As highlighted in a recent report from the Care Quality Commission, the end of life care needs of people who are homeless are often overlooked and this group generally do not access hospice and palliative care as widely as the general population – for a variety of reasons.
Earlier this month, a team of doctors, nurses and social workers from Royal Trinity Hospice who were concerned about the lack of homeless people accessing hospice services organised an event to bring together professionals from across the voluntary, health and social care sectors to address this issue.
The event featured speakers from Royal Trinity Hospice, Guys and St Thomas’ NHS Foundation Trust, St Mungo’s Broadway, University College London and Doctor Hickey GP Surgery. In total, over 15 organisations were represented at the event.
Speaking after the event, Dr Barbara Sheehy-Skeffington, palliative care consultant at the hospice, said: “The event highlighted the challenges in reaching out and providing care for the homeless population, including difficulties in accessing state-funded care and a reluctance on the part of some to engage with healthcare services.
“Many of these challenges will be difficult to address, but there is certainly much potential for improvement, for example, in terms of palliative care specialists providing education and support to empower those who work with homeless services to provide care for those with life-limiting illnesses.
“It was agreed that mutual support and networking are key to improving access to – and coordination of – care. Feedback from participants revealed an enthusiasm for developing and maintaining contact networks, as well as future events to promote joint working.”
Education and training for front line staff
This month also saw Prospect Hospice deliver the first in a series of training sessions for front line staff from organisations working with homeless people within its catchment area.
The intensive half-day session was attended by 25 individuals from seven local organisations, and feedback was very positive, according to Warren Finney, head of community engagement at Prospect Hospice. Warren also said that staff from the hospice were keen to be involved in the training sessions, so that they could learn from those with skills and experience of working with homeless people.
Prospect Hospice, along with Dorothy House Hospice Care and Salisbury’s Hospice, are providing a series of training sessions for homelessness organisations across Wiltshire, thanks to funding from Health Education South West.
The joint funding bid was made by the hospices who recognised that the best way to improve support for the homeless community was to up-skill the front line staff who are already working with – and already known to – those they are trying to reach.
Sessions cover identifying palliative and end of life care needs, how to have conversations about death and dying, where and how to refer people to other services, as well as how to support those who are left behind when someone they are close to dies.
The training being provided by the three hospices builds on successful training first provided by Dorothy House last year.
Simon Parrett, education facilitator at Dorothy House, explains why the training was such a success: “The courses provided a two way learning opportunity. On one hand, the multi-disciplinary team were able to share specialist end of life care knowledge and skills to a varied group of practitioners working with homeless people. On the other, the multi-disciplinary team learnt an equal amount from the participants about the challenges and priorities of their work contexts.
“This kind of sharing was highlighted within the evaluation process as one of the main strengths of the training. It allowed networking between agencies, a growth in confidence around the subject of end of life and, in particular for Dorothy House Hospice Care, it enabled the development of direct clinical relationships with providers offering direct support to people who are homeless.”
Hospice Education Partnership
Dorothy House and Prospect Hospice have also announced this week plans to work closer together to roll out education sessions to local healthcare staff to help improve end of life care.
In addition to training for those working with homeless people, the hospices have announced they will be working together to provide communications skills training and syringe driver training.
Rachael Chronnell, education manager at Prospect Hospice, explained: “Education services are going to be crucial in the years ahead in enabling hospices like ours to reach all the people who are going to need specialist end of life care in the coming years.
“We are delighted that we will be working closely with our colleagues at Dorothy House Hospice Care from this autumn to bring our collective expertise to train Wiltshire healthcare professionals in support of local people.”