St Clare Hospice: On the Frontline of Leadership
17th April by Imogen Ward
AAW has a deep connection with the Hospice movement in the UK. We’ve had the huge privilege of being partner to many Hospices and over the past three years have been thrilled to help CEOs and Chairs of Boards attract and appoint some brilliant leaders into their executive teams.
AAW Director, Mark Astarita, has been involved in the governance and leadership of Hospices for over a decade, sitting on the Board of St Joseph Hospice in Hackney, London and now on the Board of St Clare in Essex.
With the COVID 19 crisis placing the focus firmly on frontline health care providers, we speak to Deborah Fielding, Chair of the Board of Trustees at St Clare Hospice who works alongside Mark.
Here she reflects about the current crisis and what this means to the Hospice movement both immediately and in the longer term.
About St Clare & Its Leadership
St Clare Hospice provides compassionate care and support to adults with life-limiting illnesses across West Essex and the East Hertfordshire border. Becoming Chair of Trustees just over a year ago, Deborah leads a Board of expert Trustees with specialist experience in healthcare, retail, finance, business, fundraising and the voluntary sector. Deborah and the Board work closely with the CEO and Executive Team to ensure excellent patient care and a sustainable future for the hospice.
She brings her own technical expertise to this role with a 40 year career within the NHS, starting as a community nurse and finishing her career as a CEO before retiring. Joining the Board at St Clare was a natural fit for Deborah and a challenge that she absolutely relishes.
Like most Hospices in the UK, funding of services has always been one of the most important operational and strategic issues. It costs St Clare £4.8 million to run services and with just 39% coming from the NHS, the remaining 61% has to be funded via fundraising activities.
In a competitive fundraising market, this is always challenging, but now as the onslaught of COVID 19 shuts down community events and retail operations, the charity’s finances are under even more pressure.
The recent government bailout with specific funding for Hospices, has been welcomed by Deborah “We are in a good position. Despite the huge decrease in income, we are reasonably comfortable about the next two or three months because we have some buffer support for that”.
With the situation changing so rapidly, the Board and the Executive team have been very busy. Part of the Board’s role has been to ensure that focus is kept on the longer term priorities. As Deborah states, particularly in difficult situations, people focus on the urgent and not always on the important “We as a Board need to make sure we are focusing on the important and the longer-term future, although of course that is really difficult to predict right now”.
Hope in Adversity
Deborah and the Executive Team have also been heartened by the tremendous support of the local community. As we have seen across the whole of the UK, this crisis really has spurred some very moving and inspiring acts of kindness. When the urgent need for protective equipment at the Hospice became apparent and the charity reached out via social media, a local printing company immediately stepped in by printing 3D masks for staff. Individuals quickly sewed masks and delivered them to the charity. An emergency email appeal has raised £50,000 and in addition the Charity has been able to secure large financial gifts from individual supporters. And the nurses at the Hospices have been delighted to receive some luxury hand cream from a local beauty salon.
Some hospices have been requisitioned for Covid wards. The good news for St Clare is that at five miles away from the nearest hospital, it is currently being kept as a safe haven for non-Covid patients receiving palliative care and the best possible end of life experience. Unlike hospitals that have had to restrict all visitors, St Clare can currently allow smaller numbers of family access.
Of course, Deborah acknowledges it will be increasingly difficult to keep the Hospice Covid-free, as the virus ramps up in the community and care-home sector. Most non-clinical staff are now working off-site, and the Hospice at Home Team have been reduced from the normal teams of two to one staff member visiting, giving the Hospice more capacity and a staff increased protection.
A catalyst for greater integration
The current crisis has provided some positive opportunities for the Hospice – enabling them to work more closely with the NHS and integrate their services better into the local health system. The NHS now have a stronger recognition of the role that hospices play, particularly for end of life care.
This improved relationship between the NHS and the Hospice movement is very welcome. Thanks to this closer partnership, Hospice UK was able to negotiate the bailout directly with the government allowing for funds to be distributed in a fair, efficient and quick way. It has also led to requests for Hospices such as St Clare to provide additional services, such as trained volunteers from their Compassionate Neighbours scheme offering compassion and support to those who are socially isolating.
The Hospice has also been asked to provide specialist bereavement support services, particularly for families who are struggling from the cruelty of family members dying alone in hospital as a result of the virus. St Clare are also considering plans to support NHS staff in the long-term, when the psychological impacts of their work with Covid-19 patients may become more apparent, as well as their own hospice teams directly working on the frontline in the community.
The challenge for the leadership team is to take up these opportunities, but also to retain the Hospice’s independence, unique ethos and relationship with the community.
Deborah would like to send an enormous thanks to the Executive Team for their exemplary leadership during this crisis, to the 140 brave staff members who are working tirelessly on the frontline of care to deliver such an essential service and to the hundreds of volunteers who are working so hard to keep the spirit of St Clare so vibrant.
Anyone that has ever visited a Hospice will know that they are very uplifting, hopeful places filled with love and a spirit of care and compassion. These great institutions are inspirational places and the Hospice Movement in the UK is something that we as a society should be immensely proud of.
St Clare truly emulates this special culture and 30 years on from when the Hospice was established, Deborah is proud that it has become a corner stone of the community and that it is setting the gold standard for end of life care – as demonstrated by the recent ‘Outstanding’ rating being awarded. Whilst St Clare is facing a challenging period, Deborah knows that thanks to the great leadership of the charity, it will be able to meet this unprecedented crisis from a position of strength.
Once the dust settles a little on this strange time in our history, we at AAW hope that our ‘post covid’ society will have an increased appreciation and awareness of the work of Hospices; these institutions are often in the shadows – it is now time that we allow them to step into the sunlight.