North Devon Hospice, Barnstaple

Project summary

Filling gaps in provision for a large, rural hospice which had struggled to recruit an in-house palliative care consultant.

Background

Based in Barnstaple, the North Devon Hospice (NDH) serves one of the largest, most remote areas in the country, taking patients from a patch that spans around 800 square miles. The hospice provides community nursing and a Hospice at Home service, as well as a seven-bed unit and an outreach centre. It is run as a charity, with 168 staff and an annual budget of around £6 million.

The challenge

The hospice’s in-house care had been headed up for many years by Dr Murray Fletcher, an experienced Palliative Medicine Consultant, with extra cover provided when needed by consultants from the North Devon District Hospital (NDDH).

When Dr Fletcher retired in 2019, the NDH leadership team struggled to recruit a replacement, and while the NDDH team were able to provide daytime support, they didn’t have the capacity to cover the hospice’s full OOH rota. This risked leaving the in-house team without access to a more senior opinion for part of the week.

The CEO approached his network for support, at which point another hospice recommended SCUK.

Our solution

We began by sharing the OOH care with consultants from NDDH, providing cover from Friday mornings to Tuesday mornings, as well as two nights each week. This evolved over time to include additional daytime cover, and to fill any gaps when the NDDH team were on annual leave.

Initially, there was some concern from NDH’s internal team about how quickly our consultants would be able to respond, and about relying on people with whom they hadn’t been able to build a working relationship. We responded by putting in place ice-breaker meetings to get the rapport going between their team and ours. We also scheduled a briefing meeting at the beginning of each weekend, ensuring that our consultants were up to speed on any complex cases and would be able to take swift action if called.

Impact and outcomes

The team at NDH have noted that, as well as filling gaps in provision and finding a solution for their recruitment issues, the partnership has greatly improved staff confidence. Their in-house teams feel supported to make swift, accurate decisions and provide outstanding care, even in complex cases, because of the experience and expertise that our consultants provide.