North Devon Hospice Quality Account 2010/2011

Quality Account 2010-2011for health professionals, patients and their families and carers

Contents1 Quality at North Devon Hospice IntroductionbyChiefExecutive OurVisionandValues2 Our Performance 2010-2011 ClinicalGovernance ClinicalServiceProvision SupportiveCare FacilitatingEducationandIntegration

3 Our Priorities 2011-2012

TheBoardofTrustees’CommitmenttoQuality Withthanks

4 Annex StatementsofqualityassurancefromtheBoardofTrustees Ourserviceofferingforpatients

B e s t F u n d r a i s i n g E v e n t F i n a n c i a l M a n a g e m e n t

Dearfriends,

EverythingwedoatNorthDevonHospiceaimstodeliverthebestcareandsupporttoourpatients.OnbehalfoftheBoardofTrustees,wearedelightedtopresentoursecondannualQualityAccounttoshowcasehowwecontinuetoachievethis.

TheQualityAccountisbothretrospectiveandforwardthinking.Itshowcasesthequalityofhealthcareservicesdeliveredinthepreviousyear,enablingourclinicians,nurses,andsupportteamtodemonstratetheircommitmenttoimprovements.Wecompletethepicturebyidentifyingourprioritiesfortheyearahead,outlininghowwewillcontinuetobuildonofferingaqualityserviceforourpatients,theirfamiliesandcarers.

MayIthankthestaffandvolunteerteamatthehospicefortheirconsiderableachievementsoverthepastyear.Ihopeyouwillfindtheinformationprovidedinthisbookletusefulandwelookforwardtoreceivingyourcommentsandfeedback.

GordonLesterChiefExecutive

[email protected]

“You’re more than just my counsellor ; it’s like you are with me when I leave and I hear your voice comforting me when I’m upset.” Acarer

Patients are at the heart of everything we do. Thequalityoftheirpersonalandmedicalexperienceisofkeyimportancetous.Ensuringpatients’safety,providinghighqualitycareandpositiveexperiencesarekeycomponentsofourserviceprovision.Welistentoourpatients,learningfromthethingsthathaveworkedwellandwherewecanlooktoimprove.

Our mission is to promote the relief of symptoms amongst people with life-limiting illnesses. We do this through:

• Specialist palliative care for patientswith an advanced, progressiveillnessandtheadultsandchildrenwhoareclosetothepatient

• Personal care to patients at the end-of-life and support to theirfamiliesathomeandinothersettings

• Supportivecare topatientswhohavebeendiagnosedwitha life -limitingillnessandtheadultsandchildrenwhoareclosetothepatient

•Advice, support and education provision to patients, families,communities, organisations, and healthcare professionals who arerespondingtolife-limitingillness,deathandloss

Webelievein:

• Beingthereforallthefamily

• Recognisingandtreatingeachpersonasanindividual

• Thecaringandclinicalsupportthatisprovided

•Thesenseofsafetyandsupportthehospicebrings

• Theexpertiseofourprofessionalteams

QualityatNorthDevonHospice

Our Vision and Values

1 Palliative CareCo-ordinator

SeniorStaff Nurse 2 Counsellors

1.6 fte

11 Registered Nurses 8Fte

1 Healer/ Counsellor 0.3Fte

4 MedicalOfficers 1.4Fte 1 Chaplain 0.8Fte

All of our work is supported by a diverse team of volunteers

Hospital Based Clinical Nurse

Specialist 1 Day Hospice Team Leader

0.6Fte

1 Healthcare Assisstant

0.6Fte

5 Palliative Care Support

Workers

Head of Supportive

Care

9 HealthcareAssistants 7.5Fte

Bedded UnitClinical Services

Manager

CommunityPalliative Care

Manager

CommunityClinical Services

Manager

13 CommunityClinical Nurse Specialists 9.2Fte

Head ofClinical

Governance and Audit

Director of CareConsultant

in Palliative Medicine & Medical Director

Our hospice based Consultant in Palliative Medicine and Medical Director,MurrayFletcher,providesclinicalleadership.Heoverseesthefullrangeofcareweprovideandactsasalinkbetweenthespecialistandsupportivecareservices.

OurClinicalGovernanceActionPlanrecordsalloftheclinicalstandardsettingandauditactivityundertakenbythehospice.Itunderpinsourcarequalitystandards,enablingustomeettheCareQualityCommission’sessentialstandards.

TheClinicalGovernanceActionPlanand relevantkeyperformance indicatorsare regularly reported to the Board ofTrustees, regularly represented to theCorporateGovernanceCommitteeandreviewedmonthlybytheClinicalAuditWorkingGroup.

WecontinuetosupporttheMinimumDataSetProjectorganisedbytheNationalCouncilforPalliativeCare.

Clinical Governance

Clinical Audits

Surveys and Exercises

• TheAccountableOfficerControlledDrugAudits

• InfectionControl:HandHygieneAudit

• InfectionControl:ClinicalCareEnvironmentalAudit

• ReferralResponseRateAudit

• InfectionControl:SafeDisposalofSharpsAudit

• FoodandNutritionAudit

• CornealDonationandRetrievalAudit

• PressureDamageAudit

• OutofHoursTelephoneHelplineAudit

• ComplementaryTherapy:MeasuringtheEffectsoftheIntervention

• ManagementandTreatmentofHypercalcaemiaAudit

• BloodGlucoseEquipmentMonitoringAudit

• SpecimensandInvestigationsAudit

• InternalStaffSurvey

• HelptheHospices:PatientSurvey-DayHospiceandIn-patientUnit

• SouthWestRegionalHospicesAudit:Falls,MedicationErrors,PressureDamage

• ‘InvolvingYou’Consultation

OurPerformance2010-2011

3 North Devon Hospice Quality Account 2010 - 2011

”Hospitals try to mend people; the hospice helps you to live.”Apatient

Clinical Service Provision

During 2010-2011,we received603newpatient referrals,whose ages rangedfrom21 to98years. 88.4%of thesepatientshada cancerdiagnosis and theremaining patients were referred with various life-limiting diagnosis, includingMND,MS,HeartFailure,COPD,Liver failure,RenalFailureandDementia. Ofthese603newpatients,318diedduring2010-2011.

Insupportofvaluingourpatientschoices,wecontinuetosupporttheirrighttodieintheplaceoftheirchoiceandthispracticeisreflectedinourrecords;showinganincreaseinthenumberofdeathsathome,whichincludesdeathsofpatientsincare/residentialhomes.ConsistentwiththekeyimperativesunderpinningtheNationalEndofLifeCareStrategy,wecontinuetomonitorplaceofdeathandrecordPreferredPrioritiesforCare.

Age range of new patients 2010-2011

20-34

35-49

50-64

65-79

80+

Total

Total

4

30

123

259

187

603

%

0.66

4.98

20.4

42.95

31.01

Male

1

10

51

147

88

297

Female

3

20

72

112

99

306

Place of death

Hospice

Home

Hospital

OtherincCare&NursingHomes

Total

2009-2010

131

164

104

38

437

2010-2011

109

181

100

49

439


The Bedded Unit

FromthepurposebuiltfacilityatDeerPark,NorthDevonHospiceoperatesa7bed inpatientBeddedUnit,providingassessmentandtreatmentofcomplexsymptoms,end-of-lifecare,supportandcaretopatients,theirfamiliesandcarers.

During2010-2011,therewere163admissionstotheBeddedUnit,withabedoccupancyrunningat71%;afigureconsistentwiththeprevious2yearsperformance.Theaveragelengthofstayontheunitwas10.6days,withotherperiodsrangingupto45days.

Of the163BeddedUnit admissions,63%of admissionswere for symptommanagement,with37%admissionsforend-of-lifecare.


Outpatient Treatments

Attherequestofmedicalprofessionals,anumberofoutpatienttreatmentscanbemanagedandmonitoredfromtheBeddedUnit.During2010-2011,58ofthesewereconducted,including:

• Pamidronateinfusions• Bloodtransfusions• Paracentesis/drainage

Following the recruitmentof twopart-time alliedhealthprofessional teammembers, 189 occupational therapy and physiotherapy reviews and visitswereconducted.

Consultant Outpatient Appointments & Consultant Domiciliary Visits

Attherequestofmedicalprofessionals,ConsultantOutpatientAppointmentsaremanagedfromtheBeddedUnitandConsultantDomiciliaryVisitsareinjointattendancewithaCommunityClinicalNurseSpecialist.

ConsultantOutpatientAppointments have dropped from 25 in 2009-2010to20, and this decline is also shown inConsultantDomiciliaryVisits from25to6.Theteamattendedregularconsultationsandmeetingswithmedicalprofessionals,ensuringinterventionsweremanagedbeforeapatientwasinapositiontoneedavisitofthisnature;showingasignificantimprovementinpatientcare.

“They provided much needed respite for myself, and wonderful care and compassion to my mother. They were the listening ears and supportive shoulders I needed, and the kind, practical and skilled help that mum needed.” Thedaughterofapatient

Community Palliative Care Team & Hospital Based Specialist Palliative Care Team

InDecember2010,wewelcomedtheCommunityPalliativeCareTeam(secondedtothehospicefor5years)fromtheNorthernDevonHealthcareTrust.The5CommunityPalliativeCareSupportWorkersprovide‘handson’end-of-lifecareforpatientsintheirownhomesorotherplacesofchoice.SinceDecember,theteamhavesupported76patientsintheirownhomesandbeentherefortheirfamiliesandcarerstoprovidesupportandguidanceduringdifficulttimes.

WealsowelcomedthehospitalbasedSpecialistPalliativeCareServicewhosupportindividualswhoareexperiencingcancerandanyotherlife-limitingillness,atanystageintheirjourney.


Community Clinical Nurse Specialists

WorkinginpartnershipwithGPs,primaryhealthcareteams,carehomes,andthehospitals,our13CommunityClinicalNurseSpecialistscontinuetodeliverintegratedcareandsupporttopatients.

During2010-2011therewasanotable81.95%increaseofthenumberofGoldStandardsFrameworkandMulti-disciplinaryTeammeetingsdemonstratingacohesive approach to patient care and partnership working. There were1,331episodes where individual patients were discussed at Gold StandardsFrameworkmeetings;499episodeswhereindividualpatientswerediscussedatMulti-disciplinaryTeammeetings;all inattendancebythehospiceCommunityClinicalNurseSpecialists.

WiththenursingteamcoveringthelengthandbreadthofNorthDevon,fromHolsworthytoLynton,theytravellednearly50,000milesontheir5,417patientvisits;59%ofthesevisitstopatientsintheirownhomes.

Community Clinical Nurse Specialist Visits

AtHome

Professionalvisits,notinc.GSFmeetings

Hospitals

NursingHome

Hospice

Otherpatientvisitsinc.bereavementvisits

Total

2009-2010

3,026

1,392

330

180

200

174

5,302

2010-2011

3,081

1,625

158

128

338

243

5,573

Supportive Care

Counselling

Bereavementcounselling,incgroups

Counsellingandspiritualsupport,incgroups

Unplannedpatient/familymeetings

Supportoverthephone

Total

2009-2010

909

1,760

228

1,381

4,278

2010-2011

925

2,651

221

1,674

5,471

TheSupportiveCareteamofferstimeandspaceforpatientsandtheirfamiliestolookatwhatishappeningintheirlivesandtheopportunitytoexplorewhattheywillneedtosustaintheminthemostdifficultofcircumstances.

One to One Support

Everyoneknowntothehospicehastheopportunityforonetoonesupportand/orisabletojointhepatients,carersorbereavementgroups.Whetherindividuallyorwithinagroup,thoseattendinghavethespacetoexploreandexpressfeelings,ideas, thoughts and concerns thatmay be difficult to share elsewhere. During2010-2011, SupportiveCareprovidedpersonal support inover 5,000 instancesandcontinuedtorunwellattendedgroupsessionswhichsupported129people.

Support for Children

Atschool,athome,oratthehospice;onetoonesupportisofferedtochildren.Childrenareencouragedtoexploreandexpressthemselvesthroughtalking,painting,drawingorplay.

‘It’s Friday’ Drop-in

TheFridaydrop-inofferspatients,carersandfamilymembersthetimetorelax,meetwithothers,enjoythegardens,spendtimeintheartroom,andusetheopportunityforonetoonesupportifrequired.Thedrop-inwasintroducedthisyearwithpositivefeedbackandwelcomed894attendances.


Group sessions

Patientgroup

Carersgroup

Bereavementgroup

Total

Number of sessions held

47

28

12

69

Attendees

47

46

36

129

Attendances

400

289

166

855

NB.ThesefiguresarealsoincludedintheCounsellingtable

“I soon realised it was really normal to have these thoughts and emotions... and that everyone else had them too; thank goodness for that!” Apatient

Day Hospice

Supportedbynursingstaff,DayHospiceistimeforpatientstobetogether,wherethey can talk, laugh, bewith eachother and find a quiet space too if needed.AvailableeveryTuesday,WednesdayandThursdaythroughouttheyear,patientscanattendtimetablefreedaystoenjoyartandcrafts,entertainment,occasionaloutings,relaxationinthegardens,andtimetomeetandtalkwitheachother.WhilstourpatientsfindbenefitfromgoingtoDayHospice,itisalsoanopportunityfortheircarerstoattendaCarersgroup,orhavesomerespitefromtheir24/7caringrole.In2010-2011,DayHospicewelcomed82patients,totalling1,082attendances.

‘Look Good Feel Great’ & ‘Pamper Days’

Toboostmorale‘LookGoodFeelGreat’isavailabletopatientsand‘PamperDays’forcarers.Duringthelastyeartreatmentsincludedhand/footmassage,manicures,copingwithhairloss,hairdressingandmake-uptips.

‘Staying Steady’ Sessions

Offeredtopatientsandcarers,‘StayingSteady’sessionsteachtheartofrelaxation.Learningtheseskillscanreleaseandreducetension,calmthemind,improvephysicalbalance,sleepandtheabilitytodealwithstressfulsituations.

‘Benefits Surgery’ & ‘Question and Answers’ Sessions

The‘BenefitsSurgery’and‘QuestionandAnswers’sessionsprovideopportunitiesforonetooneand/orgroupdiscussionwithinvitedprofessionals.Topicsdiscussedincludednutrition,managingathomeandbenefits.Patientsandcarersalsobookedindividualinterviewsforspecificadviceonbenefits.

Complementary Therapy

ComplementarytherapytreatmentswereprovidedforpatientsandcarersfromthetreatmentroomsatDeerPark.TheComplementaryTherapyserviceincludedaromatherapymassage,Reikihealing,Indianheadmassageandreflexology.

Inherentlypresent throughoutall theSupportiveCarework is anawarenessofpeople’spastoralandspiritualneeds.Theteamprovidesaflexiblepresencetorespondasandwhentheneedarises,supportingpeopleofallfaithsandalsoofnone.


Our Staff and Volunteers

Allstaffandvolunteersattendappropriateannualtrainingtoensuretheyhavetheskillsrequiredtomaintainstandards.Ourcompliancelevelsforbothclinicalandnon-clinicalstatutorytrainingremainat98%.

Aspartofouron-goingtrainingdevelopment,thehospiceranitsfirstin-houseFoodSafetyCertificatecourse.

Our Wider Colleagues

Early in 2011,we began procurement for the newCrosscare software toenhancepatientmedicalrecordsandintegrationwithotherhealthcareprofessionals.

OurConsultantinPalliativeMedicineconfirmedhispositionastheElectivePeriodSupervisorfor2medicalstudentsinthecomingyear.

OurEducationdepartmentfacilitated8wholestudydays,specificallyforhealthandsocialcareprofessionalsworkinginend-of-lifecareacrossNorthDevon.Inaddition,working inpartnershipwith theUniversityofPlymouth, a specialistaccreditedPalliativeCarecourseworth20creditswasdelivered.

OurEducationdepartmentsecuredfundingfromNHSDevontodelivereducationand training in‘End-of-Life Care.’ This consisted of 4-part taster sessionsfollowedby6wholestudydays;with47tastersessionsand3wholestudydaysbeingdeliveredwithmoretofollow.Alleducationandtrainingwasofferedfreeofchargetohealthandsocialcareprofessionalsprovidingend-of-lifecare,inallcaresettingsacrossNorthDevon.

Facilitating Education, Training and Integration


“I feel that I’m living my life in full colour instead of black and white. With regards to how long my life will continue, who knows. All I know is it’s going to be a life well lived, a life completed.” Apatient

Our Priorities for 2011-2012

•To undertake stakeholder engagement thatwill contribute to thefuturedevelopmentofhospiceservices

• Thedevelopmentof a‘UserFeedback’ strategy thatwill enableustouseanexperienced-baseddesignapproachtodeliverhighqualityservices

• TodeliverservicesclosertohomeandacrossNorthDevoninordertoprovidemorereadilyaccessibleholisticcare

• Tofurtherdeveloptheintegrationofcareservices

• Tofurtherdevelopandco-ordinateeducationtomeettheneedsofstakeholdersandserviceusersand tosupport theachievementoftheabovepriorities

.OurPriorities2011-2012

The Board of Trustees Commitment to QualityOurBoardofTrustees takedirectresponsibility forensuringconsistentserviceimprovement,whilstsafeguardinghighstandardsofcareandcreatinganenvironmentinwhichexcellenceinclinicalcarecanflourish.

Qualityclinicalcareisachievedthroughevidenced-basedaudits.Theseorganisation wide audits ensure we are compliant with regulatoryframeworksaswellastakingintoaccounttheviewsandneedsofourpatientsandserviceusers.

Potentialrisksandaspectsofsafetywhichmayimpactonthestandardsofcareweprovideareregularlyreviewedandactedupon.Weareconsistentlyreviewingandimprovingourqualityofcareforthebenefitofourpatients.

StatementsofqualityassurancefromtheBoardofTrusteesareavailableintheAnnex.

With thanksOur care and support is provided to patients completely free ofcharge,however,itcostsover£3 millioneachyeartoprovide.

Withthankstothevaluedsupportofourcommunity,wecontinuetoraisethemuchneededmoneytofundourcare.Yourdonationsarewelcome,alwaysappreciatedandneeded.

Do you have any comments or questions? Wearealwayshappytoreceive feedbackaboutourservices. IfyouhaveanycommentsorquestionsaboutthisQualityAccountpleasedonothesitatetocontactus:

VanessaSaundersHeadofClinicalGovernance&AuditNorthDevonHospiceDeerParkBarnstapleNorthDevonEX320HU

[email protected]/01271344248

OurPriorities2011-2012

AnnexStatements of quality assurance from the Board of Trustees

Incompliancewithstatutoryregulations,NorthDevonHospice’sBoardofTrusteescanconfirm:

1.1During2010-2011NorthDevonHospiceprovidedorsub-contractednoNHSServicesdirectly.AgrantwasreceivedfromtheDevonPrimaryCareTrusttoprovidePalliativeandend-of-lifecare.

1.2 During 2010-2011, no National ClinicalAudits and no National ConfidentialEnquiriescoveredNHSservicesthatNorthDevonHospiceprovides.

1.3ThereportsofthirteenclinicalauditswerereviewedbyNorthDevonHospicein2010-2011andNorthDevonHospicewilltakeactiontocontinueimprovingthequalityofhealthcareprovided.

1.4ThenumberofpatientsreceivingNHSservicesprovidedorsub-contractedbyNorthDevonin2010-2011thatwererecruitedduringthatperiodtoparticipateinresearchapprovedbyaresearchethicscommitteewaszero.

1.5 NorthDevonHospice’sincomein2010-2011wasnotconditionalonachievingqualityimprovementandinnovationgoalsthroughtheCareQualityCommission.

1.6NorthDevonHospiceisrequiredtoregisterwiththeCareQualityCommissionanditscurrentregistrationstatusisactive.NorthDevonHospicehasthefollowingconditions on registration: to provide the regulated activities of Diagnostic andScreeningprocedures,Transportservices,Triageandmedicaladviceprovidedremotelyandthetreatmentofdisease,disorderorinjurywithconditionsasofthe31stMarch2011.

1.7TheCareQualityCommissionhasnottakenenforcementactionagainstNorthDevonHospiceduringthereportingperiodof2010-2011.

1.8NorthDevonHospicehasnotparticipatedinanyspecialreviewsorinvestigationsbytheCareQualityCommissionduringthereportingperiod.

1.9North Devon Hospice did not submit recording during 2010-2011 to theSecondaryUses Service for inclusion in theHospital Episode Statisticswhich areincludedinthelatestpublicationdata.

1.10 North Devon Hospice was not subject to the Payment by Results ClinicalCodingAuditduring2010-2011bytheAuditCommission.

Availabletopeoplewho:

Haveanadvancedprogressiveillness

Needadviceandcareforpainmanagementandotherdistressingsymptoms

Wouldbenefitfromholisticcare,withanyemotionalandspiritualneedsbeingaddressed

Thisincludes:

ClinicalNurseSpecialistsprovidingadviceandsupporttopatientsandfamiliesinthecaresettingoftheirchoice

Thehospicemulti-disciplinaryteamsharingcare,information,adviceandsupportwithotherhealthandsocialcareprofessionals

Community Specialist Palliative Care Nursing Service

Toprovideaspecialistpalliativecarecommunitynursingserviceforadultpatientswithcomplexproblemsassociatedwithalife-limitingillness

Access:Viacompletionofthe‘requestforservices’formorcalling01271344248.Whilsthealthcareprofessionalscanrequestcommunitynursingservices,thepatient’sGPmustgivetheiragreementonalloccasions.Acceptanceisreviewedduringthedaily(MondaytoFriday)referralteammeetings.


Haveanadvancedprogressiveillness

Needtreatmentforpainmanagementorotherdistressingsymptoms

Needend-of-lifecare

Thisincludes:

24hourcareinapurposebuilt7BeddedUnittohelpwiththemanagementofcomplexsymptomsorinprovidingend-of-lifecare

Alliedhealthcareprofessionalsprovidingonetooneandgroupsessions

ConsultantoutpatienttreatmentsandConsultantdomiciliaryappointments

Dischargeplanning

Thehospicemulti-disciplinaryteamsharingcare,information,adviceandsupportwithotherhealthandsocialcareprofessionals

Specialist Palliative Care Inpatient Service; the Bedded Unit

Toprovidespecialistpalliativecareinpatientservicesforadultpatientswhohavecomplexproblemsassociatedwithalife-limitingillness

Access:Inurgentandoutofhourscases,calltheDutyMedicalOfficerdirecton01271347214.Otherwiseviacompletionofthe‘requestforservices’form.AllrequestsmustbewiththeexplicitagreementoftheGPand/orrelevanthospitalConsultant.Acceptanceisreviewedassoonaspossible,avoidingdelayforadmissions.


Areover18andhavealife-limitingillness

Orareadultsorchildrendeeplyaffectedbythatpersonsillness

Orareleftbereavedasaresultofthatpersonsdeath

Thisincludes:

Supportgroupsforpatients,forcarersandalsothebereaved

DayHospice

‘LookGoodFeelGreat’sessions

‘It’sFriday’drop-in

Complementarytherapies

‘StayingSteady’sessions

‘PamperDays’forcarers

‘BenefitsSurgery’and‘QuestionandAnswers’sessions

Onetoonebereavementsupport

Supportforchildrenandtheircarers

PastoralandSpiritualSupport

Supportive Care Services

Toprovidearangeofsupportivecareservices,preandpostbereavement,topatients,carersandfamilymembers,includingchildren

Access:Viathe‘requestforservices’form.RequestscanbemadefromGP’s,Consultants,SocialServices,otherhospicesandotheragencies.Requestsareconsideredatanypointinthepatient’s/family’sjourneyandacceptanceisreviewedduringthedaily(MondaytoFriday)referralteammeetings.


Needpracticalnursingcareandsupportinthefinaldaysoflife


Haveadvancedprogressiveincurablediseaseandwhoagreetothereferralbeingmade

Thisincludes:

Practicalnursingcareandsupportduringthenightforpatientsduringthefinaldays

Practicalandemotionalsupportduringthenightforcarersduringfinaldays

Facilitationof‘JustinCase’boxesacrossNorthDevon

Thisincludes:

Symptomcontrol,includingpatientswithdistressingphysical,emotional,socialorspiritualsymptomswhicharedifficulttomanagebyprofessionalsinthecurrentcaresetting

End-of-lifecareforpatientswhoseneedsaredifficulttomanagebyprofessionalsinthecurrentcaresetting

Complexemotionalorspiritualissuesrelatedtothepatientsillness,thatarebeingexperiencedbyfamilyandcarers

Assessingpatientsforhospiceadmission

Community Palliative Care Service

Hospital based Specialist Palliative Care Service

Toprovidepracticalnursingcareandsupportforpatientsrequiringpalliativecare,andtheirfamiliesduringthefinaldaysoftheirlife

Toprovidesupporttoindividualswhohavecancerandanyotherlife-limitingillness,atanystageoftheirjourney

Access:Viaphoneduringofficehours(MondaytoFriday)bycalling01271347247oroutofhoursreferralsviaDevonDoctorsbycalling01392823666.Requestsfromallhealthcareprofessionals.Acceptanceisreviewedassoonaspossibletoavoiddelay.

The‘requestforservices’formsareavailableonlinefromwww.northdevonhospice.org.ukandcopiesavailablebycalling01271344248

Access:Viaphoneon01271311642.Referralscanbemade24/7bymedical,nursingoralliedhealthprofessionalswhohavetheagreementoftheconsultantteamresponsibleforthepatient’scare.

Working with GP practices& District Nurses

Working with Nursing Homes & Residential Homes

Working with Hospitals & Community Hospitals

Deer Park

Hospice Shops

Working in the homes of our patients across the community

Bideford

Barnstaple

Ilfracombe

Holsworthy

Bradworthy

Hartland

Westward Ho!

Abbotsham

Great Torrington

Black Torrington

Shebbear

Chulmleigh

South Molton

SwimbridgeLandkey

High Bickington

Braunton Heanton Chelfham

FremingtonInstow

Alverdiscott

Northam

Woolacombe

Combe MartinLynton

Beaworthy

www.northdevonhospice.org.uk/01271344248NorthDevonHospice,DeerPark,Barnstaple,DevonEX320HU

Registeredcharityno.286554

Quality Account 2010-2011for health professionals, patients and their families and carers

Documents

North Devon Hospice Quality Account 2010/2011