they will be to our evolving work.

I didn’t for one minute think the kind of support I’ve had would ever be in place. People know about the care for patients, but nobody realises what’s available to the people left behind, it’s incredible.

Our Arts service team had to continue to think creatively and move to a hybrid approach of online and in person working due to restrictions on face to face and group activities.

ART SERVICES

They did this brilliantly and provided over 100 group sessions, 136 individual sessions, 26 live music sessions and numerous online events. In total, 700 attendees made use of these important sessions, which continued throughout the year, bringing a fresh and most welcome perspective to many of our patients and families.

Prior to being diagnosed, I’d never drawn anything in my life. Since I’ve been in the Hospice for pain management, using the art room has become a regular thing. It’s therapeutic; it’s my favourite thing to do here.

During 2021-22 we were delighted to be officially recognised as the first University Hospice in the East of Scotland, following the announcement of a pioneering agreement with Queen Margaret University.

EDUCATION AND RESEARCH

Throughout the year our education and research activities adapted to virtual methods of working to ensure as much business continuity as possible. In partnership with Queen Margaret University, the Hospice transferred its academic courses online, ensuring that students could continue to study effectively.

Our experience of using virtual consultation technology (ECHO) has been invaluable and enabled us to continue to support local care homes and district nurses through a very difficult time.

ECHO networks were also established with NHS Lothian volunteers, local homelessness support teams, and the Art in Palliative Care community to further enhance their practice.

We were pleased to host an online Arts Symposium supported by the Scottish Partnership for Palliative Care, Queen Margaret University and the Scottish Music Trust, which attracted over 100 delegates from across the world. We also continued to publish articles in journals and books across nursing, medicine and the arts in palliative care, influencing practices in the wider context.

OUR SUPPORTERS

The impact our supporters make is, in a word, huge. They have continued to fundraise, send in donations, buy goods in our charity shops and online, purchase Christmas cards and gifts, and attend our events.

Most of the events our supporters took part in throughout 2021-22 continued to be online, with our popular pub quiz, our art events and a new pet show helping us stay connected to our amazing supporters. These events provided important chances to engage with our community of supporters. Although income generation has been greatly impacted by the pandemic, and is significantly down on pre-pandemic levels, we did see an increase in voluntary income, and shop sales, as compared to the first year of COVID restrictions in 2020-21.

Voluntary income started to develop again across almost all areas, and we were delighted to be able to welcome supporters back to Charlotte Square Gardens, and to St Mary’s Pleasance Gardens in Haddington, for the lighting of our Christmas Trees as part of our annual light up a life appeals. Although a little smaller in number than previous years it was wonderful to see our community around our tree in Edinburgh and Haddington, and our Facebook Live coverage of our Edinburgh lighting attracted a large audience.

Trusts and Foundations were also hugely supportive of us throughout the year, raising vital funds for core funding, and for significant projects to support our growth and development. One of these projects was the funding for a new Patient Transport Vehicle. This important new vehicle will help us support patient transport to and from hospital and also from other care settings.

2022 saw a new patient transport vehicle arrive at the Hospice

Our shops had a more stable trading period throughout 2021-22. Despite COVID restriction closures at the beginning of the year the teams worked incredibly hard to ensure a safe, welcoming and happy shopping environment. This hard work helped us exceed our income budget for the year by over £20,000 – no small effort in some of the most challenging circumstances many of our shop managers and volunteers have worked through.

The shoots of recovery were certainly starting to show throughout 2021-22. Across our community more collecting can income started to come in, our supporters were starting to organise initiatives to raise money for us, and we were talking to far more donors about their plans and activities. Corporate income started to come back too, with new partnerships formed with businesses across our area that continue to grow and develop.

Our supporters will always be part of the backbone of our Hospice services, as without them we simply couldn’t provide the services that are so important to the families we support. Throughout another year filled with changes in restrictions, uncertainty and challenge, our wonderful donors, supports, shoppers, runners, walkers (and everything else!) were there with their support. It was, as always, incredibly inspiring.

During the year we commissioned a study of both of our buildings and of one of our shops to better understand where we could implement changes that would positively impact our carbon footprint.

The results of these studies showed that our hospice building was constructed with excellent insulation, and that much of what we do across the hospice in terms of heating, lighting and air flow is already of a high standard. In fact one of the challenges moving forwards looks to be how to keep the building cool throughout the summer months.

ENVIRONMENTAL IMPACT

Lessening our impact on the environment, and looking at ways to reduce our carbon footprint across a number of key areas was an important theme for us 2021-22

Many of the changes we will strive to implement are behavioural across our teams – maintaining and growing recycling, reminding staff and volunteers to turn off screens and computers when not in use, and encouraging use of our new electric pool bikes where possible. Across our shops we are also looking at the best heating options, to reduce any excess energy loss and to increase the productivity of our heating systems.

Some of the key areas highlighted by the reports carried out, and through our own internal audit of our environmental impact included;

A high quality hospice building with excellent insulation

A good mix, at present, of electricity and gas across the Hospice

Good solar panels in use on our Hospice building, with potential to increase these

Good lighting across most of the Hospice building

Opportunities to move to electric vans for our facilities team

Moving forward, assessing and reducing our environmental impact where possible, will continue to be a key priority.

TOTAL INCOME

THE YEAR IN NUMBERS

TOTAL EXPENDITURE

group sessions were run by our Arts service team

people supported at the end of their lives to remain in their own home (44% increase on last year) average occupancy across the year

increase in referrals to our counselling services

increase in the number of referrals to our clinical services over the course of 2021–22

referrals to our Family Support Services

wonderful volunteers supported our work

Hospice at Home visits across Edinburgh

delegates from across the world attended the Online Arts Symposium

When we wrote this strategy we could not have anticipated the huge global forces that would change our world in the form of COVID-19. This commitment, however, has helped underpin much of the thought and strategic direction our services have taken over the course of 2021-22, as we continued to live with, and adapt to, a world living with a pandemic.

While we have made good progress with the key objectives outlined in our strategy there are some areas we will continue to work on over the next 12 months. We look forward to opening our new family suites within the inpatient unit which will support families to be with their loved ones contributing to their care as they would wish. We will also be launching our innovative wellbeing service integrating rehabilitation and wellbeing approaches to care for both inpatients and outpatients.

CEO’s STATEMENT

At the centre of our strategy is a firm commitment to ‘adapting to the changing world’, by reshaping our services in order to meet the needs of as many people in our community as possible.

We will be extending our Hospice at Home service out to East Lothian providing nursing care that is needed in peoples’ homes. In addition we will be launching our patient transport service which will facilitate ease of admission and discharge for people to our inpatient unit.

We will continue to work in partnership with our health and social care colleagues across Lothian and more nationally to share expertise and resources efficiently providing person centred support. In particular we will explore further research and educational opportunities with Queen Margaret University and University of Edinburgh. The opportunity to share learning and knowledge with the wider professional world will be embraced through our coordination and contributions at conferences and within publications.

Finally, we will be exploring how the Hospice can contribute in different ways to the climate change agenda, exploring practical ways we can make a difference from waste management to the use of electric vehicles to how we heat and run our buildings.

What is not in any doubt is that we will continue to adapt to an ever changing world. We have to in order to best support the families who use our services, our staff and volunteers and our wider community. Flexing and adapting our services to best support those who rely on us is as important now as it was when we first opened our services more than 40 years ago.

Thank you for taking the time to read this review of our impact over 2021-22 and for whatever part you play in our vital work.

Jackie Stone CEO