Oral History 3: Homecare

When Dame Cicely Saunders founded St Christopher’s in 1967, she had envisioned that patients would not only receive expert care and support on the wards of the hospice, but that they would also be given the opportunity to receive palliative medicine in their homes. In 1969 an interaction with one particular patient compelled Cicely to expedite her vision.

A woman with terminal breast cancer receiving care at St Christopher’s hospice had one day surprised Cicely by requesting to return home, having had her pain effectively controlled on the ward. Sadly, upon returning home, her local GP refused to continue prescribing the necessary dosage of diamorphine and she returned to the hospice in a great deal of pain. It was this upsetting incident that motivated Cicely to launch a service that would allow patients to receive bespoke end of life care and palliative medicine from the comfort of their own homes.

Doctor Mary Baines and Sister Barbara McNulty were tasked with establishing this new provision. With no existing service to draw inspiration from, Mary consulted the local community, engaging with patients and healthcare professionals alike to better understand their concerns and requirements. Their message was clear, the community wanted a twenty-four-hour service whereby doctors and nurses could be called upon to provide pain control and attend to psychological and social needs. The first palliative Home Care service in the UK was henceforth established in accordance with these guiding requests and quickly became an invaluable resource for resident across South East London. Furthermore, with an increasing number of patients choosing to remain at home, St Christopher’s was able to expand the number of patients under its care.

The model for St Christopher’s Home care has been replicated across the world and fifty years on the principles of this service remain unchanged. The home care team now provides support to patients and families across the London Boroughs of Bromley, Croydon, Lambeth, Lewisham and Southwark. Staff at St Christopher’s work side by side with GPs and district nurses, not only caring for patients in their homes but providing targeted advice and support to their families and the wider community.

In the following video, Doctor Mary Baines details the founding of the Home Care service for the Oral History Project