Transforming End of Life care in Surrey

Our team today David PerryChairman Nigel HardingChief Executive Dr Fiona BaileyMedical Director and Consultant in Palliative Medicine Pam WalmsleyDeputy Director of Clinical Services

Agenda Setting the scene Our care services The challenges we face Planning for the future Conclusion

Setting the scene Our services are working at full capacity, serving over 5,500 patients and their families every year Our current structure and facilities will not allow us to meet the increase in demand we expect from an ageing population with complex end of life needs The NHS challenge is keeping people out of hospital and beyond 2015 we have no certainty that we will have the ability to retain our site in Weybridge We have conducted a strategic review which has led to plans we believe will transform Hospice provision

Total numbers of patients

Comparing usage to giving:

Setting the scene The review produced a challenging Strategic Plan for the Hospices. With two key recommendations: to reshape the organisation, moving to a single in- patient unit to grow capacity in day care and community care services The loan from Woking Borough Council has enabled the Hospices to act quickly on these recommendations One in-patient facility with two community hubs

Our care services

Hospice support in the home Community Clinical Nurse Specialists In-patient care Day care units – over 2,600 attendances Counselling for adults, young people and families Complementary therapists Occupational therapy Physiotherapy Spiritual care

The challenges we face

Growing need for Hospice care 39% increase in the number of patients admitted since % increase in patients referred to our Community Teams since % increase in attendances to Day Care 20% increase in non-cancer referrals in the last two years

Pressure on care services expected to increase Annual mortality rate is set to rise by 2016 People are living longer and more likely to have chronic disease The number of people living with Cancer will increase By 2021 over 1 million people will be living with dementia Projected 135% increase in population aged >85 by 2033

The need for our services has grown extensively and now we must plan for the future

Options Do nothing – would result in longer waiting lists and an increase in hospital admissions Develop Woking Hospice site – cost approximately £4.5m – access to land denied, option not feasible Search for a green-field site and build a new hospice approximate cost £12m – timescale years Re-design an existing building – costs approximately £6.3m – timescale 3 years

Strategic choice Preferred option is to re-design an existing building to house a new hospice facility including a 20 bed in-patient unit Appropriate building identified in Goldsworth Park, Woking Loan of up to £6m to acquire and re-design building granted by Woking Borough Council to be repaid over 50 years Loan unlocks Hospice plans and allows speedy implementation of Hospice strategy in all key care services areas

In-patient beds Community services Day care services Enhanced service efficiencies Transforming end of life care

In-patient beds We need to keep 20 beds open 20 beds on one site will improve delivery of service: Ensure consistency Enable prioritising patients with greatest need Serve patients with complex needs better Improve delivery of patient care Ensure high quality care Cost savings – reinvesting in services

Community services We will be able to support an increasing number of people in their communities and in their homes Continue to develop a responsive service that meet the needs of the community to enable them to stay at home Improved facilities from which the teams delivering this service can be housed Improved capacity to deliver education

Enhanced service efficiency Repatriate our Counselling services Space for equipment storage Inadequate parking facilities for our visitors which has caused distress to patients and their families at times Administration and Fundraising departments back under one roof with the rest of the services

Conclusion We will implement our plans and will provide regular progress updates We will continue to work to improve our services The re-location of beds from both Hospices will not happen until 2016 Through our care provision we are aware of the close bonds between people and communities to both in-patient facilities We will work hard to ensure the transition is managed as sensitively as possible