Dr John Smith: This is an opportunity to improve hospices

Funding changes can create an opportunity to improve Cransley Hospice, says Dr John
Funding changes can create an opportunity to improve Cransley Hospice, says Dr John

Two weeks ago I asked whether the possible changes to the way in which our hospices are funded was a threat or an opportunity.

I think that potentially it is a massive opportunity for our community, but that will depend on us all being prepared in what are still difficult times to donate more money and more time to the hospice charities.

If we are not prepared to do that then the services to patients in the last few months of their lives will not deteriorate but they will not develop either. Let me explain.

About 56 per cent of the population of Northamptonshire die in places other than their home whereas 70 per cent of people, given a choice, would like to die at home.

Less than six per cent of people die in a hospice, many more would like to, it is the second most preferred place of death.

Most die in our general hospitals which is the least popular preferred place.

And of course, it is not just about place. It is about quality, humanity, time, space, anticipation of problems.

It is about being listened to and supported. We need to do all this and more. It is clear that both hospices need more beds, although Cransley has a more urgent need.

In those beds many complex problems can be sorted, allowing patients to go home and, if they wish, stay at home.

Patients in the last year of their lives need regular review, problems can be anticipated, plans of action drawn up, drugs ordered, equipment in place.

This done, there will be less crises, less emergency admissions.

The very sick do not get serious problems only between 9am and 5pm, there is a need for a 24-hour, seven-day-a-week service that can and will respond to crisis.

That service needs to be staffed by skilled, well trained staff with specialist back-up.

And all of this applies to not just cancer patients but end stage heart and lung disease, and neurological illness too.

It needs to be able to manage this in patients with dementia too, and learning disabilities who find it difficult to express themselves.

If this is to happen the NHS is not going to come up with more money.

That is the reality.

We will need to raise at this end of the county upwards of £6m to build a new Cransley and probably £2m plus each year to run the sort of service I describe.