When the Hospice opened in 1986 it was fully funded by the Health Board. For 25 years legacy income was abundant and, even though statutory funding reduced to 30%, money was never an issue.

By 2012 the Hospice had a £568k deficit and could face closure. Staff were worried, Trustees were distant.

What did we do?

• A new CEO was appointed – is the issue just about money or does culture play a part?

• Introduced “Blue Sky Suppers”, horizon scanning workshops. The Board are responsible for future direction. Help the Hospices Commission resources form the basis of the discussion. We need to look out to move on.

• Chairman stood down, 50% turnover on the Board. Board skills reviewed

• CEO joins the CCG as a Lay Member, conducts a review of commissioning intentions

• A 3 year strategy is developed linked to commissioning intentions – “Plan on a page” for each objective

• 5 year deficit reduction plan takes shape

• Review of Board Governance and sub-committee structures

• Chair joins HUK Board, CEO and Chair attend “Partners in Success” programme

• Communication channels reviewed – introduced Team Briefing, Staff Forum and revised Corporate Induction – we are all in the loop if we choose to be!

• “Keepers of the old culture” begin to move on

• Review of medical and nursing staffing structures – we must be “fit for the future”

• Intense media campaign – “Save our Hospice for Future Generations” – created a sense of urgency in the community. A social movement for the 21st Century

What did we do?2 years later we are budgeting a breakeven position and surplus in the next 18 months. The team understand why change had to happen and the community understand that a valuable community asset cannot be taken for granted.

Recommendation Hospices must be aware of current and future challenges and should review their models of working. Where is your Hospice on the scale – fossilised or future-proof?