There has been a number of events and other factors that make it appropriate to provide an update following the temporary closure of the inpatient unit.
The many stakeholders that are involved inevitably complicate the position. The hospice service is commissioned and paid for by the Hillingdon Commissioning Group. The Hospice Charity provides supplementary financial and other support but does not directly supply any services. These are provided by East and North Herts Hospital Trust but in a building that is leased from the Hillingdon Hospital Trust. The latter is responsible for any repairs but not for any major project.
The Charity’s financial position
Before examining the present position it is helpful to have an understanding of the Charity’s accounts as summarised in the following table. The 2018 accounts have just been published.
|Fund raising income||473||382||368|
|Rest of income||823||808||817|
|Loss/gain on investments||-28||76||-15|
Looking at our costs and income a few items stand out:
- Fund raising dropped from 2016 to 2017 but has not changed much since
- Legacies were huge in 2016 but returned to their normal level in 2017 and 2018
- The increased deficit in 2018 was largely due to a loss on investments
Turning to the current year, income has fallen £200k compared to the previous year if you leave out the lottery partnership income. However our costs are down £100k as was our charitable contribution making the deficit a little less this year compared to the same period last year.
The Closure of the Inpatient unit
The decision to close the inpatient unit was taken by East and North Herts on the grounds that the unit was no longer fit for purpose. Since that time the Charity has been trying to obtain an estimate of the cost of works necessary to reopen the unit. We envisaged that this would comprise three phases:
- Immediate repairs to the building to enable the opening of a four-bed unit whose running costs would be met by Hillingdon Commissioning Group
- Further work to the building to enable its expansion to an eight-bed unit
- In the longer term a new unit costing many millions of pounds
After much difficulty we became aware that the Hillingdon Trust had prepared estimates of repairs to the cold room and the repair of roof leaks amounting to less than £10,000. We had understood that these works would be sufficient to restore the service to the level enjoyed before the closure.
However, at a meeting on December 11th convened by Hillingdon Council, we learnt that these repairs would not be sufficient to enable the unit to reopen. East and North Herts claimed that the unit needed the installation of piped oxygen, better separation of beds for patient safety, private en suite rooms and other works. Otherwise they stated the Hospice staff could be liable for operating a unit in breach of regulations. They estimated that the cost of creating a compliant environment in the existing building was £11 million!
Hillingdon Council had been hoping that the unit would reopen in February 2019. East and North herts have ruled this out and have merely promised a further review by that date.
The national Care Quality Commission inspected the after life care at Mount Vernon in April 2018. The Commission found that the inpatient service was in need of improvement. Nowhere did the Commission even hint at the need for immediate closure. Indeed many other services provided by East and North Herts were similarly rated and they are still open for business.
The Next Steps
East and North Herts ostensibly transferred inpatient hospice care to the cancer wards at Mount Vernon but we understand that its presence may not be entirely compatible with the desired ethos of the ward with its understandable emphasis on recovery. East and North Herts have promised to respond to these reports. They have promised to hold an open meeting with local residents to hear and discuss their concerns. We will keep you posted on the arrangements.
East and North Herts have promised to respond to the points raised at the meeting and there is to be a further meeting of the Council’s committee in February. However it is apparent that they are exceedingly reluctant to reopen the Unit at least in the short term. Therefore the hunt is on either to find a new service provider and /or new premises. We are pressing the Hillingdon Commissioning Group to look into the contract with East and North Herts to see how long it has to run and whether the present arrangements of a few beds on an acute ward can be seen as fulfilling the contract.
In the meantime we continue to support the day centre in its entirety and Hillingdon Commissioning group has ensured that at least one palliative care consultant remains on site. Shortly we will be announcing the 2019 programme of fundraising events to ensure that the day centre continues and that funds are available to help support the inpatient unit when means are found of reopening it.
We will issue further bulletins as events unfold.
The Charity Trustees