As Brexit controversy churns on in Parliament, change is a theme that permeates public debate as does the uncertainty that Brexit poses for the country. However, the health & social care sector has been dealing with constant change over the last decade and charities like, Dorothy House Hospice Care, have been working to resolve future funding challenges since before the 2016 Referendum.
An analysis into local end of life care needs in 2016/17 conducted by the hospice, across Bath and North East Somerset, Somerset and Wiltshire, found that to meet the rising patient demand for palliative and end of life care we will have to double our income by 2025.
Health & social care continues to evolve and the Hospice’s end of life care strategy to 2025 is well in tune with the NHS Long Term Plan announced in January with its focus on strengthening integrated, community-based healthcare to reduce hospital admissions.
We have a growing, elderly population with complex health and social care needs and yet there is a need to provide more care for increasing numbers of patients but with less public money. In reality, NHS output has increased whilst public sector cuts have continued. There also remains a strong drive for efficiency savings within the NHS which made £6 billion in quality and cost improvements last year and is expected to make a further £700 million in national and local administrative costs in the next five years.
The knock-on effect of cuts to the charitable sector is significant. Charities, such as hospices, have always picked up the slack where the public sector is concerned. Indeed, if the NHS could provide all the care required, there would be no need for hospices. What we are seeing now though is a growing gulf in funding – currently the NHS funds one fifth of the health & social care we provide to the 550,000 population in our 700sq mile area.
Arguably the biggest Brexit concern is a negative economic impact on the country along with lower public confidence and spending leading to a potential drop in charitable income. In all Brexit scenarios, there are concerns in the healthcare sector over the security of medicine supplies and the recruitment and retention of EU nationals working in health and social care, as there has been a growing reliance on the EU workforce in this area.
At Dorothy House we have a well-established Workforce Resilience Programme in place to minimise any staff recruitment issues. The programme includes; hiring more Advanced Nurse Practitioners, funding clinical apprentices, in fact, two apprentices started work at the Hospice in January as Palliative Care Support Workers. The Hospice also runs a Return to Work scheme to support nurses wishing to re-train as registered nurses at the Hospice and career progression and education opportunities are available for all nursing and other staff.
We also have prepared for secure access to medicine supplies in the case of a no deal Brexit due to the funding arrangements we have with local Clinical Commissioning Groups and acute hospitals.
Brexit poses legal uncertainties for all sectors including the charitable sector which has been at the forefront of arguing for individuals’ legal protections, many of which have been strengthened by EU legislation.
In response to public sector cuts, hospices are having to ramp up their fundraising efforts to fill the gap. Clearly, an element of this will feature cost efficiencies and maximising current revenue streams, not least our NHS contracts. However, Dorothy House has chosen to be bold to meet the rapidly growing demand for palliative and end of life care in the community, hence an innovative and diversified fundraising approach is crucial to our success.
Since 2017, the business development team at Dorothy House has been growing new income streams for the Hospice by reinvigorating existing fundraising activity and investing in completely new commercial ventures. The team has recently launched the first of these new ventures, a lifestyle brand called Ubiety at www.findubiety.com. Ubiety is a collection of luxury skincare and wellbeing products with all profits going to Dorothy House to support the provision of more palliative and end of life care.
Although Brexit is the “known unknown” and the outcome remains unpredictable, at Dorothy House we recognise that the challenges it raises are largely ‘business as usual’ or an extension of existing issues we are already tackling.
Dorothy House is in the first phase of its ambitious ‘Everyday,Everyone’ strategy for 2018-2025 which focuses on doubling both our income and patient numbers. Hence, increasing income is one of the Hospice’s top five goals in the next six years and beyond.
By working in partnership with GPs in new Primary Care Networks, third sector and other organisations such as Macmillan, Dorothy House is confident that taking an integrated approach to end of life care will help us weather any financial storms ahead.