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A Chronological Review of the Development of Hospice at Home West Cumbria 

1986         
  • October: 
  • Meeting of the Macmillan and Marie Curie Nurses which recognised a need to develop the existing service to provide a service for non-cancer patients.
  • November – December:
  • Letter to Statutory and Voluntary Organisations explaining the idea and inviting them to a Public Meeting
  • December:
  • First fundraising raffle raised £750
1987     
  • January:
  • Public meeting – 350 people present – 36 volunteers came forward at the end of the meeting, some of whom are still involved with the organisation
  • First meeting of volunteers – included a solicitor, an accountant, nurses and nurse managers, a GP.  Agreed that the following were needed:
  • Trustees
  • Trust Deeds
  • Application to become a Registered Charity
  • February:
 
  • Second meeting – Nomination and Agreement of Trustees
  • Arrangements made for different committees:
  • Council – Trustees, Solicitor, Accountant
  • Executive – Council plus elected members
  • Fund raising – Groups around the area.
  • April:
 
  • Application for registration with The Charity Commission granted
  • June:
  • Fundraising had been exceptionally good and £30,000 had been raised.  A network of “Friends & Helpers” was developed.
  • Meeting with the Health Authority, agreed that the service could begin on 1st September 1987 as £30K guaranteed, £10K per year of nursing care over the next three years.
  • September:
  • First patient given night care from West Cumbria Hospice at Home.  The Day and Night Nursing Service had started only 9 months after the first public meeting – how long would that have taken if we had decided to build a Hospice.
  • West Cumbria Area Health Authority agreed to act as Pay Masters, this was a huge benefit to the organisation.
  • The service was managed alongside the Marie Curie Nursing Service by Adult Community Services
  • October:
  • Public Launch
  • Dowager Lady Egremont became President of West Cumbria Hospice at Home
  • DR. E.B. Herd    - Chairman
  • There was a video showing the work of Hospice Services plus a talk
  • An Auction of Articles and Gifts donated from local firms and individuals raised £5,000
  • West Cumbria Area Health Authority provided a Nurse Manager  

 

1988/89

 

  • Continued to have three-monthly meetings with West Cumbria Area Health Authority.  Gradually increased the amount of money available for the Day and Night Nursing Service.  Intentions had always been to provide a full and comprehensive Hospice Service.
1990/91     

 

  • An NHS Grant enabled Hospice Day Care to be introduced to the service. 
  • “Joint Care Planning Funding” secured for three years enabled the appointment of a part time Volunteer Co-Ordinator    
  • “Drop In’s” were introduced in conjunction with Macmillan Nurses who were employed by the Health Authority 
  • The West Cumbria Hospice at Home Membership Association was formed - for an annual subscription of £3 members received a quarterly newsletter, a copy of the Annual Report, the right to vote at the A.G.M and eligibility to be nominated to the Executive Committee.  This helped people to feel involved and was a means of information sharing.
1991     

 

  • October:
  • Medical Director was appointed – took up post in January 1993 for five sessions per week working in the community.

 

1994     

 

  • Introduction of Lymphoedema Clinics.  Initially the clinic was run by a Sister and a Staff Nurse.  The Medical Director attended and assessed all new patients.   

 

1995     

 

  • Medical Director’s post increased to eight sessions per week.  The additional three sessions were funded by West Cumbria Health Care NHS Trust and the Medical Director worked as Consultant in Palliative Medicine based on the specialist inpatient unit in West Cumberland Hospital, the local District General Hospital
  • A Memorandum of Agreement was undertaken with West Cumbria Health Care NHS Trust who continued to provide a Nurse Manager for the service.  In addition to using NHS Payroll there was confirmed access to Human Resources, Occupational Health, the provision of accommodation and the majority of equipment – apart from the one and only computer which belonged to Hospice at Home!!  Six-monthly meetings were held with managers of the NHS at a local level:-
  • This continued through until 2002.  At that time West Cumbria PCT became the commissioners for all Palliative Care Services, whilst Eden Valley PCT became the providers.
  • In 2005 this became North Cumbria PCT 
  • In 2006 this became Cumbria PCT
  • August:
  • A group representing the Northern Regional Health Authority visited all parts of the region to assess Palliative Care services.  They were impressed with the service in West Cumbria and the integration that existed.  This was in line with the recommendations in the recently published Calman-Hine report.  It was advocated that this should be a model of care recommended across the region.
  • November:
  • A Medical Clinical Assistant appointed for five sessions per week working with Consultant in the Palliative Care Unit and across the wards at West Cumberland Hospital.  This post was funded by the NHS but continued the unique partnership between Hospice and the NHS.
  • Lymphoedema clinic increased to two clinics per month.  Clinical Assistant attends some clinics.

 

1996     

 

  • Finance Office opened at Strawberry How, Cockermouth.  A part time secretary appointed for 3 mornings per week, but finances were still managed by the Honorary Treasurer

 

1997     

 

  • October:
  • Due to the pending retirement (March 1998) of the Nurse Manager, plans were made for her replacement.  Owing to the increased workload West Cumbria Hospice at Home agreed to fund 40% of the post.  A part time Macmillan nurse was appointed to relieve some of the clinical workload.
  • New Nurse Manager appointed with a six month handover period.

 

1998     

 

  • March:
  • His Royal Highness, The Prince of Wales, agreed to become Patron of West Cumbria Hospice at Home.
  • Prince Charles visited Cockermouth Castle, home of Lady Egremont and met with some of the Trustees.  On another occasion Prince Charles visited the Hospice Day Centre in Cockermouth.

 

1999     

 

  • July:
  • Discussions took place with Egremont Rotary Club and they agreed to purchase and install an IT system for the Hospice linking into the NHS.
  • September:
  • Joint meeting with North Cumbria Health Authority, West Cumbria Health Care NHS Trust and the Chief Executive of West Cumbria Primary Care Group to discuss possible future developments.    
  • November:
  • Meeting with Trustees of West Cumbria Hospice at Home and the Chief Executive and Business Manager of West Cumbria Health Care NHS Trust.  Memorandum of Agreement updated.  Office accommodation discussed and new offices to be found as present offices inadequate.
  • Trustees met with Voluntary Action Cumbria and a Consultant to arrangements made for an organisational review in the early part on 2000. 
  • Mrs. Pam Kirk, Clinical Nurse Advisor Palliative Care, Wakefield and Pontefract Community Health Trust, was invited to undertake a Clinical Review of the service.

 

2000 

 

 

  • February:
  • Organisational review commenced.
  • New offices identified at Workington Infirmary, the local community hospital
  • March:
  • I.T. Hardware and Software equipment ordered
  • April:
  • Moved into the new office accommodation at Workington Infirmary, complete with fully installed IT system.  The improvement was immense – the service now had SIX offices (previously there were two small linking offices lovingly referred to as the “shoe boxes”)
  • May:
  • Organisational review completed.  Recommendations to be discussed and carried forward by Council
  • September:
  • Following review and planned resignation of Hon. Secretary and Hon. Treasurer, adverts placed for full time member of staff to carry out these previously voluntary roles.  The member of staff would be responsible for the general management of the charity and would be responsible to the Trustees.
  • Discussions also took place regarding employing another full time secretary for the clinical office.  

 

2001     

 

  • January:
  • Full time Secretary/Treasurer appointed, based at Strawberry How with part time finance secretary.
  • Full time Volunteer Co-Ordinator/Secretary promoted to Office Manager. 
  • New full time secretary appointed to clinical services in Workington Infirmary. 
  • West Cumbria Hospice at Home changed from a charity governed by a Trust Deed to a Company Limited by Guarantee.
  • April:
  • First Charity Shop opened in Cleator Moor
  • The committee structure was revamped; a Clinical Development Group and a Management Team were established. 
  • The venue for the Whitehaven “Drop In” centre was moved to The Senhouse Centre which enabled Complementary therapies to be given.
  • September:
  • Launch of the “Friend in Deed” scheme – working with volunteers to help care for people at home by acting as a ‘good friend’.
  • December:
  • The first Lights of Love Service took place in St Joseph’s School, Workington.

 

2002     

 

  • January:
  • Introduction of a Palliative Care Night Nursing Service.  This meant Hospice nurses were no longer “alone” at night and had a colleague to call on for advice and support.
  • July:
  • The Chairman of Hospice (Dr E.B Herd) stood down as Chair after 15 years
  • Full time Hospice Nurse Team Leader appointed. 
  • Further changes were made to the Committee Structure

 

  • Board of Directors/Trustees
  • 10 Trustees
  • Legal Advisor 
  • Administrator
  • Promotion and Development Group
  • 2 Trustees
  • Administrator 
  • Nurse Manager 
  • Volunteer Co-Ordinator 
  • 6 Elected members 
  • Rep from North Forum of Fundraisers 
  • Rep from South Forum of Fundraisers
  • Finance Group
  • Hon. Financial Advisor/Trustee
  • Hon. Accounting Advisor/Trustee 
  • Administrator
  • Management and Clinical Development Group –the 2 groups amalgamated.
  • Hon. Medical Advisor
  • Hon. Nursing Advisor/Trustee 
  • Trustee 
  • Medical Director 
  • Nurse Manager 
  • Administrator 
  • Office Manager/Volunteer Co-ordinator 
  • Nurse Team Leader 
  • Day Care Sister.
  • August:
  • New Chairman appointed (Mrs Margaret Dowling)
  • The Hospice Nurse Manager resigned 
  • A new Trustee appointed
  • October:
  • Appointment of a part time staff nurse for the Lymphoedema service as part of succession planning. 
  • Following the resignation of Dr Brian Herd as Chair, Dr John Howarth was appointed as  Honorary Medical Advisor

 

 

2003     

 

  • January:
  • Appointment of part time Day Care nurse as part of succession planning.
  • Two new Trustees appointed to bring the number of Trustees/Directors to ten.
  • March:
  • Day Care/Lymphoedema staff nurse retired
  • New Clinical Services Manager appointed as a joint post with West Cumbria Hospice at Home and Eden Valley PCT.  The post holder to work as part time Service Manager and part time Macmillan Nurse. 
  • A job description and work plan drawn up and sent to the Regional Board for the possible appointment of a second part time Consultant in Palliative Care for West Cumbria.  This was to be another joint appointment between West Cumbria Hospice at Home and the PCT. 
  • An office was secured in Workington Infirmary to replace the Finance Office at Strawberry How in Cockermouth which had to be vacated by May 2003.   
  • Active negotiations began to build a purpose-built Day Care Centre in Workington which was to replace the premises currently rented in Cockermouth. 
  • Investigation into securing premises in Whitehaven or the surrounding area continued.
  • May:
  • A Bereavement Project Officer was appointed to map existing bereavement services available throughout West Cumbria, and to highlight unmet need and plan an improved bereavement service for the future.
  • The first Hospice Away Day combining Managers, Senior Staff, Trustees and Macmillan Nurses looking at where the Service began, where it was at that point in time and where it should be going in the future. 
  • Another re-organisation of the clinical management structure – the larger group separating again:
  • Clinical Development Group
  • Senior Management Team
  • November:
  • Appointment of Fundraising and Admin Manager

 

 

2004     

 

  • March:
  • Long serving Honorary Finance Manager and Trustee (Mr Michael Roberts) retired
  • Honorary Medical Advisor (Dr. John Howarth) resigned owing to work commitments 
  • First official visit/inspection from National Care Standards Commission
  • May:
  • Appointment of new Trustee and Honorary Medical Advisor (Dr Terry Collins)
  • Joined forces with Hospice at Home Carlisle and North Lakeland to deliver joint Mandatory Training for Hospice nurses.
  • July:
  • 2nd Away Day facilitated by Dr John Howarth
  • North Cumbria Palliative Care Website launched.
  • October:
  • Founder member of Trustees resigned (Mrs Felicity Watson)
  • Five Health Care Assistants completed the Northern Cancer Network Palliative Care Workbook
  • November:
  • Cleator Moor Charity Shop moved location

 

2005     

 

  • January:
  • Cockermouth Hospice Day Care moved to Victoria Cottage Hospital in Maryport owing to uncertainties and problems with existing premises in Cockermouth
  • March:
  • Hospice at Home moved into the new Workington Community Hospital PFI building.  The clinical team remained together with the Macmillan nurses and the Finance & Fundraising Team also moved in alongside the clinical team.
  • Bereavement project was completed 
  • Finance Manager resigned and replacement appointed.
  • August:
  • Full-time secretary emigrated to Australia and replacement appointed
  • October:
  • Original Honorary Secretary and Trustee retired (Mr Jack Frearson)
  • Practitioner with Special Interest in Palliative Care appointed (Dr Maggie Bober)

 

2006     

 

  • January
  • Bereavement Co-ordinator appointed
  • Agenda for Change process was undertaken to establish co-ordination with NHS salary structure
  • March
  • North Cumbria Palliative Care Website won The Cumbria and Lancashire Strategic Health Authority Achievement for Effective Use of New Technology
  • Dr Brian Herd retired from Board of Trustees.  Brian had been inspirational in the establishment of West Cumbria Hospice at Home and was Chairman from 1987 until 2002.
  • July
  • Cockermouth Drop-In moved to the United Reformed Church Rooms to enable Complementary Therapies to be provided.
  • December:
  • Fundraising Manager resigned and replacement appointed

 

2007     

 

  • April:
  • Winners of Impact Award from Glaxo Smith Kline in association with The Kings Fund.
  • New Hospice Shop opened in Workington
  • May:
  • Commenced Living for Today programme
  • July:
  • Finance Manager retired and replacement appointed
  • Legal Advisor (Mr Graham Pratley) retired and replacement appointed
  • September:
  • Mrs Margaret Dowling, Chairman and first Nurse Manager of Hospice, retired due to ill health.  Margaret was the corner-stone of Hospice for many years and an inspiration to many working in palliative care.
  • Dr Terry Collins appointed as Chairman for a three-year period.

 

 

2008 

General

 

    Name changed to Hospice at Home West Cumbria and new logo adopted.

    •   Twenty First Anniversary celebrations launched at Ingwell Hall and ran until  February 15th 2009 
    •  Lord Judd of Portsea became new President in October 2008 
    •  Board membership increased with broader experience base of the Trustees.

     

     

    Administration

    •  Website updated.
    •  Improved security procedures.
    •  Commitment to introduce administrative staff appraisal.
    •  Successful replacement of retiring staff.
    •  Recruitment of Volunteer Co-ordinator proceeding.

     

    Governance

    •  Formal procedures agreed for recruiting new Trustees
    •  Review of staff contracts due 2009.
    •  Reinstatement of Registration as Nurse Agency (CSCI), unannounced inspection took place with maximum grading possible.
    •  New registration as Domiciliary Care Agency - proceeding.

     

    Clinical Services

    •  Help the Hospices funding enabled extension of Living for Today programme to make it available to carers.
    •  Extension of complementary therapy service.
    •  Extension of lymphoedema service provision with some re-structuring and additional staff training. 
    •  Review and restructuring of Day Services and Support Services including providing services in Millom.
    •  Review of bereavement provision.

     

    Education and Training

    •  Establishment of the Margaret Dowling Memorial Fund to support education and development of hospice staff (paid and volunteer).
    •  Higher degrees being undertaken by Medical Director and Clinical Services Manager.
    •  Graduate Diploma in Lymphoedema management successfully completed by lead lymphoedema nurse.
    •  New North Cumbria Palliative Care website.

     

    Finance

    •  Improved income from legacies, grants and trading.
    •  Investment Management Company appointed to manage invested funds.

     

    Fundraising

    •  New design and contents of the Annual Report.
    •  Restructuring of fundraising function with Fundraising Manager becoming part time and appointment of Community Fundraiser.
    •  Grant and event income sustained.

     

    Involvement with other Organisations

    •  Cumbria Primary Care Trust - Cumbria End of Life Care Strategy  Group - voluntary sector input - Closer to Home.  
    •  Other Hospices  
      •  Meetings with Chair and Clinical Lead Carlisle and North Lakes H@H 
      • Meeting with Chairs of other North Cumbria Hospices.  
      •  Meetings of North West Regional Hospice Chairs.  
      2009

       

      General

      •  21st Anniversary Celebrations completed with Thanksgiving Service on 15th February 2009, including a commissioned poem.
      •  Extension of Patronage of HRH The Prince of Wales until March 2014.

       

      Governance

      •  Revised Mission Statement and Aims agreed.
      •  Business Plan (2009-11) agreed.
      •  Template for Governance Code started.
      •  Terms of Reference of sub groups reviewed.
      •  Service Users Guide updated.
      •  Trustee retirement and re-election in rotation started.
      •  Registration and inspection as a Domiciliary Care Agency (Care Quality Commission).
      •  Legal adviser (Mr Michael Rowell) retired and Mr Gareth Mendus appointed in his place.

       

      Finance and Fundraising

      •  Surplus on 2008-09 accounts - added to reserves.
      •  New Website established.
      •  New Charity Shop in Cockermouth planned.
      •  Successful bid to Big Lottery Fund for Living for Today from Sept 09.  £111,000 secured over 5 years.
      •  Successful major fundraising  event – Ladies Midnight Walk in June raised £127,000.
      •  Legacy initiative – ‘Make a Will’ fortnight in October.

       

      Educational development

      •  The Margaret Brown Clinical Resource Fund established.
      •  Exploration of potential overseas links.

       

      Structure and Administration

      •  Bereavement Services Review. 
      •  Appointment of Volunteer Coordinator.
      •  Administrative support for CSM.
      •  Anomalies in Bank Nurses Salaries addressed.
      •  New End Of Life Care Provider Forum (PCT led ) for Cumbria.
      2010

      A joint trustee committee was established with membership from the three North Cumbria Hospices, with the aim of presenting the range of end of life care services in North Cumbria to the public whilst fully recognising  the independence of each hospice.

      Two additional Trustees joined the Board to complete the programme of strategic recruitment to ensure expertise end experience in appropriate areas - Dr Rob Walker is a practising GP who was previously Medical Director for Cumbria PCT and Mr Steven Bostock who is a Senior HR Manger at Sellafield. There are now no Trustee vacancies.

      Inspections by the Care Quality Commission were undertaken with a two star (good) rating confirmed for the Nurses Agency registration and, following a key inspection, the rating for the Domiciliary Care Agency registration was improved to two star (good). The registration arrangements changed again in late 2010 and the Clinical Services Manager(CSM) became the responsible individual (rather than the chairman). A detailed staff survey was undertaken by the CSM with very positive feedback.

      A Family Bereavement Support Worker, Carol Green, was appointed.  Changes to Day Services were identified and a streamlined referral route into the service initiated.

      There was a surplus on the 2009-10 accounts which was added to the reserves.  A new shop opened in Cockermouth thanks to the generosity of John and Eileen Cusack who gave the charity the premises rent free for five years. This year’s Ladies Midnight Walk had 1500 entries and likely income of around £100,000. There were several innovative fundraising events and Barbara McLeod joined the fundraising office, primarily to administer the midnight walk.

      The Margaret Dowling Fund attracted a wider range of applicants from within Hospice and the Trustees agreed to top up this fund annually for its duration. Links between the End Of Life Care Observatory at Lancaster University and clinical professionals in Vietnam were established by a Trustee.

      Linda Hewitt, our Clinical Service Manager, successfully completed the inaugural Masters Course in Hospice Leadership at Lancaster University. This had been established by the university in partnership with their international Observatory on End of Life Care and Help the Hospices. Graduates were all high level managers at Hospices throughout the country with the course attracting national press interest.

      Dr Eileen Palmer our Medical Director was awarded the Fellowship of the Royal College of Physicians and also successfully completed a Master of Studies degree at Oxford University in Mindfulness Based Cognitive Therapy with a distinction.

       

       2011

      One trustee, Eleanor Hodgson, resigned from the Board due to pressure of work. A system of regular reporting to the board via subgroups was established and a protocol for the rapid handling of serious clinical incidents was introduced. The Charity was complaint at CQC inspection and a CQC Group was set up chaired by the Clinical Services Manager. A further staff satisfaction survey was undertaken

       The Charity won a bronze award 2012 GlaxoSmithKline IMPACT Champions Award – we were one of eight previous IMPACT Award winners who were short listed from 100 applicants. The charity was accepted onto the first tranche of the Monument Trust/Help the Hospices Whole Board Development Programme initiative .

       There was a surplus on the accounts for 2010-11 which was added to the reserves, helped significantly by legacy income and another successful Midnight Walk. Banking account changes were made to increase investment income. Shop trading remained satisfactory and a part-time Supervisor appointment made at Cockermouth. Successful applications were made for start –up funding of a Whitehaven shop (in 2012). The Board agreed an initiative to increase lottery income and the Charity was named as the main beneficiary of the Workington Paint the Town Red event in 2012. Gillian Moore was recruited to support the Finance Manager due to increased activity.

       Family and Bereavement Support training of the first set of volunteers was competed (40 hours over 10 weeks). An additional Nursing Sister, Carol Gibbs , was recruited to support the Nurse Team Leader and a Facilitator for the ‘Six Steps’ programme appointed - an initiative funded by the Cumbria and Lancashire End of Life Care Network to provide supportive input into care and nursing homes.

       A ‘Hospice Hub’ was established to streamline and review referrals into Hospice Support services, providing a single point of access. Day Care was closed in August and replaced by the development of new tailored support services. Linda Hewitt moved to Hospice full time, as Clinical Services Manager in September.

       In December the Finance and Fundraising team moved to separate, nearby off-site offices, facilitated by the Cumberland Building Society, with much improved space for work and storage. This allowed increased space for the clinical side on the hospital site. The Joint Hospice Trustee Committee continued its work with focus on a joint leaflet and a joint professional conference in 2013.

       

       2012

      The 25th Anniversary of the charity was launched in March.

      The Help the Hospices/ Monument Trust Board Development Programme concluded. Significant recommendations were made which the Trustees accepted. Linda Hewitt, previously Clinical Services Manager, was appointed Chief Executive and a new wholly executive Senior Management Team was established. A three year plan was formulated and new Advisory Groups to the Board were set up.

      Three long serving trustees, Mary Todd, Peter Allen and Geoff Brown, retired and two new trustees, Dennis Lydon and Bernard Courtney, were recruited following open advertisement. The Honorary Medical Advisor resigned and the Board decided not to make a replacement.

      There was a small deficit on the Financial Year 2011-12 with clear evidence of a much harsher fundraising climate. A Finance and HR administrator was appointed, with the charity undertaking its own payroll from April. All fundraising events showed a reduced return, but the Workington Paint the Town Red Day named the charity as its beneficiary. A fourth shop was opened in Whitehaven. In anticipation of the retirement of Bob Barnby as Fundraising Manager in the spring of 2013 an overlap Marketing and Income Generation Manager, Deb Muscat, was appointed.

      A number of staff changes included Christine Daniels as the Shop Supervisor at Cockermouth and Louse Cann as the Manager at Whitehaven. An apprentice, Jessica Morris, was appointed in collaboration with Lakes College and the Coalfields Initiative. In another collaborative initiative with the Cancer Network a ’ Deciding Right’ Facilitator was appointed. Additional administrative support was provided for Home Nursing by Emma Southward.  Alison Wood (Jackson) resigned as Volunteer Co-ordinator and Wendy Blackburn replaced her, but left in December. Maggie Bober retired as a Specialist Practitioner, latterly Locum Consultant, in December.

      Carol Gibb became the Therapy Lead and Carol Green the expanding Family Support Services Lead, with Karen Pirt as interim support to the latter service. Carol Green began an MA in Hospice Leadership and the Family and Bereavement Support training was accredited by the University of Cumbria.

      The Joint Hospice Trustee Group become Cumbria-wide including by including St Mary’s Hospice Ulverston.  A joint evening meeting was held, and another joint event was addressed by Jonathan Ellis from Help the Hospices.  A Joint Conference is planned for 2013.