Background St Gemma’s day hospice offered a broad range of face-to-face support services prior to the pandemic. This activity had to stop in March 2020, but it was clear that patients and families still needed support. The day hospice service was transformed into the Support, Therapy and Resources team (STAR).
Aim STAR aims to support patients and their families with advanced disease, many of whom were shielding during early stages of the pandemic and not able to access their normal treatment and support.
Methods Support was offered by telephone, face-to-face home visits, in virtual groups or more recently in outpatients. Registered nurses and palliative care support workers hold their own caseloads. The service has provided advice and education for patients and families, enabled access to MDT, reduced social isolation, built relationships and introduced patients to hospice. STAR evolved using patient feedback and review of future model will include stakeholder engagement, cost effectiveness, activity levels, the broader community model and government guidelines.
Results Day hospice attendances, prior to the pandemic were, on average, 128 per month (2019-20) in contrast to 216 patient contacts per month 2020-21. With the same staffing model this provided a reduction in gross costs of over £30 per patient (Scheme 1 £101.16 vs Scheme 2 £70.32). Patient feedback is excellent – one patient stating ‘STAR has been a lifeline in difficult circumstances when people needed to shield and were very isolated’.
Conclusions STAR has provided much needed support during a difficult period. Work is ongoing on the final community model at hospice although, through work so far, we know video training is as effective as face-to-face, patient satisfaction is high and the service is liked by the whole team but lack of peer support/social engagement is missed by patients and use of technology is a barrier for some.
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