Health chiefs speak out ahead of crunch meeting on replacement for St Clare's Hospice

Health chiefs have spoken out ahead of a crunch meeting to decide the future of end of life care in South Tyneside.
The former St Clare's Hospice in Jarrow.The former St Clare's Hospice in Jarrow.
The former St Clare's Hospice in Jarrow.

The borough has been without its own dedicated inpatient palliative service for almost two years, following the closure of Jarrow’s St Clare’s Hospice.

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South Tyneside’s Clinical Commissioning Group (CCG) previously gave £800,000 a year to support care at St Clare’s Hospice, but will almost double this to £1.5million for the new plans.

If approved by NHS chiefs on Thursday, September 24, the proposed model will pump extra resources into improving community palliative care services for those choosing to die at home.

However, the move to base a new four-bed facility at Haven Court, on the South Tyneside Hospital site, has been blasted by campaigners and the borough’s MPs.

Ahead of the meeting to decide the proposals, CCG bosses have confirmed that bed capacity at Haven Court could be boosted in future, if there is demand.

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“If we find that the demand exceeds what we have set out then absolutely we will look at whether there is a need for expansion,” said Matt Brown, the CCG’s executive director of operations.

“Firstly, the vast majority of deaths actually take place sadly in hospital and after that it’s at home and in care homes.

“The proposal talks about putting a vast amount of investment into supporting more people to be supported at home.

“We also recognise that there is the need for private, dignified, en-suite bedrooms in a dedicated facility in Haven Court for us to support people to pass away there should that be their wish.”

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Mr Brown was speaking at a Health and Wellbeing Board on the eve of the decision, following questions from the panel’s chair and leader of South Tyneside Council, Cllr Iain Malcolm.

He added: “In terms of the specific numbers, if you look back to St Clare’s previously the bed occupancy was about 51% over the last three years of its existence.

“So of the eight beds about half were generally used, the second thing is the four [beds] is what we think is workable within the staffing and the resources that are available at this point.

“I think we have got to be realistic about a very challenging financial and service delivery environment that we have and we will certainly look to review it as time goes on.

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“The other point is, I defy anyone to be categorical about the patient behaviour post-Covid, it’s really challenging for us to predict exactly what people are going to do.

“So for us it’s a case of, let’s make a start here, we have no end of life beds in South Tyneside as it stands and the proposal is to make sure there are absolutely four.

“Should that number need changing, we will change it over time.”

The plans for end-of-life care did not please campaigners or either of South Tyneside’s MPs when they were announced earlier in September.

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The demise of St Clare’s

The St Clare’s Hospice charity went into insolvency in early 2019, after Care Quality Commission inspectors highlighted a number of issues, giving the hospice service an overall ‘inadequate’ rating.

Health chiefs added the hospice also faced challenges in taking on several admissions at the same time.

And if there was a booked respite admission planned, the Health and Wellbeing Board were told, St Clare’s sometimes couldn’t take patients for end of life care straight away with people having to wait for a slot to be admitted -which could be up to a few days.

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CCG boss Matt Brown also responded to a question about why services could not return to the former St Clare’s site, at Primrose Hill.

“I think it comes back to some of the practical realities, sadly there is no hospice at Primrose Hill and I know that was a real blow to the whole community when it closed two years ago,” he told the meeting.

“But there is no facility, no entity, there’s no doctors, no nurses, no staffing, no organisation to work with, no catering, no equipment, no medicine.

“So actually creating a new establishment is a very different challenge to developing beds when you’re with existing partners to build on the facilities we have.”

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He added:”If you look at the whole hospice sector it’s really struggling.

“I spoke with a number of hospices this week about the challenges for charitable investment, which was obviously a large part of the St Clare’s costs of £2.1 million, a large part was charitable investment of about £1. 3 million.

“It’s a really difficult funding environment for existing providers, let alone establishing a new provider.”

The long-awaited report on the future of palliative care in South Tyneside was tipped to be released earlier this year but was pushed back due to the Covid-19 outbreak.

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The plans were developed through a ‘co-design’ process which included discussions with stakeholders and several workshops.

A final decision will be made by South Tyneside CCG’s Governing Body, which will be held via videolink and broadcast on the CCG’s YouTube page.

The meeting will take place between 9am-11am.

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