When I came to The Hospice of St Francis in early 1997, care was delivered from eight beds in a small family house in Shrublands Road, Berkhamsted. All bedrooms were shared except for one tiny single room. There was one day room and no other private place to have a conversation – so I had lots of meaningful chats about life and death in the bathroom with patients and families!
But the care was attentive, holistic and personal – just as it is today
So 22 years on, in a new building that is now 12 years old, what has changed?
The care is still extraordinary, but our services are much more diverse. There was a homecare service back in the 90s but the caseload was small. Now our community team is supporting around 220 patients at home at any one time, providing a safety net of support at times of crisis.
What is very different now, is the well-being and rehabilitation approach in our Spring Centre. which has replaced the day hospice. The focus is on making every day count, discovering what matters to people and supporting their hopes and dreams as best we can.
And medicine has changed! When I qualified as a doctor in 1980, the Brompton Cocktail was a remedy for severe cancer pain – a terrifying mixture of morphine, cocaine, chloroform water and alcohol! We still use morphine, still the gold standard for pain, but without the additives!
Back in the 90s there were fewer policies, fewer documents, we recorded notes by hand, we didn’t have mobiles. Now we have hundreds of policies, electronic records and mobile phones. There is certainly more to distract us but we still find time to explore the priorities that matter for each person.
The challenges for the future are many – we are all living longer with more complex health issues, our hospitals are busy and barely coping, nursing homes need support and our communities are fragmented.
So The Hospice of St Francis needs to have vision, be radical, work in different ways to reach more people, and teach more people. We need to harness the power of technology bravely, but still retain the essence of care that is our hallmark.
It has been quite a journey for me. I have learnt from every patient and family, and it has been a pleasure and privilege to return to the bedside this year – no longer as the CEO, but just a doctor journeying with our patients and those who love them.
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