News and Comment

Chief Executives must act to secure a sustainable future for hospices

Tuesday 13 May 2014


Lucy Nickson is Chief Executive of Ashgate Hospice in North Derbyshire and was a speaker at OPM’s recent seminar on end of life care

The Help the Hospices Commission report into the future of hospice care states that hospices need to be able to adapt in order to secure a sustainable future and be ready to meet increasing demand for palliative and end of life care. As Chief Executive of  Ashgate Hospice in North Derbyshire I agree with this entirely, and to this end, I firmly believe that hospice chief executives cannot underestimate the need to reflect on and review their own approach to working with commissioners in particular, as part of that process of adaptation.

Hospice chief executives are key to driving a culture which is accepting of innovation, risk and transformation. This involves engaging those at every level in hospices, from Board to ward, to ensure a readiness to respond when commissioners begin to look more closely at hospice services or, to ensure that hospices themselves can drive opportunities to increase their offer and reach.

Like many other hospices, Ashgate has struggled in the past to promote itself and to be recognised by local commissioners as a vital service provider of palliative and end of life care provision in the local area. Much of our recent success in securing further income and developing our contractual relationship with commissioners is due to a persistent approach of raising awareness with commissioners about the very broad portfolio of  services that the hospice offers, and in describing how a number of our own strategic goals are so closely aligned to those of the local CCG.

This is a challenge that all hospice chief executives face and of key importance is the ability for hospice leaders to have confidence in their own ability to influence, and to show the contribution that hospices can make to all parts of the health and social care system. It is clear that hospices have a fundamental role to play in shaping and transforming palliative and end of life care on a local, regional and national scale. I believe much of this opportunity will come through education and further penetration of hospice expertise into NHS services, care homes and other providers of palliative and end of care.

This thinking may well be met with some internal challenge. Chief executives may find that driving forward this view is unpopular with their local supporters, their workforce or even their Board. However, I would argue that as hospice leaders we have a collective responsibility to respond to the commission report and to be part of transforming the hospice movement. Promoting and developing our influence and reach to raise  standards in palliative and end of life care across all settings is essential to improving the environment in which we all operate, and in will lead to longer term improvements in the provision of hospice care, and access to it, by local people.

By reflecting on their own organisation’s readiness to change, challenging those who may resist adaptation where it is needed, chief executives can position individual organisations in local areas to gain maximum support and to provide a much more integrated service.  Furthermore, by coming together as a collective group of hospice leaders the opportunity to influence, to educate and to start to transform the provision of a really effective, high quality service for people with palliative and end of life care needs, wherever they are in the country, becomes a really exciting and more realistic strategic goal.