A ‘first of its kind’ service will allow more terminally ill people to choose to spend their final days in the comfort of their own home.
The new ‘Hospice@Home’ scheme, which was unveiled on Friday, will support individuals in their last two weeks of life as well as providing assistance to their carers.
It’s an ambitious service from Strathcarron Hospice that’s been a year in the planning, and it looks certain to be in demand from the off.
According to the National Survey of Bereaved People, only one third of those who express a preference for dying at home actually do so, with the remainder confined to hospitals or hospices.
It’s situation caused in part by a nationwide lack of trained staff working in the community as well as a lack of funding.
That’s something that the team at Strathcarron want to change. The facility in Fankerton, near Denny, cares for individuals reaching the end of their lives from across the Falkirk district and the wider Forth Valley area, and has long held ambitions to increase its ‘at home’ care.
Senior staff identified it as a ‘missing link’ in their provision and began to plan how it could be established. It will “fill in the gaps” among existing services.
It’s a service that is becoming increasingly common in England and Wales, but Strathcarron believes it is the first of its kind in Scotland - although a similar project is being run in Ayrshire.
Hospice@Home will be free to patients but, like any quality healthcare provision, it’s an expensive project to undertake.
A major hurdle was cleared when Strathcarron secured a £700,000 grant from the Big Lottery Fund which will cover 70 per cent of the costs over the next five years. Additional funding will be provided by the Robertson Trust and NHS Forth Valley Endowments.
Hospice chief executive Irene McKie said that securing a Big Lottery Fund grant was crucial to establishing the service.
“It’s all about empowering the patient. There’s lots of evidence that people want to die in their own homes and not in hospital,” she said.
“We’re not taking over from the district nurse or GP, we’re adding another dimension.
“This will make a huge difference to patients and their carers. The Hospice@Home team will provide compassionate and practical support for people at what can be a very difficult and challenging time.
“It will give patients and carers the confidence they need to stay at home where possible, and will complement services already provided by the NHS, social work and Strathcarron’s clinical nurse specialist team.”
Marjory Mackay, director of nursing at Strathcarron, will oversee a team of experienced healthcare assistants who will work with patients and their carers in their own homes. The average visit is expected to last two hours, but nurses will be free to work at their own discretion.
“They will provide emotional and practical support as well as personal care, to allow patients to stay at home in their last days of their life, if that is their wish,” she said.
“The service recognises the importance of spending time with people nearing the end of life, to listen to their concerns and to help with the things that are most important to them. It can do this in a number of ways, including providing personal care and comfort measures, providing information and supporting carers in the uncertainties of caring for someone at the end of life.
Jenny Stevenson, who will manage the service, said its philosophy is exactly the same as the hospice itself.
“Like Strathcarron, we will strive to improve the lives of people who have advanced illness, helping them to live well until they die”
The Hospice@Home team comprises four healthcare assistants who have experience in hospice care and have undergone additional palliative care training.
If there is a high demand for the service, Strathcarron has a formal arrangement with Crossroads Carers to support it.
The service will work in partnership with health and social care workers from across the are to ensure seamless care for patients and families at the end of their life.
Referrals can be made by any healthcare professional in primary care seven days a week at any time between 9 a.m. and 5 p.m. The only referral criteria is that a patient is identified as being in the last two weeks of life (with any diagnosis) and that they wish to spend their remaining days at home.
“The service aims to respond quickly. Someone could be referred on a Sunday and a nurse can see them that same day,” Irene added.
“You can’t leave it till Monday if someone wants to go home today.
“Obviously there are always going to be some patients where it will be more suitable for them to enter a hospice.
“And there will be some patients who improve and their need for support declines. They can be discharged and re-referrals at a later stage are welcome.”
Irene and her team are eager to expand Strathcarron’s range of services when possible.
“There is so much more that we could be doing if we had the funding. Every year it is a really hard struggle. I don’t think people always understand the complexities of the servies that we can provide. We know we are efficient, we know we are offering a high quality service.
“Strathcarron will need to raise £170,000 over the next five years to support Hospice@Home alone.”
Regardless of the cost, this is a service that the Strathcarron team believes is vital and can only enhance patient’s care.