Background to Harlington Hospice Association
The Association was founded in 1984 by a number of neighbours in Harlington led by Reg and Mary Hopkins who, through their work in the local pharmacy, had seen that there was a need for such an organisation in the local community.
Since then the Association has grown steadily and last year 1570 patient visits were made to the Day Centre and 5000 hours of nursing care provided at home.
The mission was to provide quality care and compassion to those within the community who are suffering from an illness they cannot recover from coupled with an understanding that this quality care and compassion is best provided by other local people directly. Neighbours looking after neighbours. The mission remains the same today.
Key Milestones
- Within a few years £125,000 had been raised to purchase a detached house, Victoria Lodge, which became the headquarters of the Association.
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- Fund raising continued and in 1993 the Hospice at Home service was started. This service provides nursing care and support to patients in their own homes.
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- 1994 saw the beginning of Bereavement Counselling and this team continues to grow, making a large number of visits last year.
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- In 1995 the Hospice was able to occupy on a rental basis a single storey extension of a local doctors surgery, Lansdowne House, and a Day Care centre was opened to the first patient early in 1996. The day centre was named Reg Hopkins Day Care Centre in memory of the founding member who had sadly died in 1990.
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- Initially the centre was opened for one day and as referrals have grown this has been increased to four with Friday being used for training, information and bereavement support group sessions.
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- Lansdowne House itself came on the market in 1999 and the association had, by this time, raised the £550,000 required to purchase it, selling Victoria Lodge for £225,000 at the same time.
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The acquisition of Lansdowne House with its increased number of rooms and extensive gardens provided the Association with the opportunity to consider the future needs of the community and what the response to these should be.
Year 2003 has already seen a number of new activities
- Augmenting our Hospice at Home service we have recruited a four person permanent team of nursing staff providing care and support for patients and grown our 'bank' of part time nursing staff to 10. Referrals to the hospice come largely from Community Nurses, and GPs and it is the growth in referrals which supports this unit.
- Increased the treatment days available at our Lymphoedema Clinic to five per week from February 2004.
- Will raise close to £900,000 revenue income, an 80% increase on 2002/3.
Continuing Need for Palliative Care in Hillingdon
The Borough of Hillingdon has a population of 250,000 located in three areas, Hayes & Harlington, Uxbridge & West Drayton and North Hillingdon, with a population of around 80,000 in each.
The first two areas have higher levels of deprivation than North Hillingdon - leading to health inequalities. Health inequalities lead to higher levels of illness and mortality (HHA Area Health Report 1999).
It is in these two geographical areas where the hospice, located in Hayes & Harlington, sees its main opportunity to help.
In the year ended March 2000 around 700 people in Hillingdon required palliative care for cancer related illnesses. 557 were referred to the Palliative Care Unit in Hillingdon and it is assessed that a further 25% (139) were not referred.
Other progressive life threatening diseases would also benefit from palliative care and numbers are estimated to be of the same scale as cancer. There are therefore around 1400 people in any year in Hillingdon who would benefit from some or all aspects of palliative care.
Discussion with Community McMillan Nurses indicate that 50% of above patients would benefit from care in their homes ranging from Hands on Care to a respite sit and that 60% would benefit from visiting a day care unit.
Current Response to the Need
The practice of enabling patients to remain at their home for as long as possible not only responds to the natural and expressed desires of the patients themselves, but has proved to be cost effective when compared to conventional care. The services provided by the Association therefore reflect this by providing a range of interventions designed to enable patients and their carers to sustain a quality of life within their own environment.
Referrals to our services come from the following sources:
| Source | Hospice at Home | Day Care |
|---|---|---|
| Specialist Palliative Care Services | 30% | 70% |
| Community Nurse | 20% | 15% |
| GPs | 35% | - |
| Relative or Self Referral | 15% | 15% |
| Total | 100% | 100% |
We have consulted with our two major referral sources and have concluded that there remains a considerable need in our community which remains to be met.
Future Response to Need
We believe that there remains a significant need for a professional care within Hayes & Harlington and Uxbridge & West Drayton. Available evidence supports this. We can contribute, as neighbours, by expanding our Home Care, Hospice at Home and Day Care Services. Together these provide a flexible, comprehensive and integrated package of care which allows patients to make choices and changes regarding the input they receive. The contribution of volunteers in service delivery ensures that community involvement is an experience as well as an organisational structure.
The purchase of Lansdowne House enables us to address the space and level of service issue.
We aim to double the number of patient spaces available by increasing the daily capacity from 10 to 15 and to open 5 days per week. The additional space available will enable us to provide Staff Training, Information and Bereavement Support without limiting the number of patient spaces.
This much enhanced increased ability to care, in a dramatically improved environment, will reinvigorate both paid and volunteer staff and supporters ensuring that the compassion and care essential for our work will continue to grow.
Philosophy of Care
All services share some common values - enabled by the independent status of the Association.
The involvement of users of the service and their carers is fundamental in ensuring that the facilities offered are useful and appropriate. A culture of participation is nurtured in place of a passive 'patient' role as a consumer of services.
The individual life needs of patients have to be accommodated if the exclusion of certain client groups is to be avoided. For example, experience has shown that parents of school age children can become users of the Associations services and so the Association will make provision so that child care needs do not form a barrier to access.
The ethnic diversity and richness of our community is reflected in our provision, in particular by recognising the contribution that volunteers can make if representative of the whole community.
The Association recognises that access should be available to younger people who are suffering from illnesses from which they will not recover and specific facilities will be made to enable their participation.
The use of complementary therapies, in a considered way, is seen as providing a unique and valuable contribution to patients' well being.
Involvement with patients extends to connections developing with their carers and families. The Association is committed to providing services to carers during the patient's illness and after death in supporting peer groups and providing bereavement counselling.
The Association is committed to providing quality in all its activities and to a culture of monitoring and review so that responsiveness to need is endemic. It will continue to be prepared to innovate as a means of meeting the needs of its patients whether those needs are physical, emotional, psychological or social.
Finance
The Associations financial position has always been carefully managed and the financial position of year 2003 and forecast for year 2004 is as follows:
| Year End £'000 |
||
|---|---|---|
| Feb 2003 | Feb 2004 | |
| Income | 502 | 880 |
| Expenditure | (504) | (674) |
| Surplus/(Deficit) | (2) | 206 |
| Balance Sheet | ||
| Fixed Assets | 559 | 625 |
| Current Assets - Cash | 168 | 310 |
| Current Liabilities | (38) | (40) |
| Net Assets | 689 | 895 |
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