We focus on providing care, love and respect

Annual Review 2015

Contents page The Senior Management Team. Left to right: Mark Jackson, Chief Executive; June Patel, Care Director; Dr Nicky Wilderspin, Consultant in Palliative Medicine and Medical Director; Tricia Cavell, Fundraising Director and Dan Corns, Shops and Commercial Director. About us St Richard s Hospice offers excellent, free specialist palliative care, comfort and compassion to patients living with life-threatening illnesses and supports their families. In 2014 St Richard s celebrated 30 years of care in Worcestershire. Originally we cared for patients in the South Worcestershire areas of Worcester, Droitwich, Pershore, Evesham, Malvern, Tewkesbury, Broadway, Martley and surrounding areas. Since 2008 we also offer in-patient care for patients from the Wyre Forest, Kidderminster, Redditch and Bromsgrove areas. We offer a free package of support, tailored to the individual, whatever the patient s physical, emotional or spiritual needs. St Richard s is an independent charity which relies on donations and gifts in Wills to fund three quarters of the income needed to provide our services. Chairman s reflections 3 Quality of life, quality 4-5 of care St Richard s Nurse 6-7 Specialists/Hospice at Home The In-patient Unit (IPU) 8-9 The Family Support 10-11 Service Day Hospice 12 Therapies 13 Spiritual care and 14 chaplaincy Education 15 Our volunteers 16 Funding our care 17 Financial Review 18 A year to remember - our achievements in brief We supported 2,597 patients and family members 1,250 patients were supported by our Nurse Specialists in their homes and in the community 273 new patients were admitted for the first time into the In-patient Unit 221 patients attended Day Hospice 1,364 individuals were helped by the Family Support Team 146,172 hours worked by volunteers across the organisation We focus on providing care, love and respect Chairman s reflections This review celebrates the many ways in which St Richard s Hospice has continued to care and support our patients, their loved ones and carers to meet the increasing needs of our local community for end of life care. The Governors are very proud of all our staff and dedicated volunteers who make it possible for St Richard s to offer excellent free specialist palliative care with compassion, kindness, dignity and respect. We are continually grateful to our wider community and supporters who fundraise so unwaveringly to pay for these services. John Bawden, Chairman All staff and volunteers, in many different ways, play an essential role in ensuring that care is of the highest standard. We are blessed to have such motivated staff and volunteers that work tirelessly on a daily basis to achieve this goal and we are eternally grateful for their on-going support, commitment and compassion. As a team, we value feedback from patients and their loved ones about the care we provide and this report provides many examples. Our focus on providing care, love, respect and attention to small things that provide comfort are eloquently expressed in this quote from a letter: June Patel, Care Director Everyone who visited my wife during her short stay under your care was most impressed with the hospice as a whole, the level and depth of care being provided and for the work being undertaken by St Richard s. My two daughters (both employed within the health service profession) could not believe the level of care given to their mother whilst she was alive and after she had died and, if printed, their accolades would run into many pages. In short, like me, they could not believe that the level of care, the attention to the smallest of details, and most of all, the love and respect extended to the patient could exist in the busy modern age. We will remain in your debt for the rest of our lives. 3

The successful integration of the new extension to our In-patient Unit means that our five year plan has been achieved in three years. Consequently, our Council of Governors have initiated an in-depth Strategic Review of options for the next five to ten years which will shape our services for the future. Mark Jackson, Chief Executive The fantastic staff both full time and volunteers. The willingness to go the extra mile such as allowing my sister to have a wedding blessing. Doctors who were happy to take time to explain things and listen to you. A general feeling that your loved one really was in the best place possible. Quality of life, quality of care Our hospice is welcoming and homely, set in beautiful gardens and grounds. Student physiotherapist Ana Dantas-Horta E Costa says the experience gave her a new perspective on life St Richard s Hospice has managed to continue to expand our community services despite increasing financial pressures. For the third year in succession our NHS grant has been frozen, which equates to a cumulative inflationary reduction of 10%. While in previous years we have been able to counter this with increased charitable income raised, this last year has been challenging. In this financial year the cost of delivering our hospice care was 4.615m, yet we only received 1.967m from Commissioners. Since the initial signs were discouraging, plans to expand our Hospice at Home team were put on hold. Due to excellent work from our income generation teams we were able to rectify that position after six months and recruit additional staff for that team. We continue to be surprised by perceptions of hospice care. There are very many people who think that hospice equals beds and a place to die. Both views are inaccurate. St Richard s started delivering hospice care with one specialist nurse in the community 31 years ago. We have only had beds for eight years. As can be seen from this report, in 2014/15 we helped 2,597 patients, families and carers across Worcestershire in the community, yet only had 303 admissions to our beds in the In-patient Unit. On average we are able to discharge 40% of all those who are admitted back to community settings. St Richard s is a community hospice supported by in-patient beds. What do we mean by that phrase? Clinical and medical staff provide hospice care through our Doctors, Community Nurses, Hospice at Home, Day Hospice and Therapists. Additionally our Social Workers and Counsellors, augmented by properly trained volunteers, provide social and psychological care. All are supported by our Chaplaincy team providing spiritual care. Additionally, we have a Citizens Advice Bureau adviser and we have local teams of volunteers that give practical support and company in patients homes. In all cases hospice care applies not just to the patients but also to the families and carers. This model of properly coordinated, compassionate, community care is exactly the type of integrated care that the NHS and Local Authorities are seeking for the future. Education is a key part of our mission. As a recognised centre of excellence St Richard s Hospice, with our partners in the Centre for Palliative Care at the University of Worcester, delivers education and training for a very wide cross section of clients. We have medical placements for Specialist Trainees in Palliative Medicine, Foundation Year 1 Doctors, and students from Birmingham University Medical School. Student Nurses, Physiotherapists and Social Workers from the University of Worcester are also placed at the hospice. In addition to our franchise to deliver the Gold Standard Framework for Care Homes we also have End of Life Care awareness and bereavement training for professionals, carers and volunteers from other charities. We are especially pleased to have been able to help both of our partner NHS Trusts train their own Ward Managers via our Quality at End of Life Care for All programme courses. Our commitment to clinical quality, patient safety and dignity The St Richard s Medical Team provides specialist medical expertise to support the different clinical teams of the hospice, with regular input to the In-patient Unit, the Day Hospice and Community Teams. We work in close partnership with the Worcestershire Health and Care NHS Trust s Community Palliative Medicine Consultant, who provides medical support to the Clinical Nurse Specialist team and with NHS Worcestershire Acute Hospitals Trust s Consultant, who leads the Worcestershire Royal Hospital palliative care team. We have a team of interested local GPs who contribute to the provision of medical cover at weekends. The new consultant led, multidisciplinary, hospice clinics for people with advanced non-malignant diseases, including cardiac, respiratory and Parkinson s disease, have evaluated well, using the successful model we established for advanced renal failure. The clinics continue to be funded by the NHS South Worcestershire Clinical Commissioning Group and are in partnership with consultants from the NHS Trusts. Members of the hospice medical team contribute to education, both within and outside the hospice. We host regular training placements for newly qualified doctors and senior palliative medicine specialty trainees. We continue to provide Connected advanced communication skills courses for senior health professionals in collaboration with the University of Worcester (UoW). New educational events this year have included a study day in collaboration with the UoW for clinicians training in acute medicine, and hosting a delegation of Chinese doctors in collaboration with Birmingham University and the Gold Standards Framework. We have become research active and are delighted that the hospice is involved in a multi-centre National Research Portfolio study, investigating some important clinical questions about the best ways of caring for people in the last days of life. Dr Nicola Wilderspin, Medical Director It is such a beautiful place, not just in appearance, but of the dedication of staff. Just know it was so the right place for my husband to be. I can t thank them enough, for the peaceful end my husband had. 4 5

Our nursing teams in the community Our Nurse Specialists support patients and families in a wide variety of ways. St Richard s Nurse Specialists The Nurse Specialist Team is highly experienced and staff are able to use their skills and knowledge to help manage patients distressing symptoms, assist them in making informed choices, identify and refer on to appropriate additional services and liaise with colleagues from different services. The Nurse Specialists tailor their support to individual needs so patients may be seen at home, in GP surgeries, at a clinic or at the hospice in Worcester. Some patients choose to be supported by a regular telephone call rather than a visit. The triage team responds to crises and offers urgent visits when required. This is highly valued by patients, families and health care professionals. The Nurse Specialist team also provides support and advice out of hours: this takes the form of a combination of telephone advice overnight and a nurse able to make home visits during day time hours at weekends and bank holidays if required. Sharing expert knowledge of response based on patient need. The telephone service triage has introduced a step down facility where patients who no longer require a home visit can be contacted by triage and support given by phone. Joint working with Prostate Cancer UK continued with the provision of Men s Space, a men s gardening and support group which has received very positive feedback. I don t know what my life would be without your nurse, no words can express the thank you for all her kindness, help and understanding, the list goes on but I m running out of paper! I very much value the home visits and phonecalls and above all the continuity of care. I do not have to start at the beginning. I also appreciate knowing that there is back up support. Hospice at Home The Hospice at Home service provides additional support which enables patients to remain in their own home at the end of life. The service runs 24 hours a day, seven days a week. The Hospice at Home service works closely with GPs and District Nurses to provide additional care for patients with palliative and end of life care needs. The patients, their families and carers benefit when most in need; whether in the final stage of life or a short, acute episode of care associated with their illness. The team offers support which includes: Crisis intervention Support to those living alone Additional pre-admission and post discharge support Carer support The team has depth of experience in supporting patients families and carers emotionally and psychologically. We are privileged to receive the help that we have experienced from you all. It is immensely reassuring to know that you are there and that we can rely on your dedicated carers support especially during the night hours. Team members have shared their expert knowledge through a range of educational activities including events at the University of Worcester and a project for student nurses. The project offers students in all training branches (adult, child and mental health) bespoke training and clinical placements within St Richard s Hospice. Evaluation has been highly positive and has seen 34 students spend time at St Richard s Hospice. Caseload management has been reviewed to identify priorities The on-going visits, despite not being on any treatment, stops my imagination going wild. Any symptoms that occur with my own cancer fixation we can discuss whether they deserve any further nervous energy and if not put down on the ignore pile. After each visit I feel my positivity is restored and I can continue to live with rather than die from cancer. The team has strengthened its ability to respond quickly by introducing a rapid response shift. A team member is now allocated to work within the In-patient Unit to respond to requests for urgent support. This service is well used and proving vital to admission prevention. The team has increased to 14 full time Healthcare Assistants enabling more care and support to be provided in patients homes 24 hours a day. 6 7

The In-patient Unit Pets are welcomed into the In-patient Unit. Here, a Pets As Therapy (PAT) dog and owner greet a patient. The In-patient Unit provides specialist palliative care to patients and their families. This whole person care aims to achieve the best quality of life for patients and their families. We try to respond to all of the needs that a patient or family may have be they pain and symptom control issues, physical problems or concerns of a spiritual, social or psychological nature. The expanded and remodelled In-patient Unit allows for the care of up to 17 patients at any one time in mainly single rooms, offering greater privacy and dignity and allowing staff to support even more patients and their loved ones. This became fully operation in July 2014 and has greatly improved our ability to admit patients. The In-patient Unit team has considerable experience in symptom management and are skilled in all the principles of palliative and end of life care.the In-patient Unit continues to support student nurse placements, physiotherapy students and paramedic student placements. Having privacy at such a difficult time was much appreciated. The nursing staff were caring and very quick to respond if you needed them. The emotional support from nurses and social services was much appreciated by us both. The use of a patio area outside and the pond was very relaxing and helped everyone get through a difficult time. My partner loved your gardens where he was pushed out in his bed to watch both the ducks and the world go by, thank you for all your loving care. 8 9

The Family Support Service Children and carers are among those receiving help from the Family Support Team Bereaved individuals learn cooking skills in a group in the hospice kitchen The staff, volunteers and students make up a skilled and professional team offering a comprehensive and specialist service to patients and their loved ones. The Family Support Service received 396 more referrals compared to last year, an increase of 35%. On average 140 referrals are made each month for counselling, social work, bereavement and group support and for advice from the Citizen s Advice Bureau Adviser. In addition, there are referrals for support for patients and families on the In-patient Unit, patients requiring support from the Community Service Volunteers and for Bereavement Support South Worcestershire, a service commissioned by the NHS South Worcestershire Clinical Commissioning Group to support individuals experiencing the sudden, unexpected death of a loved one. I was grateful for the opportunity to express my feelings to a sensitive ear. You were my lifeline at an absolutely awful time in my life. In brief: 1,526 Family Support referrals 2,110 face to face sessions 3,147 telephone contacts 1,170 Family Support Service Group attendees 117 group sessions 101,054 obtained this year for hospice patients and families in benefits and grants by CAB adviser I made it to my birthday. Thank you for everything. All the times you just sat with me, made me tea and just gave me a hug when I needed it. I nearly ended it so many times when I just couldn t see another way out and at times you were the only thing that stopped me, I feel so blessed that you stuck with me. Family Support group work Bereavement Support South Worcestershire and the Family Support Service have combined some groups so that both services are working together to provide support to a maximum number of clients. A third Carers Group started in September 2014 ensuring support for all individuals referred. The bereavement drop-in group for adults continues to offer a set number of sessions where they are able to meet at the hospice fortnightly. This group now also meets at the St Richard s Hospice Snowdrops shop cafe regularly, encouraging attendees to be self-supporting after their allocated number of sessions. The hospice Head of Catering worked with groups of bereaved individuals to learn basic cooking techniques, giving them the skills to cook healthy and nutritious meals, which can be a challenge for many reasons when grief is raw. I could explain my feelings without fear of boring others with what some people would call stupid. The fact that no one said pull yourself together you must man up. Community Volunteer Service The Community Volunteers are now based within the Family Support Service. Funded by The Daisy Foundation, currently 40 volunteers provide patients support with shopping, sitting, walking the dog, taking them to hospital and doctors appointments, amongst other supportive activities. This is a 100% service and I can only recommend it to anyone else in my situation, I could not have managed without the help I received, thank you. bereavementsupport S O U T H W O R C E S T E R S H I R E This service is commissioned by NHS South Worcestershire Clinical Commissioning Group. Counselling, support for children and families, telephone support, a telephone helpline and group support are available for individuals and families who are bereaved through sudden and unexpected death. The website is regularly updated to offer a range of information and guidance for people experiencing bereavement (and/or their carers) as well as resources available for professionals. It provides a signposting link to a range of information related to grief and loss. Awareness of the service has increased and many GP surgeries now regularly refer bereaved individuals. The telephone helpline receives enquiries from bereaved individuals who are seeking support or advice; many of these clients have been encouraged by their GPs to make contact thereby enabling them to be more autonomous in determining what support they need. The number of people supported since the beginning of the service in 2012 has reached in excess of 800 clients. I can honestly say you saved my own life, after the death of my beautiful mother. I was ready to end it all.. Counselling has empowered me in ways I had never expected. I feel I can move forward with a reclaimed sense of purpose. I am positive about the future, a future I thought I did not deserve.. The Schools Project continues to offer help to school staff when they are supporting a pupil experiencing bereavement. This joint project between St Richard s Hospice and Bereavement Support South Worcestershire has been implemented for schools in South Worcestershire during 2014, funded by NHS South Worcestershire Clinical Commissioning Group. The initial aim is to empower Teachers and Teaching Assistants to support pupils in their grief whilst enabling a more balanced and healthier view of death, dying and bereavement throughout the school environment. 10 11

A Day Hospice patient enjoys a drive in a volunteer s Morgan Day Hospice and Out-patient clinics The Day Hospice continues to be an integral part of the specialist palliative care provided by St Richard s Hospice. A maximum of 20 patients are seen on a daily basis (Tuesday to Friday 10.30am - 3.00pm). The Day Hospice is nurse led and the supporting professional multidisciplinary team includes Complementary Therapists, Creative Therapist, Chaplain, Doctor, Occupational Therapist, Physiotherapist and trained volunteers. A volunteer Yoga Therapist has also started providing once weekly yoga sessions. Patients can also access other services within the hospice which may include counselling, family support, financial and benefit advice. Every Monday a Palliative Care Out-patient Clinic is held in Day Hospice (Parkinson s, Respiratory, Cardiology and Renal) and comprises of a comprehensive team to give holistic care, including I would like to thank you all so very much for all your support during his illness. I know Fridays were very special to him he enjoyed the company and support given to him and always had so much to tell me when he came home especially the lovely meals. You are all such very special people doing a wonderful job. a volunteer Osteopath. Clinic numbers continue to grow and these clinics are receiving excellent feedback from both patients and carers. Saturday Social Group runs on the third Saturday of every month and is offered to patients who may feel anxious or socially isolated when they are discharged from Day Hospice. Patient and Volunteer Forums are held bi-monthly. Suggestions are made by both patients and volunteers regarding how Day Hospice can be improved. Feedback is given to the patients and volunteers that same day where possible. Patients and volunteers continue to make positive comments around food, transport and the wide range of activities taking place within Day Hospice. Therapies Complementary Therapies Our philosophy of care supports the use of complementary therapies in conjunction with standard care to promote a sense of well-being and improve quality of life. Therapies are available, without charge, to patients who attend Day Hospice, in-patients and out-patients. The service is provided by a Complementary Therapy Co-ordinator, Lead Complementary Therapist and ten Volunteer Therapists, all of whom are fully trained, experienced and hold recognised qualifications in their respective therapies. The therapies available include: Aromatherapy; Massage; Reflexology; Reiki; M Technique simple method of structured touch; Relaxation Techniques and Indian Head Massage. The team provided 879 treatments in 2014/2015. Occupational Therapy The service continues to offer a responsive service to both the In-patient Unit and the Day Hospice including arranging and carrying out home assessments to enable a fast discharge home from the In-patient Unit if that is the patient s wish. Out-patients are able to receive advice, home assessments and provision of recommended equipment to help improve their independence or help to manage difficult symptoms. Physiotherapy The Physiotherapy service has continued to develop to offer a diverse service to support patients within the In-patient Unit, the Day Hospice, the clinics and with staff working with patients in the community. Physiotherapists meet patients and prepare individual treatment plans. The service now has three volunteer Physiotherapists, a volunteer Yoga Therapist and a volunteer Osteopath. A training programme for Community Volunteers enables them to assist patients with exercise programmes in their own homes. Sessions in adapted Tai Chi are run as a regular exercise group in Day Hospice. Creative Therapy Creative Therapy includes the recording of treasured memories, creating memorabilia for family and friends, distracting from the pressures of life and feelings of anguish, fear, hope, reassurance acceptance guilt or confusion. Work can be created by individuals or in groups and is led by a Creative Therapist, supported by a team of volunteers. St Richard s Hospice also benefits from the support of the community with schools, local artists and musicians visiting to share their talents. 12 13

Spiritual care and chaplaincy Education and Resource Centre What could have been a lonely and cold experience for the few who care about her has been softened and changed by your cheerful kindness. St Richard s Hospice has been caring for the whole person (physically, emotionally, socially and spiritually) for over thirty years, with a chaplaincy team leading on spiritual care throughout. Today s team includes a wide range of professional and life skills to allow it to offer individual care to people of all faiths and philosophies. The Lead Chaplain is charged with ensuring that high quality spiritual care is provided across the organisation. The Associate Chaplain leads on caring for patients in the community, responding to the many referrals from our community nurses. These two part time Chaplains are supported by a number of Volunteer Chaplains in Day Hospice, the In-patient Unit and in the community. The team is available throughout the year - and 24 hours a day - offering a spiritual care service to patients, families and carers. A fair amount of time is also given over to supporting other hospice staff and volunteers in their emotionally demanding work. The team is the main point of liaison between the hospice and the clergy and other faith leaders in the community and offers regular support, advice and training. In the year 2014-2015 it was involved in the training programmes of a large number of church pastoral care teams and provided teaching opportunities for church and other faith groups. The multi-faith resources available through the team help to provide a warm welcome to the hospice for patients and families from the world s varying religious traditions, as well as those with non-religious beliefs. The team is very proud of its connections with a variety of faith groups in the community and plays a full part in the local Interfaith Forum. Chaplaincy organises the Remembrance Celebrations (formerly the Memorial Services) jointly with the Family Support Team, with around 100 people coming on each occasion. These are significant events in the life of the hospice. With the Fundraising Team Chaplaincy arranges family access to the hospice Tree of Life garden where individual memorial leaves can be hung either with, or without, a short ceremony. The Lights of Love services are very well attended and appreciated by a wide cross section of the community. The Sacred Space continues to be well used. Visitors can light a candle (1,000 a month on average), add a prayer or a memory in the books provided, come to see the Book of Remembrance, ask a Chaplain to say a prayer or just take advantage of the peace and quiet. Our thanks to you for the wonderful service you conducted. It was everything and more that as a family we could have wished for. Members of the Barbados Cancer Association (BACA) visited St Richard s to learn more about the hospice and to share experiences. Investment in education and training has made an impact on wider organisational improvement and is supporting and sustaining service improvements, innovation and research. Future workforce and providing clinical and work experience placements St Richard s Hospice has a tradition of providing high quality clinical placements for students undertaking education and training programmes in health and social care. As the organisation has grown and invested in education and training of its own staff and volunteers so there has been a growth in the availability and range of these placements. The amount of time dedicated to providing education and training to the workforce of the future will aid recruitment and sustain the services we provide. A strengthening partnership with the University of Worcester has resulted in changes to the way we provide specialist education to pre-registration nursing students and an increase in the number of clinical placements for student nurses and, for the first time, a student Physiotherapist. Innovative new ways of providing specialist education now include the annual Student Nurse Conference where specialist palliative care is introduced to the whole cohort of second year student nurses followed up with an elective second day at the hospice and then selected experience in various departments across the hospice where they experience specialist palliative care being delivered at first hand. Linked to this has been an increase in the number of mentors for students within the hospice and an understanding by staff that mentorship and training learners is a core element within their role. We now provide clinical placements and/or on-site education and training to: Medical students from Birmingham University Medical School; Student Nurses and Physiotherapists from the University of Worcester; Student Social Workers (from a range of universities) and Student Counsellors (from a range of education providers). We also provide work experience placements for students from a range of schools and colleges that include Worcester Sixth Form College, King s School Worcester and Heart of Worcestershire College. St Richard s was a wonderful placement and I am very grateful to have been part of the team for 8 weeks, although I wish it had been for longer! Practice support It is recognised that working in specialist palliative care can be emotionally and physically very demanding. All hospice staff have access to practice support which allows them time to reflect on their practice and seek ways of managing the emotional stress. As well as the internal support available, St Richard s Nurse Specialists, Social Workers and Counsellors also access external Clinical Supervision which for some is a mandatory element of their role. 14 15

Funding our care Our volunteers Volunteers have continued to provide invaluable services to all areas of the hospice with a total of 948 across the organisation, of which 361 are active volunteers in Patient Services. Our volunteers contributed a total of 146,172 hours over the last financial year. If this activity was provided by paid staff this would cost the hospice 1,060,988. Volunteers involved in patient services worked for 35,697 hours in the year; their contribution equates to a saving, if this was provided by paid staff, of 314,249. For example, trained Family Support Volunteers worked 1,502 hours during the year; Day Hospice volunteers worked 8,138 and Complementary Therapists 815 hours. Our Community Volunteers worked with patients for 1,296 hours, the equivalent of over 10,000. While volunteers assist in a wide range of patient areas, their help with fundraising events and contribution within the administrative functions of the hospice are also essential. Our volunteers within the Commercial Department make a significant contribution with over 104,000 hours contributed by our volunteers in the shops and warehouse. Their contribution along equates to a value of 700,432. Open Evenings for potential new volunteers were held at regular intervals throughout the year, attracting 72 new volunteers who went on to complete the General Induction programmes, held bi-monthly. All patient services volunteers have now also completed an Introduction to Listening Skills in the Palliative Care Setting course. Volunteering gives me a sense of satisfaction and giving back to the community a little of something that has been given to me. The principles of St Richard s and the fact that I am part of it makes me feel proud. Approximately 70% of our funding comes from voluntary income and we are extremely grateful to our community for the continued support of our work, enabling us to care for nearly 2,600 patients and families. Fundraising This has been a very challenging year for fundraising with income from both the general public and statutory sources reduced. Attracting voluntary income to sustain hospice contributions to the health and wellbeing of the individuals in the Worcestershire community is becoming increasingly vital. A further consideration is the plethora of new and emerging charities in the community all seeking the donor pound. During the next financial year St Richard s has the challenge of raising over 7million to fund the hospice services and plan for the future. The hospice cannot do this without the ongoing support from the community and the involvement of many individuals, groups, clubs, schools, churches and local businesses. Many trust and grant organisations remained committed to supporting our work. This income helped make a difference and the income received from individuals that chose to leave St Richard s a gift in their Will, helps the hospice to plan for the future. Thank you. Lottery The Hospices Lottery has had a busy year, with 1,000 new members. Our 15th Anniversary draw went well, raising just over 19,000. We had been looking at ways of raising more revenue through the lottery and, as a result of this, at the start of the new financial year Primrose Lottery merged with us. This will save greatly on administration costs, which will mean we will be able to provide more profit share to each hospice lottery partner. Shops and Commercial St Richard s Hospice shops have traded well again this year. The first three quarters of the year were buoyant but saw a downturn in the last quarter, we however still managed to increase sales 7% on the previous year. Just less than 600,000 items passed through our tills with over 6,000 customer transactions per week. This sales figure has been enhanced dramatically by the Gift Aid that we can claim on donated goods which again contributed over 100,000. With the integration and streamlining of the Gift Aid system which took place at the end of the financial year and the accuracy that the automated system with our new tills will bring, we hope to see an increase in our Gift Aid income. It has been one of our most exciting years with the opening of our largest store encapsulating over 15,000 books and 3,000 items of fashion along with a café. This continues to hold a strong market presence for the Trading Company and our shops could not survive without the support of our donors and customers. This is propped up by the fantastic facility of our Warehouse at Leigh Sinton which has to sort through approximately 2.3 million items a year donated by the generous public and local businesses. All this is only achievable with the support of our committed staff and our incredibly loyal and generous volunteers. 16 17

Financial review Total income decreased by 4% to 7.35m with total expenditure increasing by 14% to 7.37m. Expenditure on patient and family care and education services amounted to 4.9m. Lottery income of 83k and investment gains of 291k enabled the hospice to increase its total reserves by 357k to 12.5m at 31 March 2015. The reserves which are freely available for general purposes amounted to 5.5m. The Council of Governors is undertaking a Strategic Review that will set out the direction and use of these reserves for the next 5-10 years. For the third consecutive year NHS funding has been frozen with 73% of this year s funding coming from voluntary income and our shops. Once again we are indebted to our community, through the wonderful commitment of its individuals, businesses and groups, which has enabled the hospice to end the year in a strong financial position. Richard Shaw, Honorary Treasurer How we raised our money... Summary of Income... and how we spent it Summary of Expenditure Year Ended 31st March 2015 INCOME 000s Fundraising, grants, donations and events 2,122 Trading Company 2,371 Gifts in Wills 698 Education and Study Centre 61 NHS contributions 1,967 Investment income 139 Total 7,358 EXPENDITURE Our charitable work Patient and family care 4,615 Education and study centre 286 Fundraising and publicity 729 Trading company 1,729 Governance 16 Total 7,375 (17) Income from joint venture Lottery 83 SURPLUS for year 66 Investment gains 291 Net increase in reserves 357 BALANCE SHEET ( as at 31st March 2015) Fixed assets 10,959 Current assets 2,274 Current liabilities (684) Net current assets 1,590 Net Assets 12,549 Represented by: Unrestricted funds general 5,547 Unrestricted funds designated 3,060 8,607 Patrons Col William Bell Mrs Rosalie Dawes MBE Mr Andrew Grant DL Mrs Louise Hewett Lady Huntington-Whiteley The Right Reverend Dr John Inge, Bishop of Worcester Digby, Lord Jones of Birmingham Mr Colin Kinnear OBE Mr Jim Lewis Miss Patricia Routledge CBE Mr Philip Serrell Mrs Sonia Woolven Mrs Jeannie Young MBE Board of Governors (as at 1st October 2015) Mr Galen Bartholomew Mr John Bawden Mrs Jenny Cowpe Mrs Hannah Edwards Mr Peter Flagg Mr Anthony Glossop Mr Simon Hyslop Prof Richard Lewis Mrs Andrea Palmer Dr Jan Quallington Cllr Andy Roberts Mr Richard Shaw Miss Brenda Sheridan Mrs Anne Sullivan Professor Tamar Thompson OBE Professor Veronica Wilkie The Senior Management Team Chief Executive Mr Mark Jackson OBE Care Director Mrs June Patel Medical Director Dr Nicola Wilderspin Fundraising Director Mrs Tricia Cavell Shops & Commercial Director Mr Dan Corns Bankers National Westminster Bank plc 1 The Cross, Worcester, WR1 3PR Solicitors HallmarkHulme, 4 Sansome Walk, Worcester WR1 1UQ I would like to help my local hospice... I enclose a donation of (please make cheques payable to St Richard s Hospice) Please debit my MASTERCARD / VISA / CAF / DEBIT CARD Number Valid from / to / Issue No Security No (last 3 digits) Signature If you do not require a receipt, please tick box To donate quickly and securely online go to www.strichards.org.uk Gift Aid allows us to claim back 25p for every 1 you give to us, boosting the value of your donation by a quarter. All you need to do is to sign the declaration here. Signature I confirm I have paid or will pay an amount of Income Tax and/or Capital Gains Tax for each tax year (6 April to 5 April) that is at least equal to the amount of tax that all the charities or Community Amateur Sports Clubs (CASCs) that I donate to will reclaim on my gifts for that tax year. I understand that other taxes such as VAT and Council Tax do not qualify. I understand the charity will reclaim 28p of tax on every 1 that I gave up to 5 April 2008 and will reclaim 25p of tax on every 1 that I give on or after 6 April 2008. Name Address Date of Declaration Postcode Please complete and return to: St Richard s Hospice Fundraising Dept, Wildwood Drive, Worcester WR5 2QT. Tel: 01905 763963 Fax: 01905 760938 Please send information on my local fundraising support group Please send a Gifts in Wills leaflet Please send a lottery leaflet I would prefer to receive information via email. My email address is: I would like to become a Hospice Volunteer Please send me information on Regular Giving Please send information on Payroll Giving If you do not wish to receive updates from St Richard s Hospice, please tick Restricted Funds 3,942 12,549 18

St Richard s Hospice Wildwood Drive Worcester WR5 2QT Tel: 01905 763963 Fax: 01905 760938 www.strichards.org.uk email: enquiries@strichards.org.uk Registered charity no. 515668 Registered company 1850502 A Gift for the future Find us on Facebook Follow us on Twitter and Instagram Caring for life The mission of St Richard s Hospice is to enhance, through specialist palliative and end of life care and education, the quality of life of patients, and those important to them, suffering from life-threatening illnesses. After you have provided for your family and friends, perhaps you would consider a gift in your Will for St Richard s Hospice. Every in every Will makes a difference Gifts from Wills to St Richard s ensure that we can continue to care for our patients and family members in the future. Including a gift to St Richard s in your Will is easy There are a number of options when it comes to writing your Will, but we always recommend consulting a solicitor. If you already have a Will and wish to add a gift to the hospice, your solicitor will advise on the best way to do this. For more information about leaving a gift in your Will to St Richard s Hospice please contact the Fundraising Team on 01905 763963 or email appeals@strichards.org.uk www.strichards.org.uk/raise-funds/gifts-in-wills Copyright St Richard s Hospice, October 2015