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30 years of hospice care2011/12

ih Isabel Hospice Local Care for Local People since 1982

AnnuAl Review

In 2012 Isabel Hospice celebrates 30 years of providing specialist end-of-life care to the people of eastern Hertfordshire.

Founded in 1982 by Welwyn Garden City resident Isabel Last, Isabel Hospice’s ethos of care is based on the simple idea that patients are ordinary people living with physical, social, emotional and spiritual needs, who together with their families and friends need support and practical care.

Chief Executive, Nigel Furlong said:

We are honoured to have been able to serve our local community for 30 years, providing local care to local people. We could not have continued to do so without the generous support of the community over those years. The breadth and depth of the services that we now provide have increased greatly since 1982 as we strive to meet the ever more complex needs of our patients and their families in uncertain economic and social times.

However, the underpinning Isabel Hospice ethos of treating the person, not just the illness, has not changed, and we remain as committed as ever to the provision of that care.

Celebrating 30 years2

Messages from the Chairman and Chief Executive ............................................................ 4

Pauline’s Story ................................................................. 6

In-Patient Services .......................................................... 8

Community Nursing .................................................. 11

Day Care Services ........................................................ 14

Allied Health Team ...................................................... 17

Family Support ............................................................ 20

Rob’s Story ..................................................................... 23

Volunteers .................................................................... 26

Education & Training .................................................. 28

Trading ........................................................................... 30

Lottery ............................................................................ 32

Fundraising .................................................................. 34

Key Achievements ....................................................... 38

Aims & Plans ................................................................ 41

Financial Report .......................................................... 42

What Our Patients Say ............................................... 45

Our Service Catchment Area .................................... 46

Our Trustees & Senior Management Team ........... 47

ContentsAll patient stories, quotations and pictures are used with their permission.

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A Message from our Chairman of TrusteesAt the beginning of April, the start of the 2012-13 financial year, Isabel Hospice reached another milestone – its 30th Anniversary. This is a cause for celebration and we have been reflecting with pride on everything the Hospice has achieved since it was founded in April 1982 by an altruistic, committed group of local people inspired by Isabel Last.

From modest beginnings has grown a very sizeable organisation and an important, highly-regarded member of the eastern Hertfordshire community. We are in a new phase in our development now and face challenges of a kind that have not confronted us so far. The changes taking place within the NHS affecting the way in which our services are commissioned and the issues arising from the redevelopment of the QEII Hospital and the Howlands site in Welwyn Garden City are but two.

The care of our patients and their families remains top of our list of priorities. But we will only be able to maintain – and meet the increasing demand for our services – if we are adequately funded. This Review shows how we use our funds to benefit patients and, once again, we thank all those who make donations and support our fundraising activities. We believe we use our resources wisely and effectively.

Countless people work unobtrusively in our support. Some 1,000 serve as volunteers. We could not function without them. Staff and volunteers complement each other and make for a multi-skilled, dedicated team. We thank them all for their hard work and constancy.

In September 2011, Nigel Furlong was appointed Chief Executive and Helen Dodd took on the role of Hospice Director and Deputy Chief Executive. They and the other members of the senior management group work closely with the Trustees.

The Board of Trustees saw four departures during the year – Christopher Bird, Anthea Cecil, Michael Freeman and Angela Lever. We thank them for their contributions, particularly Michael Freeman, whom I succeeded in January 2012. Michael’s commitment to the Hospice over ten years was exemplary.

Charles Lewis Chairman

A Message from our Chief Executive

The care of patients is the raison d’être of Isabel Hospice so this report is threaded through with patient stories. It is those stories and the skill and dedication of our staff and volunteers that inspire me and my colleagues day by day, and I hope will inspire readers to continue to support us as we enter our fourth decade of service to the community.

We have grown hugely over the past 30 years and to sustain the vital patient services, whilst meeting all our regulatory and good governance obligations, requires a tremendous team effort involving a wide range and high level of expertise in clinical and associated patient care, coupled with marketing and sales, human resource, facilities, financial and information management.

It is a privilege to be asked by the Board to lead this team effort and I pay tribute to the hard work and commitment of all our staff and volunteers who have contributed to the successful year just ended. The financial highlights are summarised later in the

report, as are our key clinical achievements and plans for the future outlined by my close colleague Helen Dodd, our Hospice Director and Deputy Chief Executive.

Together we reiterate our Chairman’s thanks for your support over the year; through your generous giving of time, goods and money you demonstrate individually and as a community that you care passionately. Thank you.

Nigel Furlong Chief Executive

To maximise the quality of life of those living with cancer and other life-limiting illnesses.

To provide high quality specialist palliative care, including support for those who are in the terminal phase of their illness.

To support the families and carers of patients, and to continue such support into bereavement.

Our Mission

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Pauline’s Story

Pauline spent some time in Isabel Hospice early last year for respite care. They provided her and our family with great support. They gave her back to us for another two months so that we could spend quality time with her and spoil her rotten. I will be eternally grateful to them for this, and took part in the Midnight Walk, walking with pride in memory of Pauline, and to help other families like us in the future.

Jenny Wilcox, Pauline’s sister

Pauline Saggers sat on the sofa at home, hooked up to oxygen. “I was admitted to the Hospice from hospital, following the diagnosis of life-limiting secondary lung cancer. It was a massive shock for me and my family.

I knew of Isabel Hospice by reputation, and living in Waltham Cross they are a well known local charity. I never expected to use them myself though. When I was in hospital the nurses were good and so was the care, but it wasn’t the expert palliative care I needed. It’s just the little things that make all the difference in the Hospice. I love my baths and in hospital the nurses are so busy, with so many patients to see, I was offered a bowl of water for a wash.

The Hospice nurses had the time to ask me how much I felt able to do, how much help I needed. Just taking the time to talk to me was so refreshing. I knew I could get to the bathroom on my own, and get myself ready for a bath, I just needed help taking my oxygen in. I felt empowered to be able to do things for myself again. One of the best moments was when the nurses asked if I’d like 10 minutes to myself. I just lay in the deep bath, and relaxed. I hadn’t had time like that for weeks.

I had prepared my sons and daughters for the fact that once I was in the Hospice, I wouldn’t be coming home. That was my own misconception. Once there I was surprised to be discussing going home! I thought that was it, I was in the Hospice until the end now, and would be going home occasionally for visits. In fact it’s the other way round! After a home visit where the Hospice Physio and the Occupational Therapist measured up my house and checked it was suitable for me to return there, I was discharged to home. I have made my plans and know that I don’t want to go to hospital as an emergency at the end.

I want, if at all possible, to go back to the Hospice. My children know I will get the best care there, and that has lifted a weight off my mind as well as theirs. But, with the help of the Hospice, I am able to cope at home, and have more confidence. I now have visits from the Hospice Clinical Nurse Specialists, the Physio Team and the Occupational Therapist. Not being able to breathe easily is very frightening. I have been taught relaxation techniques that help with the breathing and have a stair lift and special equipment at home to help me.

I don’t quite know how to explain

how wonderful all the staff and volunteers are at Isabel Hospice.

They all work together there as a team. They have

something specialabout them.

Now, I just take every day as it comes, knowing the Hospice will be there when I need them.”

Pauline Saggers30th July 1951 – 12th April 2012

Jenny and Pauline (right) in happier times.

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In-Patient Services8

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Our In-Patient Unit (IPU) has 16 beds, of which the NHS commission 12.

Our patients are predominantly cancer patients but we also care for patients with other life-limiting illnesses such as end stage renal failure, heart disease, end stage lung disease and Motor Neurone Disease for whom specialist palliative care is needed that cannot be provided at home.

Patients are admitted for various reasons: some may come for care when they have distressing symptoms which cannot be managed at home, whilst for others it is a safe haven where they can be cared for in the last days of their life.

One of our beds is a short stay respite bed. We can offer a short admission of 3 nights to patients under our care who wish to be looked after at home but who have a family carer who needs a short break.

The holistic care we offer means we do not only care for the patient’s physical needs, but also for their psychological, spiritual and social needs. Within the In-Patient Unit we also provide support for family members.

We are proud to have a committed team of health and social care professionals at the IPU, headed by our Medical Director and Lead Nurse and they are supported by specially trained volunteers.

• We provide out-patient services as well as patient admissions

• The atmosphere is relaxed and informal

• The services are staffed by experienced Palliative Care Nurses working alongside Consultants, Doctors, Family Support Workers, Complementary Therapists and Allied Health Professionals

• All our staff and patients are supported by trained volunteers

• There is a flat for family members to use

• Our chef and her team provide nutritious meals to tempt even the smallest appetite

• Beds can be wheeled into our lovely courtyard gardens

• Patients and their families can talk to our Family Support Team about any worries or concerns they may have

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It costs over £2 million to provide In-Patient Services annually

Patients stay an average of 11 days We cared for 278 patients last year in our In-Patient Unit

236 of these were new admissions There were 386 admissions to the Unit during the year, including day cases

52% of patients are discharged to home

In-Patient Services

New initiatives

• We opened a nurse led respite service. The aim of the respite service is to offer short planned admissions (3 nights/4 days) for patients being cared for by Isabel Hospice to provide a break for their carer

• We are now able to admit patients 7 days a week between 9am–5pm. This helps prevent unnecessary hospital admissions

• We have a drop-in craft group which is run by volunteers and is open to patients and carers known to our Community Team as well as patients in the unit

Community Nursing11

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Community Nursing

Our Community Team’s Clinical Nurse Specialists provide end-of-life care to patients and their families, in their own homes, across eastern Hertfordshire. They are all registered nurses with additional specialist skills and knowledge in palliative care or oncology.

They work closely with our Hospice at Home team to enable patients to spend their last days at home, if they so wish, or if the need arises, we can refer them to our In-Patient Unit.

The Clinical Nurse Specialists can refer patients to any other part of our extensive service including Day Care Services, Physiotherapist, Occupational & Lymphoedema Therapists, and our Family Support Team.

• We have 11 Clinical Nurse Specialists – there are no Macmillan nurses working in patient’s homes in the community in eastern Hertfordshire, only Isabel Hospice Clinical Nurse Specialists

• They are supported by our Palliative Care Support Workers as well as fully trained volunteers who provide social support

• Our nurses work closely with GP surgeries, District Nurses, Community Matrons and Practice Nurses to address pain and symptom management

• ‘Home’ can mean a residential house or flat, a care home or specialist unit that supports those with dementia and learning disabilities

• Our Consultant in Palliative Care works alongside our Community Nursing Team to offer both out-patient appointments at our In-Patient Unit and Day Care Services as well as in the patient’s home

• Patients often are visited at home for many months before they may need the care of our In-Patient Unit

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It costs almost £1 million to provide our Community Services annually

1,141 patients were visited across the 254 square miles of our catchment area

Of these, 784 were new to the Community Team

On average we care for these patients for 140 days

9,000 visits were made to patients

We supported 260 patients who chose to to die at home

We supported 90 patients to the end of their lives in their Care Home

11% of our patients visited had a non-cancer diagnosis

New Initiatives

• We introduced Palliative Care Support Workers who cover the whole of our catchment area from Friday to Monday, 9am – 9pm on a rota basis

• All our Day Care Services are overseen by Clinical Nurse Specialists

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Day Care Services

We offer a wide range of Day Care Services throughout our catchment area. This means that patients don’t need to travel too far from home to access specialist palliative day care.

Patients and their family members are able to visit different locations to receive specialist nursing advice and information as well as to benefit from music, art and craft activities and complementary therapies as part of their care.

We have listened to the views of our patients, their carers and service providers, and are providing more targeted Day Care Services, in wider geographical areas. This will mean we are able to see more patients on a weekly basis, in a wider variety of settings and in a more cost-effective way.

• Our Day Care Services are provided in: Hoddesdon, Waltham Cross, Thorley in Bishop’s Stortford and in two locations in Welwyn Garden City

• The atmosphere is relaxed and informal

• The services are staffed by experienced Palliative Care Nurses working alongside Consultants, Doctors, Family Support Workers and Allied Health Professionals

• All our staff and patients are supported by trained volunteers

• We provide drivers to transport patients to and from our Day Care Services if necessary

• Patients often visit these services for many months before they need the care of our In-Patient Unit

Stuart calls the Day Care Centre his “safe place” where he can talk to the nursing staff, relax and take part in the art activities run there. He is currently working on some calligraphy, a skill he learnt there, having not done any art since leaving school. It is a place where Stuart does not need to put on a brave face for his children.

Photo courtesy of Herts & Essex Observer 15

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Our Day Care Services were visited 165 times in Hoddesdon, 172 times in Waltham Cross, 348 times in Thorley, 842 times in Hall Grove and 170 times at our Welwyn Garden City Day Care Service

218 patients used these services last year

Of these 153 were new to our services We had 1,697 attendances at our Day Care Services

Patients attend for an average of six months

There were 4,140 face to face consultations

Day Care Services

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Allied Health TeamPhysiotherapy

Sessions enable our patients to gain confidence and build strength in their body and in their movements. This in turn improves their quality of life and that of their family and carers. They can visit the In-Patient Unit as out-patients, and visit the gym. They can be seen individually or in group exercise sessions.

Occupational Therapy (OT)

Our aim is to help people feel like people, rather than being defined by their illness. Through the work of our OT, they can regain some sort of control over their lives through setting goals to help make everyday actions and routines easier to manage. This could be as simple as showing them a new technique to help with dressing when bending becomes painful or uncomfortable, or more meaningful activities which no longer seem possible such as climbing up steps onto a bus. They can be seen individually or in group sessions with the aim of increasing confidence, stamina, balance and providing relaxation.

Lymphoedema Therapy

Secondary lymphoedema is a chronic condition caused by the build up of fluid in the tissue spaces, commonly resulting in swelling in the arms and legs, although it can affect any part of the body. It occurs as a result of surgery or the treatment of cancer. It impacts greatly on the patients’ quality of life. Our Lymphoedema Therapist works with patients to reduce this swelling and so reduce physical discomfort. Increased limb size can also affect mobility and body image. Lymphoedema care and management aims to reduce these effects.

These 3 services make up our Allied Health Team. They care for patients in partnership at our In-Patient Unit, at our Day Care Service locations and in the patients’ own homes. The therapists work closely with other members of the Hospice Team as well as local medical professionals, Health and Community Services and other charities.

Ray Bevan, age 49 said “The FAB group has been brilliant for me. I found the relaxation techniques particularly useful as I had been suffering from panic attacks and they have helped me keep these under control. They calm me down and make the day go so much better.”

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1,156 Physiotherapy sessions

359 Occupational Therapy sessions

717 Lymphoedema Therapy sessions

Allied Health Team

New initiatives

Fatigue And Breathlessness (FAB) sessions have been introduced by the team with the aim of relieving these symptoms which a life-limiting illness can cause. These are distressing for both the patients and their carers. Through education and guided instruction each participant gains useful tools to help them to open the airways, maintain and increase energy levels and restore control and confidence in their abilities.

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Family Support

The diagnosis of a life-limiting illness is distressing for both the patient and their family. Our Family Support Team is comprised of Social Workers, Counsellors, an Art Therapist, the Complementary Therapy Co-ordinator, Volunteer Therapists, a Lay Chaplain and a Welfare Benefits Adviser who is contracted to us from East Herts Citizens Advice Service. She provides advice and support on claiming appropriate benefits and other financial matters.

The team support patients and their families in individual, family and group sessions, offering practical, psychosocial and spiritual support.

A team of trained volunteers, working under the supervision of the Bereavement Co-ordinator, provides bereavement support to adult relatives.

We also have a specialist Childhood Bereavement Service, including a twice yearly group CATS (Children and Teenage Support), which is available to all children across eastern Hertfordshire, not only children whose relative has been cared for by Isabel Hospice.

• We co-host an annual Family Fun Day and a Christmas Party for bereaved children

• We provide training on some aspects of our work to colleagues, schools and to other external agencies

• Our patients and their families benefit from a range of Complementary Therapies provided by our trained volunteers

• We hold an Annual Service of Remembrance at a different church within our catchment area each year

• We re-launched our local carers support groups

• We are supporting the Hospice “Service User Forum”

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We supported 143 children

275 people were helped by

our Benefits Advisor

721 patients and family members were supported by our Palliative Social Workers

Our Bereavement team provided 845 counselling sessions

588 art therapy sessions were run

Family Support

New Initiatives

• We have a new full time counselling post in place

• We have introduced a programme of therapeutic groups for patients

• A Youth Support Group has been piloted

• Family Support now provides a modular-based programme of groups at our Day Care Service on Tuesday afternoons

• Our Chaplaincy Team is now led by a Lay Chaplain and volunteers

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Rob’s Story

Rob is 63 and was diagnosed with Motor Neurone Disease (MND) two years ago. He knows his condition is terminal and has found the strength of mind to make his end-of-life plans.

“When I was diagnosed with MND, my consultant at the time put me in touch with a Palliative Care Team more or less immediately” explained Rob from Welwyn Garden City. “I had a visit from Di, an Isabel Hospice Clinical Nurse Specialist, and to be honest, I wasn’t in a good place to see her at the time. I had never had contact with a Hospice before, and the thought put the fear of God into me. To me it was a building where people go to die and this was still very early in my diagnosis.

When I saw Di, she explained that they could do so much more for me than I imagined and so initially she arranged for the Hospice Physio Team to see me as I had some shoulder problems. Although I have a phobia of hospitals, and always have had (so much so, that when I drive past the QEII I have to look away), I went along to the Hospice’s In-Patient Unit to meet the team. That was quite a thing for me. However, as I was shown round the Unit, my fears began to diminish. The atmosphere of the place was so different to what I ever imagined.

The physiotherapy on my shoulder gave me great relief, and soon it was suggested I went along to Hall Grove to see what they did at the Hospice’s Day Care Services.

Again I was quite reluctant. I thought “I know I’m old, but I’m not that old!” But I decided to go along on a Wednesday afternoon as I knew it would give my wife Sue a break from caring for me. I am on a ventilator most of the time to help me breathe, including at night, but I don’t use it on Wednesday afternoon when I visit Day Care. It’s a way of having a bit

Looking towards my death, I have always been aware of my own mortality. I have never found it particularly hard to talk about, and so when I was diagnosed with MND I was able to accept it, not deny my fate.

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more freedom. Now, I just love it at Hall Grove and wouldn’t want to not go! I go along to see my friends, I’ve spoken to the Hospice Benefits Adviser, and have managed to find a good barber through word of mouth! I’m amazed at the scope of the Hospice Service. The attitude isn’t all “there, there” and have a cup of tea, it’s practical help given by people who really care about each patient as an individual.

Looking towards my death, I have always been aware of my own mortality. I have never found it particularly hard to talk about, and so when I was diagnosed with MND I was able to accept it, not deny my fate.

I talked to my Consultant and wanted to know exactly what to expect as my condition progressed. I wanted to know in effect how I was going to die and know what my options for living my life with MND would be.

My end-of-life plan means I have visited a funeral director and got that side of things sorted. I know I want my ‘do’ at the local golf club and have even chosen the sandwiches! All the household bills have been transferred into Sue’s name to make things easier after my death. I know I don’t want to go to hospital or be resuscitated should I have a heart attack, but I am happy to be admitted into the Hospice. I have also stipulated what kind of medication I will accept if I fall ill. I have a red folder at home with all the information in and stickers on the fridge to indicate to the paramedics that I have my Message in A Bottle* in there. I have planned as much as I can to make things for Sue that bit easier at what is going to be a terrible time for her.

My attitude towards my condition is I may as well get on with it. I retired at 56 after years in the motor trade. Sue and I had some great times together and when I was initially diagnosed we went on a couple of cruises. I can’t travel now but I can either accept it or fight it and become bitter. What’s the point in that? The Hospice is helping me live my life as well as I can. I’ve never been one to cry over something that gets broken, so that’s my attitude for the rest of my life, how ever long that may be.”

* Message in a Bottle holds the patient’s key information including their wishes for end-of-life care and their medication. It is kept in the fridge as this is an easy place for medical professionals to access in times of emergency. Rob’s Story

It’s practical help given by people

who really care about each patient

as an individual.

The Hospice is helping

me live my life as well as I can.

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Our volunteers bring a range of skills and talents without

which we could not continue to provide the range of high

quality services we do. Their value to the Hospice is so

much more than the financial face value that their donated

skills give to our patients, their families and our staff.

They keep us rooted in our local community and strengthen

our links with those we work with and care for. They help

us put life into the days of those who are terminally ill

by providing empathy, care, enthusiasm and personal

attention along with a collective desire to make a real

difference to end-of-life care.

• Our volunteers give us over 40,000 hours of their time each year

• Volunteering is a win-win activity and we see individuals grow in confidence, competencies and skills

• Volunteering can be patient centred or part of our Administration, Fundraising and Trading Teams

• Many companies and businesses volunteer their time for special projects

• After an extensive induction we offer ongoing training and learning opportunities

• Volunteering offers flexible times and the chance to work as part of a team

• Volunteers are kept up to date with a monthly newsletter

Volunteers

Volunteers

We have around 1,000 volunteers

128 volunteers regularly support at our In-Patient Unit

We have 52 volunteer drivers

We have 69 volunteer cake bakers & 22 flower arrangers

We have 430 volunteers in our shops

We have a volunteer photographer

39 volunteers support us with their admin skills

We have 9 fundraising groups

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Staff education and training enables Isabel Hospice to maintain and develop its high quality specialist palliative care services.

Our internal programme includes a variety of mandatory, clinical and non-clinical topics aimed at supporting life-long learning for staff and volunteers.

We strive to convey knowledge and skills to colleagues working throughout our catchment area in a variety of health and social care settings. We have delivered training to nursing and residential homes, adult care services, GPs, schools, volunteers, complementary therapists, pulmonary rehabilitation teams, Primary Care Trust staff and acute hospital generalist staff.

We continue to support and provide a positive learning environment for pre-registration student nurses and junior doctors.

Education & Training

New initiatives

• We have presented a number of papers at conferences including one at The National Facilitators Conference aimed at providing education to nursing home staff. This enables them to participate in providing excellence in end-of-life care for all, not just those in the Hospice

• Hertfordshire PVI Workforce Development Partnership has provided funding for end-of-life non-cancer neurological education. During 2011-12 we have delivered a multi-professional education programme in relation to specialist end-of-life care for patients and families affected by conditions such as Parkinson’s Disease, Dementia and Motor Neurone Disease

• In conjunction with Mount Vernon Cancer Network we have delivered training for Spiritual Care Advance Care Planning and Communication Skills

Education & Training

130 staff attended external teaching programmes

Within the Hospice environment 79 members of staff have completed record keeping competencies

7 members of staff have completed accredited qualifications

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Trading

The income raised from our 11 charity shops and weekly Lottery, combined with the income raised by our Fundraising Department, goes towards the £3 million plus that must be raised from charitable sources each year.

Our shops can be found across our catchment area of eastern Hertfordshire, with each one staffed by up to 40 volunteers each week. They all have a real community feel and are stocked with donated items so you can always be sure of a good quality bargain!

They are supported by our Warehouse which can be found at our Head Office on Bridge Road East in Welwyn Garden City. From there, additional stock is despatched, as well as it being an easy drop off point for any donations, both large and small.

Our shops are in Bishop’s Stortford, Buntingford, Cheshunt, Cuffley, Hatfield, Hatfield galleria, Hertford, Hoddesdon, Waltham Cross, Ware and Welwyn Garden City.

* Her Majesty Revenue & Customs

New initiatives

• With Gift Aid on donations we can claim an extra 25% from HMRC* on any donated item when we sell it

• We have introduced a new, more efficient till system

• We have a new range of greetings cards including a range of Christmas cards which were the outcome of our first Christmas card competition

• Waltham Cross was converted to a £1 shop and has increased its sales by 40%

£1.88 million of goods were sold in our shops last year

Items were sold in shops ranging from as little as 99p to £400

430 volunteers donate their time to staffing our shops

We are grateful for the support of Sworders Auctioneers who value and sell donated items for 0% commission, making a significant extra contribution to sales

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The weekly Isabel Hospice Lottery was started in 1995 and has supporters who buy anything from 1 to 10 chances per week. They sign up via standing order, cheque, credit card or can purchase their tickets directly from any of our shops.

Supporting the Lottery with a standing order provides us with vital, regular, guaranteed income. This enables us to plan ahead for future care projects.

If you are a Lottery member and would like to increase your weekly chances, or maybe you want to join for the first time, call our Lottery Manager on 01707 382500 to sign up.

£369,000 was raised by Lottery sales

Our top weekly prize is £1,000 with 27 other cash prizes

We sell 200 tickets per week on average in our shops

Around 7,100 people play the Lottery weekly

Some lucky winners donate all or part of their winnings back

to us, and even Gift Aid the donation!

Lottery

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Fundraising

All the services you have read about in this Annual Review are completely free of charge to our patients and their families.

Our team of fundraisers have a value-for-money philosophy and, along with our Trading Company, are tasked to raise £3 million plus as cost-effectively as possible. They run centrally organised events such as On Your Bike, Make a Will Week, The Midnight Walk, golf days, swims and our Lights of Love ceremonies. They also support and encourage local people to raise money in aid of the Hospice in a variety of ways. We are constantly delighted at how many of these events are staged each year, ranging from jumble sales to music events, dinners and dances, sponsored bouncy castle bounces, skydives, long distance walks and cake bakes.

Again, vital volunteer support is in place and we could not be without our fundraising groups and volunteers.

Many people choose to support Isabel Hospice by making donations in memory of loved ones that we have cared for, and others in lieu of gifts for celebration events such as birthdays, weddings and anniversaries. However they choose to support us, we are always grateful.

Leaving a gift in your Will (a legacy) to the Hospice is another way in which people can support us. Over the last few years legacies have become increasingly important to us, and the generosity of those who choose to remember us in their Will is very much appreciated. For those who may not currently be in a financial position to help us as much as they would wish during their lifetime, gifts in Wills are a great way of doing so in a tax efficient way after their death.

Along with individuals, groups and clubs, we work closely with businesses in our local community and beyond. We run successful networking lunches, The 1st Thursday and The 3rd Thursday in Hertford and Bishop’s Stortford, and are supported through donations, sponsorship and gifts in kind from a wide variety of businesses, both large and small.

We are also grateful to all the charitable trusts and foundations who have supported us over the year, in particular those who support us on a regular basis.

No matter how you have supported Isabel Hospice over the year, thank you, we could not continue to provide our end-of-life services without you.

Trusts and Grants We would like to thank those below for their support.

Annandale Charitable Trust Beatrice Laing Trust Big Lottery Fund Borough of Broxbourne Cathedral & Abbey Church of St Alban Cecil Rosen Foundation Children in Need Childwick Trust Freemasons Grand Charity Heath Charitable Trust Help the Hospices Herts County Council Herts PVI Workforce Development Partnership Hospice Aid UK James Tudor Foundation Jarvis (Harpenden) Charitable Trust Ladbrokes in the Community Charity Lynn Foundation Michael Game Charity Norman Evershed Trust North Mymms Parish Council Simon Gibson Charitable Trust Sir Jules Thorn Charitable Trust Summary Ltd

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We received £595,000 in donations

£87,000 was raised in Gift Aid alone which gives us 25p extra from HMRC* on every £1 raised

£3,700 was raised from jumble sales

We were gifted £833,000 in legacy income

£11,000 was raised from our Sunflower Appeal in June

Wherever possible we use email to save on postage costs

* Her Majesty Revenue & Customs

Fundraising

New initiatives

• As our networking lunch The 3rd Thursday went from strength to strength in Bishop’s Stortford, we started a new event, The 1st Thursday in Hertford

• We embraced the world of social networking with a Facebook page and a Twitter feed, both of which have proved popular ways to promote our fundraising events free of charge

• We held our first Midnight Walk in September, sponsored by Roche pharmaceuticals which raised £40,000

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Key Achievements

The Hospice is now obliged to submit a Quality Account to the Department of Health outlining our key achievements and plans for the future; this Annual Review has for some years summarised achievements and plans as a matter of good practice, as recommended by the Charity Commission, so what follows is a synopsis of the Quality Account, the full version of which can be found through our website (www.isabelhospice.org.uk).

Helen Dodd, Hospice Director and Deputy Chief Executive

Clinical objectivesOur aims and plans for 2011/12 covered a range of clinical objectives which were measured externally against three Hertfordshire-wide goals set by the Hospice’s commissioners, the NHS Hertfordshire Primary Care Trust. They seek to ensure patients’ care is planned with their own and their families’ agreement, and encourage informed choices to be made about the nature and place of care. We consistently achieve the results that we as a Hospice are able to influence, but we continually strive to improve further the standards we set ourselves.

In addition we set ourselves a number of internal objectives to further strengthen and develop our services; these included:

Review of Education and Quality DepartmentA review was undertaken which demonstrated the need to reorganise roles and responsibilities. It was identified that the department should be led by a Head of Quality, Clinical Compliance and Training, supported by a Lecturer/Practitioner (already in post) and an Auditor, for implementation in 2012/13.

Day Care Services During 2011/12 a review of our Day Care Services was undertaken.This led to reorganisation of Day Care Services to tailor more closely the different types of care in order to meet the diverse needs of our patients.

Patient records The use of our electronic patient information system continues to be an important part of care planning and provision. During 2011/12 it continued to be reviewed with new information requirements added. Access is carefully controlled to ensure that there is only access for those providing clinical care, audit and management information so that confidentiality is maintained.

Staff attitude survey

During the year the Hospice undertook its first ever, independently run, organisation wide staff satisfaction survey. With 58% participation the result benchmarked well, but key areas for management action were training and development, and internal communications. Specific action plans are in the process of implementation and the survey will be repeated annually to track the results and monitor changes in attitudes.

Six year old Jamie Martins, whose Mum was cared for by the Hospice, organised a mini marathon for his classmates to raise money in her memory. Jamie was just 4 when she died. He said “I like running and I wanted to help Isabel Hospice because they looked after my mummy. Daddy was very surprised when I told him, and very pleased.”

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Our Family Support Team runs a popular weekly coffee morning for bereaved relatives at Hall Grove Day Care Service. It has up to 40 regular members who come along to meet people in similar situations as themselves, receive complementary therapies, and have a cup of coffee.40

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Aims & Plans

Priorities for improvementPRIORITY ONE – PATIENT SAFETYHigh levels of patient care and safety are our number one priority. We have strong audit, inspection and anecdotal evidence that we achieve high standards but we recognise the need to remain focused on, and continually improve all aspects of patient safety, particularly in the environment of the In-Patient Unit where we provide 24/7 care.

PRIORITY TWO – CLINICAL EFFECTIVENESSObviously our staff are key to providing high quality care so we continue to invest directly and indirectly in their development, support and competency development, and indirectly in tools to improve their effectiveness. We are therefore planning to;

A) Implement new e-learning training courses which will develop clinical competencies.

B) Further develop the Hospice’s electronic patient information system so that patient records and associated data are easily accessible and usable.

PRIORITY THREE – PATIENT EXPERIENCEThis priority is strategic in its nature; in particular it will involve developing an integrated care pathway with other healthcare providers involved in end-of-life care. It has two main components;

A) A service strategy with East & North Hertfordshire Clinical Commissioning Group.

The current contract for services with the PCT expires in March 2013, so our priority is to agree the service configuration with the new Clinical Commissioning Group (CCG), ready for April 2013 and beyond.

The focus of the strategy will be on providing patients with the best possible experience in the place they call home, commensurate with their safety and their family’s/carers’ needs. This will entail examining carefully how best to use our limited resources on what we, as a hospice, do best – providing specialist palliative care.

B) Planning for reconfiguration of services at QEII site in Welwyn Garden City.

The Hospice’s In-Patient Unit is currently attached to the QEII Hospital which will be replaced by a new local general hospital on an adjacent site by the middle of 2014. The Hospice is exploring options that will put the patient experience at the heart of the design concept.

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Financial Report

We have changed our financial reporting procedures this year with the aim of giving greater clarity to how much it costs to run the charity and how these costs are funded. We wish to record our thanks to the NHS Hertfordshire Primary Care Trust, the grant making bodies listed on page 35, and our many individual and corporate supporters who provide the majority of our funding.

2011/12 2010/11 Variance £000s £000s £000s Direct costs of Patient Services £3,324 £3,239 £85Indirect costs £697 £658 £39Governance costs £92 £133 (£41)Total cost of Charitable Activities £4,113 £4,030 £83

Income from NHS Hertfordshire £1,584 £1,655 (£71)Fundraising income £1,488 £1,457 £31Legacy income £833 £1,873 (£1,040)Trading income £2,252 £2,127 £125Investment income £24 £16 £8Total income (gross) £6,181 £7,128 (£947)

Costs of income generation £2,231 £2,186 £45Total income (net) £3,950 £4,942 (£992)Net surplus/deficit (£163) £912 (£ 1,075)

The previous financial year (2010/11) was exceptional in respect of legacy income. In 2011/12 we kept costs flat and worked hard to compensate for a reduction in NHS funding, giving rise to a small increase in non NHS income and the result that we are left with a small deficit. This is manageable within our reserves, but is the focus of our efforts to balance the budget over the next few years, which we have begun in 2012/13. The role of legacy income in providing reserves to cushion fluctuations in income cannot be overstated, and we are very grateful to all supporters who remember the Hospice in this way.

Footnote: Full statutory accounts, audited by Nicholsons, Chartered Accountants of Hatfield, will be available on request to the Company Secretary, 61 Bridge Road East, Welwyn Garden City, AL7 1JR, from 1 October 2012.

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Where our money came from How our money was spent

Investment Income 1%

Grants 4%

Event Income 15%

Shops & Lottery 13%

Donations 13%

NHS Income 35%

Legacies 19%

Governance 2%

Fundraising & Publicity 12%

Medical 11%

In-Patient Unit 45%

Community Care 21%

Other Patient Services 9%

We could not operate without all of our volunteers who enable us to care for our patients and their families and who raise funds for us in our offices, in local groups and in shops. We are also grateful to all those other individuals and organisations, too numerous to mention, who have supported us.

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Roy said

This isn’t the life I thought I was going to have, but it’s a good one. The care I have had has been marvellous. I would give the Hospice the world if I could.

What Our Patients Say

Mark said

The Consultant from the Hospice has just been so brilliant. She is the most marvellous person. She completely sussed me out. I was always one for leaving taking the drugs until I really needed them. Now, whatever she tells me to do, I’ll do it. She phoned me over the weekend to see how I was. She made me understand that the drugs were there to help me enjoy my life, she helped me ‘get it’, she taught me how to think differently about them and I am so grateful to her.

Helen said

We never knew how much help was out there until we got referred to the Hospice. I have so many people with specialist knowledge just at the end of the phone. I don’t know what we would do as a family without them.

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Our Service Catchment Area

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Board of Trustees Charles Lewis, Chairman

Geoffrey Perrin, Deputy Chairman

Christine Brown

Anne Collins

Sophie Cowan

Dr Richard Dent

Marlene Duke

Christopher Garrett

Jill Geall

John Morris

Barbara Newman

Life Presidents: Barbara Doherty MBE, John Lockhart

Senior Executives

Nigel Furlong , Chief Executive

Helen Dodd, Hospice Director and Deputy Chief Executive

Lisa Seccombe, Director of Fundraising & Public Relations

Matt Seccombe, Director of Trading

Dr Dee Traue, Medical Director – Consultant in Palliative Care

Sue Balcombe, Head of Human Resources

Pauline Willson, Deputy Director of Hospice Services

Isabel HospiceRegistered Office: 61 Bridge Road East, Welwyn Garden City, Herts AL7 1JR Tel: 01707 382500

Registered Company Number (England & Wales) 3056823. Registered Charity No. 1046826

Find out more at www.isabelhospice.org.uk Like us on facebook Follow us on twitter ih

Our Trustees & Senior Management Team

Every day of every week of the year, Isabel Hospice provides specialist care for patients and their families living with cancer and other illnesses.

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STANDING ORDER FORMPlease cut out and return to: Fundraising, Isabel Hospice, 61 Bridge Road East, Welwyn Garden City, Herts AL7 1JR

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until further notice and debit my Account No: ................................................

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Recipient Bank Details: Pay Co-operative Bank (08-02-28) for the credit of Isabel Hospice Account No. 65424870

GIFT AID DECLARATIONI would like Isabel Hospice to treat all donations that I make from the date of this declaration until I notify you otherwise as Gift Aid donations. I pay tax on earned or unearned income and will have paid sufficient tax to cover the tax reclaimable on my donation(s) to Isabel Hospice.

Signed: .....................................................................................................................................

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(to find out more about Gift Aid go to our website www.isabelhospice.org.uk

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Regular Giving is precious to us

To provide this service annually costs £4.2 million, of which we plan to raise £2.6 million from fundraising and trading, with £1.6 million coming from the NHS. To achieve this we rely heavily on the generosity of our supporters.

By making a regular donation you can help us to be there for more people who need our care and support. This also means we can plan for the future with greater confidence. Ensuring the security of the Hospice means we will be there for future generations.

Your Regular Gift will enable us to continue to help those living with cancer and other life-limiting illnesses.

Regular Giving

30 years of hospice care2011/12