Bringing hospice care into patients' home
It was just a small error, but it signifies a common misconception. When a national newspaper reported the death of the television presenter Keith Chegwin, it said he died at Severn Hospice.
He actually died at home, where he had been receiving care from the hospice, but deputy chief executive Heather Palin says most people still think of hospices as places where people come to spend their final days.
"For every five patients we get, four will be receiving care at home," she says. In 2016, the last year for which figures are available, a total of 3,499 patients were visited at home by members of the hospice team. The figure will almost certainly be higher for the past 12 months, and the length of time that the hospice cares for patients is also much longer than it would have been in the past.
"Ten or 15 years ago, most of the people we cared for would have come in as inpatients for their last few days," says Heather.
"They can now come in when they are quite well, they may have just been diagnosed with a terminal illness. We can now be caring for a patient over a number of years."
This, of course, means that there is much more variation in the level of treatment and care needed by the different types of patient, and to reflect this the charity is spending £4 million on new buildings as part of a shake-up of how it is run.
The bulk of this investment will go on a new purpose-built centre at the hospice headquarters in Bicton Heath, although the newer building at Apley Castle in Telford will also be updated.
The reorganisation will see outpatient care split into two different streams, depending on the severity and intensity of the condition.
The Living Well service will see specialist nurses visiting patients in their own homes to check on their welfare, and ensure that their medication is working as it should.
"Ten or 15 years ago, most patients would come to a bed, and would stay with us until they died.
"But being diagnosed with a terminal illness no longer means that a patient will not have a useful life ahead of them," says Heather.
"We can care for a patient for a number of years, but we only provide beds for them in their last two or three weeks.
"For most of the time they will be cared for at home, and the support they receive will depend on them."
For example, a recently diagnosed patient in good help may only need to receive occasional visits, to check on their welfare and whether their medication is working correctly.
Over time the illness is likely to progress and may become more debilitating and require more attention, still in the home.
At this point, there might be a "crisis" – an episode where in the past the usual solution might be for the patient to be admitted to hospital. However, under the new regime, the idea is that hospice nurses will increasingly be able to provide such treatments in the home, avoiding the need for them to go to hospital. This will also benefit the health service, freeing up valuable hospital beds.
For patients with greater care needs, the Hospice at Home service – which supported Keith Chegwin in his final weeks – is also being extended, to provide both daytime and overnight services.
She says part of the expansion plans are to create areas which look less 'clinical', and will provide activities where people can take part in social activities and receive a wider range of therapies.
Becky Richardson, deputy director of care and matron for community services at Severn Hospice, says the changes come after many months of looking at how the charity can improve the support it offers to meet future needs.
"It means is that more patients will have access to the care they need, helping them stay at home and avoid unnecessary admissions to hospital," she says.
“The changes form part of our wider strategy to invest and expand our community services enabling us to better meet the needs of the people of Shropshire and mid- Wales."
The role that the hospice plays in Shropshire should not be underestimated. Latest figures from Public Health England show that approximately one in 10 adults in the Telford and Wrekin at the end of their lives are receiving hospice care, and 7.5 per cent for the rest of the county. Nationally, the figure is five per cent.
Paul Cronin, Severn Hospice chief executive, says: “We are the only adult hospice service in Shropshire and Telford and Wrekin so these figures underline how important and how successful our strategy has been in providing care to people in the community. However demand for our services is growing each year and we need to expand our services accordingly.
“We are caring for more patients each year than ever before; we care for more of them at home than in our buildings and we are caring for more people for longer.
“This is what’s driving our Living Well strategy and why we are enhancing our at home provision and building in community services to our future plans.”
