1. 1 What is Hospice Palliative Care? The Canadian Hospice Palliative Care Association defines hospice palliative care as a special kind of health care for individuals and families who are living with a life- threatening illness that is usually at an advanced stage. The goal of palliative care is comfort and dignity for the person living with the illness, as well as the best quality of life for both this person and his or her family. A "family" means whoever the person considers to be family. It may include relatives, partners and friends.

2. 2 Care at Home More than half of the people registered with North Shore Palliative care choose to die at home, close to family, friends and familiar surroundings. Although we have strong partnerships with the Home & Community Care Nurses and other home support services, we do not have the benefit of a Palliative Response team.

3. 3 History of Macmillan Nurses In 1911, a young man named Douglas Macmillan watched his father die of cancer. Douglas wanted advice and information to be provided to all people with cancer, homes for patients at low or no cost, and voluntary nurses to attend to patients in their own homes. In 1911 he established the 'Society for the Prevention and Relief of Cancer', providing information on recognising, preventing and treating cancer to patients, doctors and members of the public.

4. 4 1924- It became a Benevolent Society changing name to 'National Society for Cancer Relief', providing practical help to patients and their families. 1930- First paid member of staff is appointed. 1969- began to support in-patient care, making first contributions towards building hospices. 1975- first Macmillan nurse and Macmillan cancer care unit funded 1978- 10 th Macmillan Nurse funded. 1986- 1 st Macmillan Doctor funded. 1989- Name changed to 'Cancer Relief Macmillan Fund'. 1991- Macmillan Nurse Appeal launched to raise £20 million. 1993- 1000 th Macmillan Nurse appointed. 1997- changed name to 'Macmillan Cancer Relief‘. Information Line opens. 1998- Macmillan National Institute of Education (MNIE) opens, with 10 lecturers for training specialist cancer care professionals. The Information Line helps more than 11,000 people during its first year of operation. 2006- Name changed to Macmillan Cancer Support.

5. 5 Macmillan Nurses in UK For many people affected by cancer, Macmillan nurses are a valued and trusted source of expert information, advice and support - free of charge. There are over 3000 Macmillan nurses across the UK, working both in hospitals and in the community. 99% of the funding is from supporters of the campaign.

6. 6 Funding for Macmillan support Macmillan nurses are usually employed by the NHS and their posts are funded by Macmillan for a set time, commonly the first three years. After that time, the long-term funding is taken up by the NHS or other partner organisations.

7. 7 What do Macmillan Nurses do? Macmillan nurses specialise in cancer and palliative care, providing support and information to people with cancer, and their families, friends and caregivers. Macmillan nurses offer the following: specialized pain and symptom control & emotional support both for the patient and their family and/or caregiver give care in a variety of settings – in hospital (both inpatient and outpatient), at home or residential setting. provide information about cancer treatments and side effects offer advice to other members of the caring team, for example district nurses and Residential Care nurses co-ordinate care between hospital and the patient's home

8. 8 Macmillan nurses do not carry out routine nursing tasks, such as personal hygiene, changing dressings and giving medicines. Macmillan focuses mainly on people affected by cancer but are increasingly sharing experience and working with colleagues caring for people with other conditions and do therefore provide some support for non- cancer patients Macmillan nurses usually work normal office hours. The service is 90% pro-active as opposed to reactive

9. 9 Patients generally consider that hospices are the end-of-line. Our aim- To build the idea that Hospice promotes living life and making every moment count. To be seen as experts at creating healing environments for palliative care. To ensure that our clinical environments include the essential supportive services needed to meet personal, emotional and practical needs, as well as treating the medical symptoms. A ‘Community Centred Hospice’

10. 10 To offer a clinical, educational and advisory resource, which appropriately meets the assessed needs of the local population. To provide accessible, auditable and accountable end of life care, reflecting evidence-based practice. Our Aim

11. 11 Our Goal To provide specialist care to patients, caregivers and families who are facing complex physical, emotional and practical difficulties arising from advanced progressive life-limiting illness. We believe in respecting the individual's dignity and choices and enhance the quality of care for patients in all care settings through partnership, collaboration, advice and education.

12. 12 An innovative approach Our aim is to bring Community and Hospital together within the Hospice. Community Nurses and Hospital Nurses will rotate through the North Shore Hospice. For the first time they will work side by side; sharing and collaborating.

13. 13 We recognize that our greatest resource is our highly trained and skilled workforce and the community of volunteers and supporters who have together developed the strong sense of shared ownership enabling us to excel. Recognition