St Mary's Hospice to stop accepting inpatients

Val Stangoe delivered the news to staff this morning, explaining the reason for the decision, which has been driven by a shortage of specialist doctors.

The hospice has been trying to recruit a senior doctor in palliative care since May to cover a temporary vacancy, so it can offer continuity of care when a member of the team leaves in October.

But despite its best efforts, the role remains unfilled, meaning the hospice will not have the medical expertise it needs to provide round-the-clock care to inpatients.

From today, and for an initial period of three months, inpatients will no longer be accepted at the hospice’s In-Patient Unit (IPU).

The hospice is working with staff across the NHS to identify how patients will be supported instead, and is keen to continue to be involved in the care of patients wherever they are.

The hospice will also enhance its Hospice at Home service during this period, enabling more people to be cared for in their homes.

Val said: “Today has been one of the most challenging days in the 30-year history of St Mary’s Hospice.

“Despite repeated attempts over a number of months - both alone and working in partnership with local health organisations – we have as yet been unable to fill specialist doctor vacancies or find sufficient cover.

“As a specialist unit, there are strict rules about the level of doctor who is able to take responsibility for our patients, and while we have some fantastic doctors at the hospice, they do not have the required length of experience to take on this central role at this time, when our more experienced doctor leaves.

“We will use the next three months to redouble our efforts and leave no stone unturned in our quest to find the right person for this role.

“In the meantime, every other element of the hospice operation will continue to run as normal. Notwithstanding the issue relating to the IPU, it is business as usual and as ever, we are hugely grateful for the support we get from our fantastic community.”

The temporary suspension of IPU admissions will take full effect by mid-October and if any patients are still being treated at that time they will be moved to alternative care facilities.

Patients already booked for future respite care will be invited to have an individual discussion to see how the hospice team can continue to offer support.

All of the other services St Mary’s offers will not be affected, with plans already being developed to extend the Hospice at Home team so it can support more people in their own environment.

Bereavement counselling and Living Well services will continue to operate as usual, or be expanded, while the hospice building and Orangery Cafe will remain open.

The primary focus of the hospice’s senior management team and trustees will be to find a suitable recruit to fill the vacant position, however, they will also be working on a back-up plan, which would come into effect if the search is unsuccessful.

St Mary’s Hospice is celebrating its 30th anniversary this year. Every year, it receives in the region of 1,350 referrals, of which fewer than 200 use inpatient beds. The remainder are supported in many other ways by the hospice.

Val said: “Our goal is to recruit the individual we need to allow us to reopen the IPU and once again to admit inpatients. The vast majority of our focus will be on this.

“But we must not be blind to the fact this has been a challenge for some time, and is likely to continue to be so.

“For this reason, the right thing to do is to develop a Plan B which allows us to reach and support as many people as possible and ensure there is a hospice service in this area for many years to come.

“I have been asked today if the temporary suspension of the IPU means job losses. In the short term, as we refocus our efforts to recruit a palliative care doctor, we will protect those roles which may be affected in the longer term.

“What I pledge is to make every effort, first and foremost, to find a way of reopening our IPU beds. And in the event of us having to turn to Plan B, I will do everything in my power to maintain the jobs and employment of as many of our team members as possible.”

FAQS

What does the temporary suspension of inpatient beds at St Mary’s Hospice mean for patients, staff, and public?

From today, and for an initial period of three months, inpatients will no longer be accepted at St Mary’s Hospice’s In-Patient Unit (IPU). During that three months members of the hospice team will work in conjunction with staff at Furness General Hospital to help support patients with complex needs. The hospice will also enhance its Hospice at Home service during this period, enabling more people to be cared for in their homes.

Why is this happening?

The reason we can’t take inpatients at this time is that so far we have been unable to recruit a senior doctor in palliative care. We will continue to look to recruit that person. If we are successful we plan to reopen the inpatient beds. But until that time the admissions will be suspended.

What is palliative care?

Palliative care is care for the terminally ill and their families

Is the hospice going to close?

No. The hospice will remain open and we will focus on improving our outpatient care while we search for the doctor required for us to reopen the beds. This is a recruitment issue. We need to recruit a senior doctor in palliative care to be able to keep the beds open at the hospice.

What happens if I have a relative in the hospice right now? What will happen to them? 

Patients who are being cared for in the hospice at present will continue to have their treatment provided there and we have a plan in place to ensure that before the shortage of medical staff begins all patients will be being cared for in the place that is right for them.

What happens if I, a loved one, or a friend, find out they need hospice care in the immediate future? Will I have to go somewhere else - like St John’s in Lancaster; somewhere else in Cumbria, or further afield?

All other hospice services will continue as they are or be expanded. More people will therefore be able to access care in their own homes or in nursing homes. Currently 350 people a year are cared for at home compared to less than 200 people in our beds. However we are talking to other local services to identify what kind of support can be put in place for that small number of people who absolutely need an inpatient bed.

Is the hospice short of money?

No. The hospice service has the finances it needs to continue to care for its patients. This is a recruitment issue. It is not a finance issue. People may feel that we don’t now need fundraising. That is not the case. We still need fundraising to support the outpatient work we do. So the message is, it’s business as usual on the fundraising side.

Has it been mismanaged?

No. It is a recruitment issue. Many organisations and businesses struggle to find the right people to fill specialist roles at certain times. And we are no different.

Does that mean we stop fundraising for the hospice?

We still need fundraising to support the outpatient work we do. So the message is, it’s business as usual on fundraising.

What happens to events which have already been organised to raise money for the hospice?

It’s business as usual as we still need that fundraising for our service to outpatients.

Will people lose their jobs? How many? When?

We will do everything we can to protect jobs and during the initial three month period we have given ourselves to find a new doctor, there will not be any job losses. During that three months members of the hospice team will work in conjunction with staff at Furness General Hospital to help support patients with complex needs and we will be talking to all staff about how this might affect their roles in the short-term. Longer term it is difficult to say right now, although we will, of course, do everything in our power to protect jobs.

Will the building be sold? What will happen to the site? Will it be turned into housing?

We are keeping the building open and keeping the outpatient service we provide open. This is a recruitment issue, and about our need to recruit a senior palliative care doctor. It is not a building issue, and not a finance issue.

Can the beds be saved?

Yes. If we can find a suitable palliative care doctor to fill our vacancy we plan to reopen the beds.

What can we do to save them?

We would be very grateful if you could use all your contacts and influence to spread the word in helping us to find a senior doctor in palliative care. We would also be grateful if you could spread the word that any fundraising carries on as normal. It would obviously not help us if this situation was misunderstood and people stopped fundraising. We need continued financial support to continue to offer our services in the community.

Why can’t you borrow a senior doctor from Furness General to keep the beds open for now, or get a locum?

In order to continue to offer safe and effective care for inpatients, we need a senior doctor who is experienced in palliative care. There are very strict regulations in place regarding the level of medical expertise we need on site to be able to do this. We know there is a national shortage of doctors with this kind of experience. We’ve tried extensively to find the right person for St Mary’s but have not been able to recruit into the position.