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Background Rowcroft Hospice delivered community, inpatient, hospice@home and chronic oedema services to a population of 2 80 000 over 300 sqm. By Christmas 2015 it was clear that legacy income was going to fall well short of the budget; a risk we carried for many years was now realised. Our plans had proved unsustainable and the trustees had to make the decision whether to close the hospice or significantly reduce services. Aims To reduce the hospice’s financial deficit and bring financial stability, including replenishing sufficient reserves for Board assurance, whilst retaining ‘core’ patient and family services and our reputation for outstanding care. Methods Develop plans to redesign and reduce patient, family and support services to those deemed ‘core’ within four months. Launch a Crisis appeal for £585 000 Establish ‘Project Red’ including staff and volunteer briefings, a collective consultation, involvement of trade unions, staff empowerment to negotiate savings within teams Develop a transformation plan Results Plans were developed through collaboration with the local NHS provider and CCG. Our chronic oedema service was taken over by the NHS. We reduced from 17 to 12 inpatient beds – redesigning a bay into a dayroom; reduced staffing of hospice@home and redesigned our community and support services. We have delivered similar service activity to the previous year, although our contacts are fewer. We exceeded our crisis appeal target by £20 000 and gained 500 new regular givers. Our transformation plan has meant closer engagement with our local NHS provider and other partners. Conclusion Although born out of crisis, the opportunities for learning, redesigning services to fit within a reduced budget, supporting team cohesiveness and a ‘one hospice’ culture, enhancing our collaborations with the local NHS provider and CCG and in gaining support from the public and partners have all served to secure the hospice’s position. |
