Annual Review

July 2007 - June 2008

The Norfolk Hospice

Our Vision Our vision is of a world where the best possible care is available to people living with a life-limiting illness or at the end of life whatever their circumstances.

Our Mission To be the centre of excellence for specialist hospice care for the people of Norfolk and the Fens and to be the main point of contact for health professionals requiring support with complex problems in palliative care.

Acknowledgements The Norfolk Hospice, Tapping House, thanks all those who have contributed to this Annual Review with their time, text, quotes and photographs. © The Norfolk Hospice 2009

The Norfolk Hospice, Tapping House (Tapping House Hospice Ltd) is a Registered Charity and is governed by a Board of Trustees. Patron Lord Fellowes GCVO, KCB Board of Trustees Mrs Tessa Scott (Chairman) Sir Jeremy Bagge, Bt, DL (Vice Chairman) The Very Reverend Michael Yorke (Vice Chairman) Mr Edward Carpenter FCA (Honorary Treasurer) Mrs Anne Bailey Mrs Lucinda Fox Dr Christina Mason Dr Rory McGouran Mr Richard Shaw Mr John Symington Senior Management Team Janet H Doyle, Chief Executive Tom Fitzalan Howard CBE Support Services Director John Hunt Director of Care Services Development Dianne Rowe, Director of Fundraising Glenda Skipper, Finance Manager Marc Stowell, Capital Campaign Director

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Capital Campaign President: Lady Jane Dawnay Chairman of Capital Fundraising: Mr Nicholas Corah OBE, DL Patrons: Mr Richard Jewson JP HM Lord-Lieutenant of Norfolk The Right Reverend Graham James Lord Bishop of Norwich The Right Reverend Michael Evans Bishop of East Anglia Charity Name: Tapping House Hospice Registered Charity Number: 1062800 Company Number: 3185605 Company Secretary: Mr Edward Carpenter FCA Registered Office: Tapping House Hospice, 38a Common Road (West), Snettisham, King’s Lynn, Norfolk PE31 7PF Auditors: Izod Bassett, 105 High Street, Needham Market, Suffolk, IP6 8DQ Solicitors: SJP Solicitors, Waverly House, 37 Greevegate, Hunstanton, Norfolk, PE36 6AB Bankers: Barclays Bank plc, 21 Tuesday Market Place, King’s Lynn, Norfolk, PE30 1JX

The past year has been busy and one of transition for the Norfolk Hospice, Tapping House. We have successfully reached important milestones in our plans for the future. Our dedicated staff and volunteers have met significant challenges with determination and commitment and I enormously appreciate everyone’s hard work during the year. The staff team has been strengthened by new colleagues joining us, bringing fresh energy and skills which complement the experience and local knowledge of the established team. As Chairman, I have received tremendous support from my fellow

Our patients and their families have been very complimentary about the care they have received. We are inspired by their confidence in the Hospice. All our services are provided free of charge to patients and their families. We continue to rely heavily on the generosity of our local community and benefactors to fund this care. During the year we held our first founder lecture dedicated to Dr. Hugh Ford, entitled ‘Unlocking Resilience in Hospice and Palliative Care’. Unlocking such resilience is what we aim to do for the individuals and the community with whom we work. Looking to the future, after a long search and an enormous amount of hard work, we successfully acquired

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the site, together with the necessary planning permission, for a new purpose-built hospice. This milestone enables us to finalise preparations for our capital fundraising campaign. Next year (2009 to 2010) we celebrate our 25th anniversary and there will be events to mark this achievement, as well as much work to do in developing our services to address unmet needs. We acknowledge that the coming year will be a challenging one, but know we can rely on your help to continue to support our existing and vital care services whilst we build the foundations for the future. We are most appreciative to all who have contributed over the past year in whatever way and we ask for your continued belief in our work.

Tessa Scott Chairman, Board of Trustees

Chairman’s message

Trustees, our Patrons and close associates, who have shown wisdom, foresight and great commitment in their freely given time.

A year of growth

services in the area. We are working to achieve this in collaboration with the community, and with colleagues in health and social care in the statutory and voluntary sectors. We have been pleased to be involved in working groups established by NHS Norfolk (the new PCT) to take forward the local End of Life Strategy. This year we have hosted the End of Life Facilitator post, funded by the Cancer Network. 2007-8 has been an eventful year with the focus on delivering and enhancing services, whilst developing the infrastructure to support the necessary growth of hospice care. An historic under-provision of hospice care in our region is widely acknowledged amongst policy-makers. We are encouraged that we have been recognised as the organisation best equipped to lead the development of new specialist palliative care

Continuity of care, and providing choice of where to be cared for or to die, are the objectives of this initiative. The Norfolk Hospice’s development plans are essential to the delivery of these objectives in the region. Much essential work has been dedicated to raising the profile of the Hospice, resulting in greater interest and support from community organisations, local and regional businesses, churches, schools

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and individuals. This has been aided by our new image and website, and the readiness of the staff, volunteers and supporters to host and attend events, and to develop stronger relationships with the community and the media. We are grateful for the support of Lord Fellowes as Patron of the Hospice and of Lady Jane Dawnay as President of the Capital Campaign, together with Campaign Patrons Mr Richard Jewson J.P., HM Lord-Lieutenant of Norfolk, The Right Reverend Graham James, Lord Bishop of Norwich, and the Right Reverend Michael Evans, Bishop of East Anglia. In December 2007, the first Founder Lecture took place, dedicated to Dr. Hugh Ford, a local GP who founded the Hospice in 1984 with the support of colleagues and volunteers. The lecture was delivered by David Oliviere, Director of Education from St Christopher’s Hospice, London. The theme was ‘Unlocking Resilience

in Hospice and Palliative Care’. Fostering resilience is essential for both the care services and for the organisation to achieve its objectives. Resilience includes the capacity to survive, thrive, grow and achieve in the face of adversity. At the event we were delighted to present long-service awards to many of our volunteers and

County Councils, MPs, local Parish Councils and other supporters. All have been eager to engage with, and support, the Hospice and to learn of our plans for the future.

David Oliviere ‘Unlocking Resilience’

to announce the new site at Hillington for our purpose-built hospice. A private launch of the Capital Campaign was held at the House of Lords in February 2008 and attended by both London and Norfolk-based supporters. It was a splendid occasion.

Dr. Hugh Ford

During the year, we have welcomed a wide range of visitors from local and regional community groups, civic and church organisations, related charities, the NHS, Social Services, Borough and

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We are conscious of the significant challenge that organisational growth presents, particularly for staff and volunteers. We have worked hard to achieve a balance between maintaining the current ethos whilst also creating the new and stronger profile and capabilities that will be needed to enable us to meet the urgent regional need for more hospice care.

Janet Doyle Chief Executive

“Working with the hospice means that together we can provide authentic holistic care to patients and families . . . we need more of that.”

Quality of life, quality of care

“We have nothing but praise for the expert care and understanding that my wife and I received.” Making a difference to someone who is living with a life-limiting illness, or facing death, can range from a meticulous assessment and plan of care by one of our specially trained nurses, to a simple act of support, practical help or a ‘listening ear’ just when it is most needed. Our Services We provide specialist care and support to patients living with cancer and other life-limiting illnesses, and also to their families. All our care services are provided without charge. We work closely with community and hospital health and social care services and alongside GPs, District Nurses and hospital colleagues, including the palliative care team, and with other

hospital admission or enable a patient to be discharged more speedily. We know from speaking to patients and their families that our Hospice Home Care service is invaluable. We are seeking new funds to enable us to help more people in their preferred place of care. voluntary service providers. We hold a weekly multi-disciplinary meeting at the Hospice and attend one at the Queen Elizabeth Hospital (QEH).

Day Therapy Patients visit our Day Hospice to enjoy therapies, rehabilitation programmes and other services.

Hospice Home Care For many people there really is ‘no place like home’ and we continued to provide trained specialist nurses, therapists and volunteers to care for people in their own homes, to the extent our resources allowed. This included care for those with diagnoses other than cancer.

The services include advice and help from our nursing team, physiotherapist, occupational therapist and social worker, complementary therapies such as – massage, reflexology, shiatsu, reiki, relaxation and visualisation – hairdressing, chiropody, creative activities and more.

Our home equipment loan service is well used. It can avoid an unnecessary

Many of the therapies have proved helpful in reducing anxiety, pain

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and stress-related symptoms and in promoting relaxation and general wellbeing. Day care patients often form close bonds with each other as a group and we celebrate birthdays and other events and offer time for reflection remembering those who have died. Lunch is a family arrangement, with volunteers ensuring beautifully laid tables and waiting on the patients. After lunch there is quiet time, a chance to doze or take part in creative therapies. A review of the Day Hospice was

undertaken this year as we know there is unmet need in our community and there are space limitations with our current building. This resulted in some changes to long-established practices and the recognition of the need for us to actively promote our home care and outpatient services. Also we completed a programme for people with neurological illnesses, funded by St James’s Place Foundation. Following its evaluation we have increased our physiotherapy service by one day per week. We are identifying new resources for this large and dependent group of patients, who often wish to retain independence for as long as possible and yet have to cope with complex symptoms and a changed way of life. Outpatients Our outpatient services include nursing assessment, advice and support,

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complementary therapies, podiatry, physiotherapy, occupational therapy and lymphoedema management. These will expand in the coming year in response to the wishes of our users. The lymphoedema service, run in conjunction with the local PCT, continues with regular clinics held at the Hospice. A joint review of this service revealed the need to ensure better access, especially for women with breast cancer. Further discussion has taken place with the QEH to begin to address this.

Quality of life, quality of care

The planned provision of blood transfusion, and other technical procedures, due to be implemented in partnership with the Norfolk Community Care and Treatment Team, has been delayed due to organisational changes in the PCT. Once established, this will enable care closer to home. Carers’ Support An integral part of our work is carers’ support. We recognise that the contribution played by those who look after loved ones with life-limiting illnesses is complex and physically and psychologically demanding. Each situation is different and our aim is to look at each person individually and tailor care accordingly. We continue to provide support for carers both individually and through group meetings, where members can share their experiences and their responses to problems. We aim to

We have run a small ‘back to back’ pilot programme, where an outpatient visit combines a session with the family support worker and a complementary therapy session. There is great potential to develop this with a range of benefits to all. We have involved carers through questionnaires and meetings in helping us consider how to take the service forward.

support carers through the highs and lows of their loved ones’ illnesses, to encourage, listen and learn, and to be there at the end and in bereavement, if necessary. This year we have developed closer links with other agencies, including West Norfolk Carers, to ensure continuity of care.

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Bereavement Support Bereavement is something that will touch us all and it can be an overwhelming experience that affects every area of our lives. For most people the support of family and friends is sufficient to help them cope with the distress, but others find it helpful to talk with someone else. Supporting people in bereavement is an integral part of the care offered by the team at The Norfolk Hospice.

Many of the people we support are already known to us, whilst others are referred from colleagues including the hospital Macmillan team, local GPs or through self referral. We try to base the support we offer on the needs of the individual through:

• telephone support • one-to-one counselling at the

Hospice or in their own home

• informal visits to the Hospice for a cup of coffee and a chat

• complementary therapies that may help relax and aid sleep

• the opportunity to meet with others in a similar situation through the Hospice Bereavement Support Group

• time to remember loved ones at

special services such as the ‘Light Up a Life’ series of services at Christmas.

The need for more equitable

bereavement care across Norfolk has been identified, and our expertise has been recognised. We will take this work forward in the coming year so that more people receive the appropriate assistance they need. Working Together This year we have hosted the End of Life Facilitator, funded by the local PCT. This is a short term post, which has focused on implementing the National Gold Standards Framework (GSF) in the community. The Facilitator worked with GPs and District Nurses implementing the GSF, which assists teams to ensure the patients’ preferences are met and that care for those at the end of life is as seamless as possible. It has also helped to raise the profile of the work of the Hospice. User Feedback Internal feedback arrangements have been reviewed and, in addition to questionnaires and feedback forms, a

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new user group has been established. We continue to receive very high levels of user satisfaction. John Hunt As the year draws to a close, we welcome John Hunt to the new role of Director of Care Services Development.

Our volunteer team

“I used to help as a volunteer at the Hospice and thought it was a terrific place; now I’m a patient. That’s why it is such an important part of our community . . . it could be you next!” Over 150 local people generously give The Norfolk Hospice their time, energy, commitment and skills, free of charge. They are the backbone of our hospice; they fundraise, drive, support the care team, cook, stick up posters, offer IT support, staff our shops, look after our lovely garden, work in the office and help us with events. The list is endless! Perhaps more importantly, volunteers help us to create a rich environment of relationships offering friendship, laughter, comfort in times of need, practical assistance, relaxation and the gift of dignity. Anyone can apply to join us and we are extremely fortunate to continue to

We have a wide range of volunteer roles at the Hospice including:

attract people with a variety of talents and backgrounds. We offer training in many areas for volunteers. This year, we’ve visited other well established hospices around the country. With new insights we are now looking at how we can improve our volunteer support and training as we increase our care services and outreach work. We estimate that volunteers working for the Hospice have saved us in the region of £200,000 this year. The Hospice recognises the enormous support of the volunteers and highly values their contribution. We look forward to continuing to increase the volunteer team in the year ahead.

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Fundraisers From country fairs and fêtes, to charity balls and sponsored events, there’s always something exciting going on. Drivers / Escorts Could you help us with the challenge of transporting patients who otherwise could not visit the Hospice? Administrative Staff It’s really important that we keep records up to date, deal with incoming calls in a friendly manner, and that our filing is accurate. Event Volunteers Team From putting up marquees to setting out chairs, tables and other event equipment, the Hospice requires people who can help out with setting up and clearing up at events. Care Volunteers Supporting the care team in patient and family services.

Total incoming resources Expenditure Cost of generating funds: Cost of generating voluntary income Lottery operation and prizes Shops expenditure Charitable activities: Provision of hospice services New Hospice Development costs Governance costs: Total resources expended Net incoming resources

2008 £

Summary Balance Sheet Fixed assets Current assets Creditors: amounts falling due after more than one year

211,170 63,530 107,071

Net current assets

501,821 1,304,351 (700,305) 604,046

120,512 167,977 164,176 38,076

Total assets less current liabilities Creditors: amounts falling due after more than one year

1,105,867

Net assets

1,105,867

130,612 2,006

Funds Unrestricted Restricted

1,005,130

Total

803,407 302,460 1,105,867

105,268 106,962 94,936 503,257 198,736

“When I’d experienced the difference the Hospice makes, I decided to remember it in my Will . . . Who knows when any of us will need such care”

7,446 1,016,605 (11,475)

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Financial summary

Income Incoming resources from generated funds Voluntary income: Donations and grants Development Legacies Activities for generating funds: Fundraising income Lottery income Trading from shops Investment income Incoming resources from charitable activities: Grants and contracts Services and other income

Funding our vital work

Morning and our Autumn Fair. Of particular encouragement is the development of more events and fundraising activities organised by our volunteers and supporters, including the Priory Rotary Club Dinner and Auction, Stratford’s Golf Day, numerous Open Gardens and sponsored events.

The success of our fundraising activities is fundamental to meeting the growing demands for our vital care and support. In the last year, we have achieved significant income growth. This year we have increased the number of, and income from, events organised by the Fundraising Team, as well as providing support to volunteers and organisations that raise money for the Hospice. Some key events this year have been our Great Norfolk Skydive, Norfolk Companion Dog Show, Sandringham Stroll, Spring Coffee

We have continued to raise funds directly from new and existing individual supporters through our Spring Appeal, Light Up A Life and, increasingly, through regular giving by standing order or through payroll giving. The largest gift that many people can make to support our work is to remember the Hospice in their Will. This year, legacy income totalled over £100,000 (10% of income). The Hospice is grateful for the support that we receive through various partnerships with local and regional businesses and organisations including

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Cooper Roller Bearings who selected us as their charity partner, Beeston Hall School who supported us through a May Ball, Inner Circle Homes, Abbey, The Norfolk Provincial Grand Lodge of Freemasons and many more. Many other individuals, companies, organisations, trusts and foundations have supported us during the year and we would like to thank all those who have helped us and continue to do so. This year we have also successfully increased our income from our retail shops in Downham Market, King’s

Lynn and Snettisham. Our shops continue to be an important source of funds as well as providing a strong presence on the high street. The introduction of some new product ranges and a record year of Christmas card sales have boosted the amount raised by our shops.

Aside from income generated from our shops and lottery principal funding resources are from the Norfolk PCT (now called NHS Norfolk), voluntary individual donations, charitable trusts and organisations and businesses, some of which are listed below.

The Norfolk Hospice Lottery has had a successful year and we have been regularly encouraged by record numbers of weekly players. Our Lottery continues to appeal as a regular way of making a contribution, whilst having the chance to win £1,000 each week!

Abbey Charitable Trust Barclays Bank Caithness Crystal Campaign Care 94 Cooper Roller Bearings Dent’s Charity Book Sales Hardwick Association Help the Hospices Hughes Electrical Hunstanton Round Table Hylton Gott Images Joey and Friends

Our fundraising efforts are only successful due to the crucial part that our volunteers play in helping to raise money through events and ongoing activities. To all the volunteers who help in our office or shops, at events or collections, and the many other ways, we are extremely grateful.

John and Lucille van Geest Foundation King’s Lynn Football Club King’s Lynn Priory Rotary Club King’s Lynn Vancouver Round Table Palgrave Brown Foundation Pandora Books Provincial Grand Lodge of Norfolk RAF Marham RAOB Appleton Lodge RAOB Wiggenhall Lodge Sandringham Estate Cottage Horticultural Society Snettisham Caravan Park The AB Charitable Trust The Caron Keating Foundation The Freemasons Grand Charity The John Ackroyd Trust The Sandringham Royal Warrant Holders Association Wogan plc Wolferton Social Club

The Norfolk Hospice, Tapping House, is proud to be a Member of the Fundraising Standards Board scheme and the Institute of Fundraising. We adhere to a

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strict set of codes and we are committed to treating the public with respect, fairness, honesty and clarity in all our money raising activities.

Looking ahead

“Our heartfelt thanks for helping my father’s transition from life to death be – just right. We will never forget the Norfolk Hospice.”

to our facilities to enhance privacy and dignity, through our Creative Living Project (funded by the DOH).

25th Anniversary In 2009/10, we shall celebrate the 25th Anniversary of the Hospice. A series of events will be held to mark this occasion, celebrating our first 25 years and looking forward to our half-century. The Future In the year ahead we will strengthen our partnerships and collaboration with the NHS and other related agencies. All our work enhances and complements the services which patients and their families receive from statutory health and social care providers. However, the statutory sector is unable to meet all the needs of those requiring palliative and hospice care. This situation is expected to continue, regardless of national initiatives and frameworks being

introduced. Patients, and families, who are at the end of life and facing death and who require hospice and specialist palliative care need to know that high quality, responsive and coordinated care is available for them now. Over the next three years, we shall build on the knowledge we have gained of what the community needs and we aim to create new day therapy programmes and broaden our home and outpatient services. We plan to expand our multi-disciplinary care team and make cost effective improvements

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Developing our services Our service development plans will take account of the national and local End of Life Strategy and our evaluation of how well the community is served. We will continue to develop our engagement with user views and feedback. We have already identified the need to extend and develop additional posts in the clinical multi-disciplinary team, in particular a palliative care medical officer, spiritual care and rehabilitation expertise including occupational therapy. The latter was previously funded by a short-term grant and this now needs to be reestablished. Negotiations have begun with the local Queen Elizabeth Hospital Trust, Palliative Care Consultant and PCT to explore the potential of joint working and a partnership proposal to acquire a second consultant, whose focus would be the community including the Hospice.

Other services which will be expanded over the next three years, subject to resources are: • Bereavement Care • Family Support Service • Outpatients including lymphoedema service • Hospice Home Care • Carers Support • Information Service • Complementary Therapies How much of these service improvements can be implented in the next three years will depend on income generation. We recognise that the economic climate is not auspicious, but we have a compelling case because the area we serve is currently so underprovided compared with other parts of the UK, and we enjoy tremendous support. Developing our Hospice We expect to continue to make significant progress with the new hospice project and the capital

campaign. We shall further increase organisational capacity to deliver services to meet the needs of the communities served. In November 2008, Nicolas Corah was appointed Chairman of Capital Fundraising. He brings significant capital fundraising experience and his appointment has been a great boost to our campaign. We are very grateful to have been provided pro bono with a

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small office at the Sandringham Visitors’ Centre to house the Campaign HQ. Work for the new development over the next two years will include completing the detailed design, refining and containing costs, preparing to tender for the construction contract, further strengthening the fundraising team and increasing revenue fundraising capacity.

How you can help

The Norfolk Hospice, Tapping House, has to rely heavily on its friends and supporters. If you would like to help us you can do so in many ways – big or small. You may wish to: • Make a donation to support our care. • Encourage your workplace, community, local school or church to support us. • Become a Hospice volunteer – you could help us with driving, day or home care, fundraising, our charity shops and much more!

• Join our Lottery – you could win £1,000. • Attend one of our events – or organise your own! All sorts of great events support our work: from coffee mornings to skydives! • Consider leaving a legacy in your Will to ensure future security for the Hospice.

To obtain an information pack on ways of giving, or suggest any ideas of how you can support us, please contact the Fundraising Team on 01485 542891 or email: [email protected]

Common Road (West), Snettisham, King’s Lynn, Norfolk PE31 7PF Care Team 01485 543163 Fundraising Team 01485 542891 [email protected]

www.norfolkhospice.org.uk Registered Charity No. 1062800

Hospice Services The Norfolk Hospice,Tapping House, is founded on a philosophy of holistic care. Simply put, we aim to care for the whole person, encompassing the physical, emotional, practical and spiritual needs of patients. We also offer a range of services to families and carers. Our services include: • Holistic day therapy • Home hospice support • Bereavement support • Regular carer support groups • Transport • Equipment loan • Information • Physiotherapy and complementary therapies • Occupational and creative therapies • Lymphoedema management • Family support service