Cicely Saunders, the founder of the modern hospice movement said, ‘You matter because you are you. And you matter to the end of your life.’

We could add to the end of that quote, ‘no matter where you are’. Whether someone is in a care home or a hospice, they have an equal right to palliative care, and every person providing that care should be equally valued.

At Hospice UK, we recognise that care home and care at home staff are at the forefront of delivering palliative and end of life care, though many may not call it that. We also recognise the toll such care can take on staff who can feel unsupported and undervalued, as Scottish Care revealed in its major workforce report ‘The Trees that Bend in Wind.’

Hospice UK is the national membership charity for hospice care in Scotland, and across the UK. Our mission is to enable hospice care to transform the way society cares for the dying and those around them. Part of that work is to highlight and promote the benefits of joint work across care settings and expertise.

For example, over 37,000 Scots live in care homes, many with complex palliative care needs. With need set to grow against a backdrop of shrinking budgets and workforce challenges, we conducted a survey of Scottish hospices and found that 85% are engaged in some form of joint work with care homes, with member hospices keen to do more.

Examples of joint work include:

• Technological ‘hub and spoke’ knowledge exchange and support like Project Echo where a hospice team works with a number of care homes across a wide area.
• Hospices have developed a wide range of formal and informal training such as foundation level palliative care, Quality End of Life Care for All, communication skills, dementia focused care, complementary therapy, anticipatory care planning, debriefing techniques for emotional staff support and early identification tools. Hospices also offer bespoke and ad hoc training to social care staff such as pain management for people with cognitive impairment.

But there is so much more happening. Hospice and social care teams are increasingly working together across a range of settings with a range of objectives in recognition of the strength in collaboration.

The learning and support is two way: hospice staff have much to learn from social care colleagues. This joint work is about professionals with a wide range of expertise coming together to share resource, experience and strength to ensure the very best care is given to every person in need, and the people who care for them.

We know that partnerships between hospices and social care providers improve people’s end of life experiences and reduce avoidable hospital admissions. However, our research suggests there are barriers that can stop these partnerships reaching more people such as low awareness of the benefits of such partnerships and short term funding models.

Increasing awareness of what hospices, care homes and care at home teams do, and could be doing together is key to widening access to palliative care. At the same time, we want to see Health and Social Care Partnerships supporting joint work in their areas, and ensuring there is enough money to sustain joint work over time.

Collaborative working across providers is not just a nice idea. It’s absolutely crucial to supporting staff to deliver and sustain the best care to ensure everyone has access to palliative care at the right time, no matter where they are.

Eilidh Macdonald 
Policy and Advocacy Manager Scotland, Hospice UK

For more information on what hospices in Scotland do and about their work with care homes, visit www.hospiceuk.org – Hospice UK’s 2017 report: ‘Hospices and Care Homes in Scotland’ can be found in the Briefing and Consultations section.