2014 - 2015

Quality Account

“The service provided is invaluable both to ourselves in helping to provide palliative care and to our patients and their families. Without you, more would be dying in hospital rather than at home in their preferred place of care”

Quote from a District Nurse October 2014 Reporting period: 1st April 2014 - 31st March 2015

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Contents Chief Executive’s Statement Page 2 Part 1 - What we achieved in 2014 - 2015 Page 3

Part 2 - Mandated Statements Page 7 Part 3 - Quality Overview Page 8 Part 4 - Priorities 2015 - 2016 Page 20 NHS Southern Derbyshire Clinical Commissioning Group (CCG) Statement Page 22

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Chief Executive’s Statement On behalf of the Board of Trustees and Senior Management Team I welcome you to Treetops Hospice’s 2014-2015 Quality Account. Treetops Hospice is considered pivotal to palliative care provision within our catchment area, and is highly respected by our health and social care partners. This account will reflect on the significant progress that we have made during 2014-15, and report on our key priorities for improvements to services for patients and families in 2015-16. Treetops Hospice’s success is thanks to a dedicated and committed clinical team and together with our Board of Trustees I would like to thank them for their continued commitment to providing excellent patient and family care. Through the NHS transformation programme, we recognise that partnership working with our colleagues in the community and acute trusts will need to increase. We look forward to more collaborative working that will improve and streamline patient care. One of our most exciting developments during the last twelve months has been the opening of the Support and Information Service. Through client feedback we are already aware of the benefits that this service offers to those who have either been newly diagnosed or for those that need support through the transition of discontinued treatment plans and instead facing end of life decisions. I am responsible for the preparation of this report and its contents. To the best of my knowledge, the information reported in this Quality Account is accurate and a fair representation of the quality of healthcare services provided by Treetops Hospice. Our corporate and clinical governance structure ensures that we have both the systems and processes in place to maintain a viable and responsible business, whilst ensuring that our services are of the highest quality and meet the aspirations of our mission statement: “Where every day counts.” George Cameron Chief Executive June 2015

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Part 1: Looking back at what we achieved in 2014 - 2015 With the recent changes in the inspection process of the Care Quality Commission (CQC), we have not had an inspection since January 2014. However, we are aware that the hospice will be inspected in the next 12 months following submission of a Personal Information Return. The clinical team will lead on the inspection, but familiarisation of the new regulatory system is a requirement across the wider organisation and therefore training and awareness will be a priority. We have updated our five year strategy document that identifies both planned development of service provision and improvement priorities.

Priorities for 2014 – 2015

1. To open the new Clinical Support Centre that will be known as the Cheetham Centre in recognition of our founder, Cally Cheetham.

Our founder Cally Cheetham visited the Hospice in July 2014 to officiate at the celebration and opening of our new Clinical Support Centre. This was witnessed by staff, volunteers and selected guests including local dignitaries and stakeholders.

2. To develop and enhance Day Care Services

We are pleased to report that our newly appointed Day Care Services manager was successfully recruited in May 2014. The benefit of having an overall Day Care Services manager who has the added responsibility of the Support and Information Service has promoted a more cohesive multi departmental approach to care. February 2015 saw the introduction of a weekly heart failure clinic led by a Clinical Nurse Specialist from Derbyshire Community Health Services. Both psychological and occupational Day Care activities have been developed and explored to enhance the guests’ experience and quality of life. An example of a psychological activity was the provision of mindfulness sessions delivered by a professional trainer. Occupational activities included visits to a garden centre, cake decorating, a culturally challenging visit and performance by The Ladyboys of Bangkok and the extraordinary visit of “Party Animals” that gave our guests the opportunity of holding and petting small mammals, reptiles and a tarantula spider. The introduction of a monthly clinical managers meeting has provided a forum to explore how our therapeutic services can be optimally developed and managed.

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During the year we launched a peripatetic complementary therapy service which has been greatly appreciated and successful in providing therapies to patients in their own homes. Criteria for this service are that the patient is unable to travel to the hospice, and is generally in the last weeks/days of life.

3. To review Carers’ Support

A scoping exercise for carers was carried out by a carers’ development worker. This has resulted in the development and provision of a Carers Support programme of six workshops to commence in June 2015. The subjects explored within the programme were identified by carers and include: planning for an emergency, dealing with guilt and anxiety, and anticipating and dealing with loss.

4. To develop Hospice at Home Services

Our Hospice at Home coordination team are now located in the Cheetham Centre. This much improved environment not only provides a much larger office space to work in but also has a manager’s office that is utilised for confidentiality and also provides a much more suitable place to make and receive bereavement/ condolence calls and other sensitive communication.

Our target to provide 33,000 hours of care was not achieved but we did increase our hours to 31,220. This equates to a 4% increase on the previous year. We provided 4,614 episodes of care during the year compared to 4,219 the previous year an increase of 9%.

The continued high quality and satisfaction of the service was evidenced in the annual evaluations received.

5. To continue the nursing team development programme

Our Nurse Educator has successfully completed the first of two modules to gain her Post Graduate Certificate in Inter-Professional Practice Education. As an identified target we have increased our training/ education sessions to every six weeks. The sessions have been well attended and our nurses have received support and advice regarding the new code of conduct and re-validation requirements. The development of our Nurse Educator has been fundamental to providing an enhanced training programme for our nursing workforce. This is key in supporting our trained nurses through the Nursing and Midwifery Council planned re-validation process. To ensure that our training programme is appropriate for all of our services and to meet the needs at all levels of qualification across the teams, the nurse educator works collaboratively with two of our Health Care Assistants, one from each of the Day Care and Hospice at Home teams.

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We now have two certified manual handling trainers on the nursing staff who are responsible for organisational and clinical training.

6. To develop the Bereavement Service

Following the successful re-location of the service into our purpose built suite of offices and counselling rooms within the Cheetham Centre, the service has expanded to provide 2,459 support sessions, an increase of 44% on the previous year.

The student placement service has proved to be extremely successful project and has been instrumental in providing the significant increase in activity. The quality of training and supervision afforded to the students has resulted in Treetops Hospice becoming a coveted placement for students. This has allowed us to be very selective of those to whom we offer a place. To support this cohort of students and the development of our existing volunteer team, an extensive educational programme has been facilitated.

7. To launch and develop a new Support & Information Service

In September 2014 we launched our Support and Information Service which was

supported by two open evenings where health and social care professionals

alongside warm corporate supporters were invited to the Cheetham Centre to view

the bespoke facilities and to have the opportunity to talk to the clinical leads.

Another landmark for the service was the success of a grant application made to the Big Lottery for the first five years funding of the service. This additionally supported the recruitment of a part-time administrator who with the Clinical Nurse Specialist will support a growing team of dedicated volunteers.

In the first seven months we have provided 96 sessions to 113 individuals. All sessions are assessed using an adapted Macmillan ‘levels of intervention’ classification tool.

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8. Partnership working

The Director of Clinical Services remains an active member of the Southern Derbyshire End of Life group. She is also a member of one of the four work streams identified in the five year transformation strategy for Southern Derbyshire. Work stream four is responsible for “Dignified Long Term Care” associated with the growth of the elderly population. The group will ensure that End of Life care remains a priority for the CCG, whilst ensuring that equitable care of the highest possible standard is available to all wherever their care is being provided. To achieve this goal, it is recognised that communication and partnership working across both health and social care providers is both co-ordinated and embraced by all providers. Additionally, with the nationally agreed withdrawal of the use of the term and concept of End of Life care pathways, the director has also been involved in the development of a supportive care plan that can follow a patient on their End of Life journey and promote delivery of high quality care. Gold Standard Framework for Hospices During the year, we have adopted the Gold Standard Framework (GSF) for hospices. Both Day Care and Hospice at Home now require an assessment on referral utilising the GSF prognostic indicator tool. This helps not only with prioritising and planning care but also ensures that patients’ needs are fully recognised and appropriate measures are taken to either meet those needs, or refer to the relevant health or social care personnel.

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Part 2: Mandated Statements Statements of assurance from the board Within a submitted Quality Account, all providers must include the following statements, despite some of them not being applicable to hospice services. Review of services From 1st April 2014 to 31st March 2015, Treetops Hospice was commissioned to provide Day Care and Hospice at Home services to three CCGs in Derbyshire and four CCGs in Nottinghamshire. Bereavement Support was commissioned by the three Derbyshire CCGs:- Treetops Hospice raises 66% of the funding for these services through retail outlets, lottery and fundraising. The remaining 34% comes from the NHS via the above CCGs through cost and volume contracts. In addition, Treetops Hospice offers a Support and Information Service, Complementary Therapy, Art Therapy, counselling for people affected by life limiting illnesses and hosts Outpatient clinics. Our Clinical Services are governed by the Clinical sub-committee of the Board of Trustees, who meet quarterly and receive individual service reports, which enable them to review the management and quality of care provided by the hospice. The reports are then submitted to the whole Board of Trustees at their meetings. Participation in clinical audits During 2014 – 2015, Treetops Hospice did not participate in any national clinical audit or national confidential enquiries. Research During 2014 – 2015, the hospice was not involved in any research projects. NHS Quality Improvement and Innovation Goals Treetops Hospice has quality requirements set by Derbyshire CCGs

All quality requirements for 2014 - 2015 were met (Quality schedule available) CQUIN requirements were met:-

To achieve objectives as set in the End Of Life implementation plan (copy available)

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Part 3: Quality Overview Treetops Hospice submits a National Minimum Data set (MDS) to the National Council for Palliative Care.

Comparison with National Minimum Data Sets

The most recent available National MDS covers the period 1st April 2013 to 31st March 2014. Day Care Unit MDS data

2014 - 2015 2013 - 2014

Treetops Hospice

Treetops Hospice

National Median

Total number of patients 228 240 243

Total number of new patients 92 121 167

% New patients 40 50 67

% New patients with a non-cancer diagnosis 29 39 22

% New patients aged over 84 18 16 11

The total number of patients during 2014-2015 has gone down by 5% and the number of new patients is down by 24%. This reflects the 24% drop in referrals to the service from 228 last year to 165 this year while the percentage of those referred who attended Day Care was maintained at 56%. This year the percentage of new patients aged 85 or over was 18%, an increase of 2%. Hospice at Home MDS data

2014 - 2015 2013 - 2014

Treetops Hospice

Treetops Hospice

National Median

Total number of patients 699 711 494

Total number of new patients 607 619 441

% New patients 87 87 89

% New patients with a non-cancer diagnosis 25 23 20

% New patients aged over 84 28 26 21

% Home deaths 84 82 74

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The percentage of new patients aged over 84 at referral has remained high, corresponding to the demographics of the general population.

The percentage of our Hospice at Home patients who died at home rose from 82% to 84% compared with last year by comparison with the National End of Life Care Intelligence Network figure of 45%. In addition to this, 100% of patients had a recorded preferred place of care/death and 84% achieved their choice. Bereavement Service MDS data

2014 - 2015 2013 - 2014

Treetops Hospice

Treetops Hospice

National Median

Total service users 385 334 159

% New service users under 16 years 16 18 3

% New service users 16-24 years 6 9 3

Our Bereavement Service is very unusual in Hospice terms as we accept referrals from anyone in the community regardless of any previous association with Treetops Hospice. We also provide bereavement support to children and young people under 18 years old.

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5

10

15

20

25

30

05/06 06/07 07/08 08/09 09/10 10/11 11/12 12/13 13/14 14/15

Percentage of Hospice at Home patients aged over 84

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The impact of this is that our Bereavement Service supports a much larger than average percentage of clients dealing with non-cancer related deaths, including unexpected deaths which was 35% for the adult service last year. This is even more significant in our Children and Families Service where 57% of new service users presented with issues related to unexpected deaths. 25% related to traumatic death by accident, suicide or murder and a further 32% from unexpected health related deaths including two cases of Sudden Infant Death Syndrome. All new clients are assessed for levels of intervention one to four. In 2013 the Bereavement Services Association and Cruse Bereavement Care Services introduced an evaluation tool, setting three levels of achievement within seven separate standards. As part of our CQUIN for Southern Derbyshire and Erewash CCGs we were targeted to achieve the highest level in three of the standards, Assessment, Support and Supervision and Education and training. All standards were met at the highest level of evaluation.

What others say about us 1. Care Quality Commission Treetops Hospice is registered with and regulated by the Care Quality Commission in accordance with the Health & Social Care Act 2008. Our most recent inspection report dated 8thJanuary 2014 is available on the CQC website and finds us meeting the standard in all five core criteria inspected. www.cqc.org.uk/ 2. What our patients and carers say about us Day Care Service

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Service user evaluations Due to the constantly changing client group, our Day Care service is surveyed bi-monthly on a rolling questionnaire programme to ensure that we capture more patients’ views and are able to be pro-active in our response to suggestions or concerns. Areas surveyed are:

Before you got to Treetops Hospice Day Care

Your journey to Treetops Hospice Day Care and your first day

Relationships with staff and volunteers

Dignity and Safety

Your care

Catering

Transport

Activities Examples of evaluations 1. Before you got to Treetops Hospice Day Care Of the 82 guests surveyed 25% felt uncertain or apprehensive about being referred to Day Care. Both the initial assessment and the information that guests received at assessment was rated highly at approximately 75%. Overall the results of the survey were that 100% felt welcomed at the Day Care Unit and that the day met their needs. Mode of transport is planned at the initial assessment and can be either volunteer’s car, mini-bus, taxi or own transport, only one guest felt that the mode of transport that was provided caused them some difficulty in getting in and out. This was addressed immediately and more suitable transport provided. 2. Your care The overall response to how satisfied guests were about the care that they receive whilst at the Day Care Unit was overwhelmingly excellent. Each guest is involved with formulating their individual care plans. Treetops utilise a key worker system where every guest at their initial assessment is allocated both a named nurse and an associate worker to be responsible for their care whilst attending the Day Care unit. 3. Your activities in Day Care All of the guests who completed the survey confirmed that they enjoyed the break from home and the meals that were provided in Day Care. Suggestions for activities highlighted that many of the guests (69%) enjoyed the opportunity for outings; this was following the pre-Christmas trips to a local garden centre.

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“In my opinion Treetops got it right, first time” “I found my first visit a bit daunting at first but everyone was very kind and helpful” “Fabulous place, wish I’d known about it earlier”

Guests’ Voice (Day Care Patient questionnaire) Complementary Therapy Service In-house Complementary Therapy Evaluations We surveyed all clients who had completed four sessions. 44 questionnaires were returned. 17 referrals came from Macmillan/Palliative Care Nurse with the remainder spanning a wide range of other health professionals. Of those returned:

100% thought that the time between referral and first session was acceptable.

100% said that they were given information about the available and appropriate therapies on their first visit.

100% said that their therapist acted professionally at all times.

100% said the environment in which therapies took place was satisfactory.

100% found the Complementary Therapies beneficial.

Community Complementary Therapy Evaluations Our newly appointed peripatetic therapist has been equally well received. In the seven months since the re-launch of the service we have received 12 returned questionnaires. Our greatest referral source during this period was our own Hospice at Home service.

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Of the forms returned we similarly received 100% for four of the questions and the one regarding the information given before therapy achieving 83% as Good and 17% as adequate. “Very comforting and recharged batteries so I could carry on” “Alleviated stress and anxiety, helped with relaxation” “Helped with sleep and muscle spasm and relieved pain” “A privilege to have treatment” Art Therapy Service All clients are asked to evaluate their experience of Art Therapy. “Art Therapy bypassed my often critical mind, and helped me to get to the heart of the matter.” “The progress I made over the seven sessions was incredible. I went from a sad, angry, hopeless person to someone who wants to fill my life with lots of good things.” “Using Art Therapy enabled me to express feelings when I couldn’t find the words. It enabled me to get in touch with and acknowledge my grief.” Hospice at Home Service Referring professionals’ evaluation Each year we send out a service evaluation to referring health professionals. Of the 29 health professionals who returned the evaluation last year:

100% said that that the Treetops Hospice at Home nurse co-ordinators are very helpful.

93% said the patient and carer were satisfied with our care.

96.5% said that our service was reliable.

89.5% reported that our service helped to prevent or delay hospital admission. “Patients and carers are very grateful for the invaluable support your service provides” “Always professional. Always excellent feedback from family and patients. Great service – so necessary to support palliative patients at home – it gives them confidence to stay in their own environment”

From referring professionals’ evaluations

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Carer Evaluation Each year we send out a service evaluation to the carers of (1 in 4) patients who died in our care during the year. 169 evaluations were sent out during the year January to December 2014 to carers of patients who died in our care and 63 (37%) were returned. Of those who returned the questionnaire:

97% thought that the referral to the service was timely.

90% said that the amount of day time care provided was enough.

85% said that the amount of night time care provided was enough.

100% were totally at ease or comfortable about the way we cared for their loved ones.

“There is not enough room on this form to express my thanks to Treetops. The nurses were respectful, informative and a great support which allowed me to give my dad his last wish to die at home in his own bed.” “My only regret with this amazing service is that we didn’t accept it sooner.” “It was a huge blessing and comfort to have a professional on hand and gave us the strength to cope when the end did come.” “A very high standard of nursing care and a great support for me too at a very difficult time in our lives.” “When I was most exhausted, you always rang to see if I would like help and I was so grateful – and still am.” “Made a difficult final few weeks bearable.” “I can’t praise Treetops enough. The staff were wonderful caring for my husband, so I could take care of my children aged 8, 4 and 2 years.”

Carer evaluations

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Bereavement Service All clients who finish receiving support during the year are asked to complete an evaluation of their experience. Adults 151 forms were sent out of which 80 were returned (53%).

89% said that the support had made their experience of bereavement more bearable.

96% said they were satisfied with the service provided.

96% said they would recommend the service to other people.

80% said the support was offered at just the right time. Parents/Carers 35 forms were sent out of which 10 were returned (29%).

100% were happy or very happy with the speed of response to the referral.

80% reported a decrease in their level of concern about their child after the support had finished.

90% were happy or very happy with the extent to which the support had addressed their child’s bereavement needs.

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80% were happy or very happy with the number of sessions/length of support their child received.

100% would recommend the service to other people. Children/Young People 35 forms were sent out of which 12 were returned (34%).

86% reported an improvement in their feelings after the support.

64% said the sessions had helped them. 29% were not sure if the sessions had helped them.

93% said they would recommend the service to other people.

100% reported an improvement in their feelings after the support.

“My son now communicates more with both me and his brother and is less angry. We are a happier and closer family now”. “The sessions helped me to come through some fears. I found it helpful to have someone to talk to and a place to think, relax and sort through problems.” “I really cannot fault the service I received. I am so grateful for all the help and support during a time that was truly dark and desperate.”

Bereavement evaluations

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What our staff says about the organisation Treetops Hospice for the past five years has surveyed their staff by investing in the Help the Hospices Birdsong Hospice staff survey. It gives us a barometer to how the staff feel against certain questions. We can therefore measure the responses against the mean value of other hospices that have participated and the wider charity environment. Comparison to previous years The survey completed by staff in 2013 was carried out in the wake of our first conference and showed exceptionally high agree percentages. It is therefore better to compare with 2012 results. The following are the questions that show a significant gap i.e. more than 5% variance. 9. This charity is doing everything it can to reduce its impact on the environment shows a drop from 67% to 50% and falls back to 2011 levels. This may be due to some staff feel the new building could have been more eco-friendly. We also may need to communicate better to employees about what we are currently doing to reduce our impact on the environment. 17. I like my working environment has dropped from 92% to 84%. This may be due to the survey being done around the time of the office moves in June. Office space is tight at the hospice. 20. It is safe to challenge the way things are done here; shows a fall of 8% from 72% to 64%. This result is a surprise and will be discussed along with the other highlighted questions at the next staff meeting in October. 38. I would recommend my line manager as a boss falls from 82% to 75% and may be a fall out from question 20 Comparison to other hospices We normally compare well to other hospice mean values, and this year is no different. Of the 46 questions, we had a higher score in 45, with 29 answers being a double percentage point higher than other hospices’ mean values. Overall we may have a few issues in comparison to previous years; however, this must be put into perspective when we compare ourselves to other hospices, where our comparisons are very favourable. “I’d like to say a very massive thank you to you all at Treetops for giving me the chance to be part of such a wonderful team. You are all brilliant and provide fantastic service, and now I can say I am part of that service. Thanks for making me so welcome! I can now give my all to you and each and every one I care for.” Quote from a recently appointed Health Care Assistant

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Complaints and compliments Complaints During 2014 – 2015, we received no clinical service complaints. Compliments In addition to the positive evaluations of our services, we also received over 100 individual cards and letters of thanks during the year and 84% of our in memoriam donations came from the families and carers of those who were cared for by our services. “I know how much my friend enjoyed and valued her weekly visits to Treetops and, as she put it, do “arty-farty’ activities as well as support the bar for lunchtime tipple! She told me how much help and support you gave her to live each day as best she could.” “Your staff were very kind and conscious of what we were all going through and treated my wife and family with a lot of respect and dignity for which we are all very, very grateful. They also injected some humour during their visits which I know lightened the mood and gave us all some release.” “I can’t thank you enough for your kindness and caring attitude you showed towards my dad on what turned out to be his final night. The support you gave to me was tremendous on what would otherwise have been a frightening and difficult experience. As it is, I have a lovely memory of his passing and am so comforted by this.” “Although the notice you had to support my family and myself was very short, your early response was most appreciated and it did mean that my husband could spend his final hours at home, which is what he’d wished for.” “I shall always remember the skill, calmness and kindness showed, not only to my father, but to myself. Please make your service more widely known so others in my position can gain support.” “As for myself, living so far away, I took comfort from knowing that my sister was in such caring hands.” “The sessions helped so much and we really noticed a difference when our daughter started to sing again – something she loved to do with her Nana but had stopped since she had died.”

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Patient Safety Indicators Patient safety is paramount to our Services and all incidents are reported and logged. We ensure that every incident is assessed, relevant risk assessments reviewed and any wider implications are considered. We have a Health and Safety Committee, made up of staff and trustees, who meet quarterly and receive departmental reports. They review and drive forward the health and safety action plan and scrutinise all accidents and incidents in order to identify trends. During the year we had eight patient slips, trips and falls, none of which resulted in fracture.

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Part 4: Improvement Priorities for 2015 – 2016

1. To increase our Hospice at Home provision to 36,000 hours

Our commissioning CCGs recognise and promote the concept of patient choice for End of Life care. Our Hospice at Home service is recognised as a key factor to this being achieved. Our aim is to increase our Hospice at Home provision to 36,000 hours during the year.

Staffing of our co-ordination hub will need to be reviewed to manage the increased workforce and the co-ordination of this increase in activity.

2. To expand and develop our Bereavement Service to include the support of people affected by life limiting illnesses

During the year Erewash CCG agreed to fund a six-month pilot to introduce a counselling service for patients and their families and carers affected by life-limiting illnesses. Following evaluation of the pilot, funding for the continuation of this service will be sought from all our commissioning CCGs but if not available the hospice will apply to other possible funding streams for its continuation. To date this much needed new service has been well received and supports the employment of a lead counsellor who has been tasked with its development. With this planned expansion the overall service will be known as Counselling and Emotional Support Service with two departments. One will support people affected by a life limiting illness and the other will support bereaved people.

3. To develop carers support services

Our successful bid for Big Lottery funding for our Support and Information service includes carer support as one of its outcome measures. During the year Erewash CCG funded a six month feasibility study on the needs of carers. Results of the study recommended the development of carer programmes that will provide advice on caring for the physical needs of patients, end of life decision making including advanced care planning and awareness of good symptom management. The programme is aimed at giving carers a forum to express their anxieties and concerns and includes peer support, a recognised benefit of support networks. We will also be planning the development of programmes that relate to caring for patients with specific illnesses, symptoms or long term conditions.

4. Review the structure and management of all therapeutic services

Last year’s relocation of our Bereavement Service with the introduction of an increased range of counselling, emotional and practical support as well as information provision has brought into sharp focus an awareness that our overall

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therapeutic services have not previously worked as collaboratively as they might. With this continued growth and development of all of our therapeutic services, and the number of staff who are employed in the departments, it is becoming evident that the structure of our therapeutic services needs to be reviewed.

We believe that collaboration and a shared vision of an overall departmental therapeutic structure would optimise our service users’ experience.

5. To develop our internal and external education programme

Following the successful completion of the first of two modules of a Post Graduate Certificate in Inter-Professional Practice Education, we will be supporting our Nurse Educator to complete the second and final module in curriculum development. The programme will include support and education for our registered nurses to help them prepare for Nursing and Midwifery Council re-validation. In light of the endorsement of the Hospice UK report “Harnessing the expertise in hospice”, we continue to offer external training and have been approached by a local care provider to deliver End of Life education to their 60 strong staff team. The three day bespoke course will include practical and emotional care, mental capacity, lasting powers of attorney, and bereavement care. This opportunity confirms the value of our organisation’s expertise in this field of education. We intend to promote our existing intensive 14 session Bereavement Service Training Programme to external candidates.

6. Outreach services and Day Care clinics

Working in partnership with the Royal Derby Hospital NHS Foundation Trust we are hoping to introduce a clinic for patients with non-malignant respiratory diseases where active treatment has been deemed no longer being beneficial. The future support of these patients will then be transferred to community health care and patients will also be referred to our Support and Information Service Clinical Nurse Specialist who will be available to patients for their ongoing needs. It is also planned that in collaboration with the hospital team a breathlessness support programme is developed. This model of community clinic will be used to encourage more transitional care to be supported by Treetops Hospice, whilst moving patients away from secondary care settings.

7. Implementation of Gold Standard Framework for hospices

As part of our continued implementation of the GSF, we will introduce colour coding of patients using the standardised prognostic indicator tool across all clinical services.

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Southern Derbyshire Clinical Commissioning Group

Quality Account 2014/2015 Treetops Hospice

STATEMENT

GENERAL COMMENTS NHS Southern Derbyshire Clinical Commissioning Group (the CCG) is the co-ordinating commissioner for the NHS contract held with Treetops Hospice. In this role the CCG is responsible for ensuring pre-publication clearance of the Quality Account produced by the Charity for 2014/15. The production of a Quality Account is not currently a mandatory requirement for independent sector providers of NHS funded care but it is considered good practice and Treetops are to be congratulated on the completion of their third quality account which is exceptionally well written and presented. COMMENTARY The Quality Account submitted by Treetops Hospice has been reviewed by the CCG who is pleased to confirm that it agrees with all the contract related data that is stated in the Quality Account. This is the third Quality Account that has been produced by Treetops Hospice which gives a detailed overview of the year 2014/15, fully reflecting the tremendous amount of work that has been undertaken within the organisation. The comments from staff, guests and carers are powerful testimonies for a well-run and effective service. The comprehensive and ambitious priorities for 2015/16 are clearly laid out and will further serve the people in the care of Treetops whilst contributing to the vision of better End of Life care for the population of Southern Derbyshire. Treetops continued to take an active part working with the CCG and partner organisations in Southern Derbyshire to ensure the voice of the hospice is heard in designing End of Life services for the future.