Patient feedback in 2018 highlighted the value of therapeutic intervention for patients accessing inpatient services in supporting timelier, more innovative symptom management and safer discharges home and a requirement for equitable access to therapy provision across the hospice, seven-days a week. A bespoke 18-month intensive competency based learning and training programme was created to develop healthcare assistants to deliver therapeutic interventions inclusive of non-complex physiotherapy, occupational therapy, complementary therapy and lymphoedema care. A blend of practical and theory based learning to evidence practice of extended knowledge, skills and expertise.

This interdisciplinary approach has strengthened collaborative working with patients, their relatives/carers to support them to achieve their personal goals and priorities. The responsiveness to patients resulted in a reduction of waiting times and a flexible person-centred treatment plan enables confidence building in performing daily living. A patient described how adopting a pacing approach taught by an Advanced Assistant has influenced significantly on her fatigue levels and on her mood as she feels less guilty and is able to enjoy more activities with her family. The significant impact of the roles have been captured through quantitative and qualitative data. Activity data supports that they are now already able to offer Reiki and Slow Stroke Massage across seven days, which in some cases, has resulted in patients not requiring pain medication due to non-pharmacological symptom relief.

A year into the training programme, the Advanced Assistants are ahead of the envisioned timescale of learning and development. They are able to optimise people’s function and wellbeing to enable them to live as independently and fully as possible, with choice and autonomy, within the limitations of advancing disease.