Report 2015 – 2016
This is a brief summary of the activity of the Charity over the past 18 months. It will report on activity, management functions and nursing issues, with sections on finance and fund raising.
Between 1st June 2015 and 31st Aug 2016, we received 87 new referrals for assessment. During the same period, we nursed 82 patients.
The outcomes for those patients are as follows: 44 died at home, 26 died elsewhere (hospital, nursing home or hospice bed), and 12 remained on the active rota at 31st August 2016.
During this period, severe disruption to the senior Nursing staff arose due to the untimely death of one of our most active team members, and the temporary but lengthy absences of our Nurse Manager due to family circumstances. This led to a recruitment drive to initially employ 2 new permanent Nurse Co-ordinators with direct nursing hours and a revision of the nursing model to ensure the service can deliver more direct nursing hours, both during the day and also at night for those who need them. Our Nurse Manager has now returned to work and a third Nurse Co-ordinator has recently been appointed.
In response to the loss and absences of key members of the nurse management team in mid 2015, and a recognition by the Trustees that the Charity had grown to the extent that it needed to review its structures and processes, a Management Sub-committee was appointed, comprising 4 Trustees, to assist the nursing team with both short and longer term management issues and to develop and improve operational services. The Management Sub-Committee meets weekly and is joined by members of the nurse management team. The Sub-Committee was also tasked with preparing for registration of the recently incorporated Charitable Incorporated Organisation (CIO) with the Care Quality Commission (CQC) with the intention that the CIO will take over the activities of the Charity shortly after registration.
In addition, a new Nominated Individual has been identified for appointment to support the Registered Manager in line with CQC requirements.
Completing the CIO’s application for registration with the CQC remains a managerial priority for the Trustees, as does increasing the level of activity of the Charity. To this end, the Charity is supporting Bereavement counselling sessions and looking at ways of receiving referrals and providing support particularly for non-cancer patients earlier in the patient pathway, possibly before active nursing is required.
An Office Manager has been appointed and is resident at the new office premises in The Ellen Badger Community Hospital.
During the year, longstanding secretary James Little retired as Secretary following a period of handover to his nominated successor, Richard Lloyd.
Chris Owen remains the Treasurer and Clive Irwin is Chair. As well as acknowledging James’ outstanding support since the Trust started in 1997, the Charity also bade farewell to 2 other Trustees (Flora Ashmead-Bartlett and Alan Joy) who had given much value and advice to the team. Meetings continue to be held quarterly, with much of the operational work now devolved to the Management Sub-committee.
The Charity remains in a strong financial position, with reserves boosted by a generous local bequest. The annual accounts to the 30th June 2016 are with the independent reviewer and will be available to view on the Charity Commission website in the early part of 2017. The Charity continues to receive financial support from the NHS for the services provided to patients which meets some of the running costs of the Charity.
Fundraising/ Marketing / Publicity
Fundraising continues to be successful, maintaining a steady flow of income from largely local community ventures. The efforts of the fundraising team led by Rebecca Mawle, who calls on a vast array of local supporters and volunteers, is to be commended. The Fund raiser event par excellence for the Charity remains the Nursing Ball which has been deferred till Sept 2017 to coincide with the 20th anniversary of the Charity’s inception.
The Charity does not have any in-patient beds of its own, but can refer patients to local facilities as needed, e.g. Ellen Badger Hospital Community Hospital via local GPs. However, this year, the Charity has taken a tenancy of an office suite at the Ellen Badger Community Hospital which is proving very useful as an administrative base and for nursing handover and team meetings. It is located next to the offices of the District Nurses based at the hospital with whom the Charity’s nurses work closely on patient care. The proximity of the two offices has resulted in a closer working relationship with the District Nursing team and improved co-ordination of patient care.
The Trustees embarked on a review of both the structure of the Charity and the service it provides in 2014. This review received added impetus with the appointment of the Management Sub-committee which was tasked with taking the review forward.
Early on in the review the Management Sub-committee identified the difficulty experienced by the nurse management team in providing night sits at times when they are important to support both patients and their carers. The difficulty is inherent in a structure heavily reliant on bank nurses. A retainer system was put in place and has resulted in greater availability. The aim of the Management Sub-Committee is to have at least one nurse available to do a night sit on every night of the year. The operation of nights sits continues to be reviewed by the Management Sub-Committee.
The Management Group also identified the inherent problem of relying on bank nurses when seeking to expand both the number of patient being cared for and range of patients to whom care can be provided. There are now nurses and co-ordinators employed to work contracted hours thus guaranteeing their availability.
The earlier introduction of patients to the Charity’s service is something the Trustees consider will benefit patients and this is to be trialled with the Shipston GP Practice once the criteria for referrals has been established. It is thought that some non-cancer patients will benefit from this in particular and criteria for referrals has been drawn up and is being consulted upon.
The Charity has responded to a criticism about the process of referral which arose from the lack of referral to the Charity in a particular case. This did not involve a patient receiving care from the Charity or any issue regarding quality of patient care, but rather the reliance of the Charity on third parties to operate the referral process to access the service. This was dealt with in correspondence and two meetings were attended by trustee representatives. The Charity has drawn on the circumstances of this case during its review of the procedures to access its services which is on-going as part of the service review.
A year of significant change not only in terms of personnel, but also strategic direction to deliver the services now offered by the Charity through a CIO and expand our activity and capability by appointing new contracted staff, and the inception of a new Management Committee.