CARE at home and avoiding unnecessary visits to Plymouth hospitals is a key priority says local charity St Luke’s Hospice.

Research from Dying Matters, a national coalition which aims to help people talk more openly about dying, death and bereavement, states that more than 70% of people wish to die peacefully at home. St Luke’s Hospice Plymouth care at home teams are helping to make this a reality for residents in Tavistock as they work in partnership with other healthcare professionals to put end of life care on the agenda locally.

This week is Hospice Care Week, an annual celebration of the work hospices do. This year the theme is ‘We are Hospice Care’, highlighting the many faces of people involved in hospice care throughout the country. From St Luke’s nurses to the healthcare providers that work alongside, Hospice Care Week is about celebrating everyone involved in providing and supporting hospice care.

St Luke’s works in close partnership with local GPs, Livewell Southwest district nurses, Tavistock Hospital and Brentor and Moor Compassionate Neighbours to give end of life care in Tavistock.

The St Luke’s at home team provides the support to enable people to remain in the comfort of their own homes, reducing unnecessary journeys to Plymouth hospitals and ensuring that they receive the care they need in the last months, weeks and days of life.

Derek Hart is the dedicated St Luke’s specialist nurse for the Tavistock area and has been working for the local charity for the last six years.

Derek can travel up to 100 miles a day visiting terminally ill patients in their homes, offering support, guidance and medical care and advice. He supports patients throughout Tavistock and the surrounding area.

In the last year Derek has made 605 patient visits. Almost half of all these visits took place in rural outlying areas including Princetown, Bere Alston, Mary Tavy and Lifton.

Although the majority of Derek’s patients are seen in their own homes, Derek also works closely with Livewell Southwest staff at Tavistock Hospital, local care homes and agencies and has even received funding from The Burdett Trust to facilitate end of life care at Dartmoor Prison, helping to deliver symptom and pain management to prisoners with terminal illnesses.

Derek wants to ensure that wherever possible, his patients are cared for where they want to be, in a familiar setting or environment: ‘Many of our patients don’t want to go all the way to a Plymouth hospital,’ he said. ‘They would prefer to stay locally in their own homes or at Tavistock Hospital, which many feel can be more relaxed and not as busy as a ward in an acute hospital.’

A key aspect of the end of life care provision that St Luke’s provides in Tavistock and the surrounding area is partnership work, ensuring that patients receive the best possible end of life care. Derek said: ‘When facing the rural challenges of Dartmoor we have to ensure that our care is co-ordinated with other local healthcare professionals, with effective communication, using our resources more efficiently, to deliver patient care, but also giving a higher standard of end of life care as well.’

These challenges mean that Derek and his team have to think efficiently when visiting patients, often undertaking joint visits with other local healthcare professionals or planning to fulfil a patient’s medication needs.

Harry Lee Cutler, Livewell Southwest GP at Tavistock Hospital, said: ‘St Luke’s is really important. We get a few palliative care patients in this hospital and they can have quite complex needs that require specialist input. St Luke’s has that extra bit of time to be able to run through their symptoms and offer advice with specialist medications to ensure that patients are comfortable and their holistic needs are met at the end of their life. They can also provide this care right here in Tavistock without the need for patients to go into the unit at Turnchapel or Derriford.’

Jane Martin, Livewell Southwest community sister at Lifton surgery and district nurse for the Tavistock area, works alongside Derek and St Luke’s on a regular basis. She said: ‘Compassion is fundamental to all nursing care but even more fundamental is the provision of caring for dying people and those close to them.

‘Working in partnership and having frequent communication with Derek are paramount in the rural area we serve. He has the specialist knowledge of guiding us throughout the patients care in particular with pain relief and symptom control. Our joint home visits are so beneficial to the patient, dedicating time to talk through any worries or concerns and providing a co-ordinated package of care to ensure they remain at home.’

Derek has also been instrumental in creating the Tavistock Palliative Care Forum, providing an opportunity for local healthcare professionals to join together every few months to share their skills and knowledge and help to deliver seamless end of life palliative care.

Derek said: ‘Education and communication are the two prime factors for effective working here in Tavistock and I think that utilising all our skills and helping to support each other are paramount in achieving this.’

However, the care Derek and his team provide for the people of Tavistock goes far beyond hands-on care. A key part of the work Derek does is encouraging conversations around advanced care planning, working closely with Brentor and Moor Compassionate Neighbours to help communities come together in care provision. For more information visit: www.stlukes-hospice.org.uk/ compassionate communities

‘Living in such a rural area does mean that traditionally it has felt difficult for some patients to get access to support, which means they become more reliant on the involvement of family members with the delivery of care.

‘With an aging population it is important that we help to find new support networks for residents. That is why we work to educate carers and other healthcare professionals in delivering end of life care and in doing so we are helping to develop compassionate communities, giving everyone a responsibility when it comes to end of life care.’

Derek concluded: ‘We do still have work to do and are constantly adapting the care and support we provide to meet the needs of the Tavistock community and an ageing UK population. End of life care is high on the agenda in Tavistock and I believe as a collective of healthcare professionals we are making a real difference to the Tavistock community.’

For more information about St Luke’s work in Tavistock and to watch a short video, visit www.stlukes-hospice.org.uk/tavistock