As from today, I’m on to my second tranche of rebuilding photos. Just to remind you, I am posting photos of the rebuilding works at St Christopher’s Hospice, in solidarity with colleagues who are working in difficult conditions, so that things can be better in the future. This first photo of the new lot is of the new chapel; a while ago I posted a photo of the closure notice of the old chapel, and here is the new one finished, although not yet open. But this is the glimmer of a new era coming.
New Chapel

Looking for Telegraph stories on palliative care, the 5th August yields a report about a GP trainee who behaved inappropriately with a female patient, but was cleared of various allegations. he has now decided to move work into palliative care and work in a hospice. Yes we’d really like to employ someone like that…
Trainee GP’s ‘hell’ over false rape allegation

The Department of Health has published a rather basic public information document about LINks (Local INvolvement Networks) – the small k is intentional, an abbreviation of network, and is bound to cause endless trouble. It’s a network because nothing can be a committee nowadays, it’s just so uncool, but this is the second round of replacements of Community Health Councils as ways in which local people can express views about their NHS and (this is the innovation) also their local social services department. I was incvolved in a failed experiment for a community social services council in the early 1980s, plus ca change… LINks can express views about serviecs commissioned in their area, so this inclues the local hospice.

Department of Health (2008) Listening and responding to communities: A brief guide to Local Involvement Networks. London DH (http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_087758)

Pics of the rebuilding at St Christopher’s, now under way, in solidarity with all colleagues working through a difficult time, to make things better in the future:
In the cage

A study on transferring patients from a hospice to care homes is published in a social work journal that some readers may not see. It is interesting not only in pointing up how distressed people are by the mere suggestion, partly because it means another move or possibly cost, If continuing care is not available people have to pay or have a local authority means test. But continuing care often is available for palliative care patients, though people may not be aware of it. The other interesting set of comments queries how we have come to assume that palliative care is a short term intervention. Where has this come from? Is it another example of medicalisation – the only intervention that counts is the expensive medical and nursing care, not the emotional and personal care of the family? Although this study is convincing and fits with past studies on the very small proportion of patients who actually get to nursing homes, this is not universal, becasue at St Christopher’s we seem to get more people who can transfer; this might be a London phenomenon perhaps.

Reith, M. and Lucas, C. (2008) Questioning the evidence for service assumptions: audit of transfers from a hospice to nursing home care. Journal of Social Work. 8(3): 233-45.

Pics of the rebuilding at St Christopher’s, now under way, in solidarity with all colleagues working through a difficult time, to make things better in the future:
Walled up

The news that various charities, including NACRO, the main organisation working for ex-offenders, are bidding to run prisons, raises the question why NHS services are not being put out to bidding, and if they were, whether voluntary sector hospices might bid to run their local NHS palliative care services. A lot of voluntary sector hospices and palliative care services have great expertise in developing and managing palliative care services. NACRO demonstrated that they could do the job by very effective management of high volume services for years; many hospices could show the same record. Some big hospitals are chauvinist about running their own community palliative care when a hospice could do it better, and the added value to the connectedness of patients’ services would often be great, and if the proposal shows it wasn’t, the PCT or hospital trust could say ‘no’. And there might also be something to be said for having external palliative care fed into hospitals. There might be disconnections, but there might also be a strengthening of the service because an external service would have focus. Increasingly, in business, the giant organisations of yesteryear, are giving way to small organisations simply becauase focus is more important than size and variousness. And people working in other medical specialties tell me that their lead doctors are as uninterested in good care for dying people as cancer doctors were a few years ago; a good external hospice service might ginger this up. Perhaps the problem with bidding for this kind of work comes from the fact that the NHS has had palliative care too cheap for for too long, because the NHS has paid nothing like the full ticket for the costs of voluntyary sector hospices, and sensible bids for NHS services would show up how much the NHS should pay for the services it is currently getting from the voluntary sector.

Pics of the rebuilding at St Christopher’s, now under way, in solidarity with all colleagues working through a difficult time, to make things better in the future:
The pilgrim’s progress (the Pilgrom Room for visitors is closing to become the new chapel)