The Earl Mountbatten Hospice presents the Annual
Accounts for 2006

These are a brief presentation -
for a full set of accounts please email to chiefexec@iwhospice.org

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Earl Mountbatten Hospice

Report of the Trustees

For the Year Ended 31 March 2006

 

 

The Aims of the Hospice

In general, to contribute the special skills and resources of the Hospice to the overall provision for the continuing care of those who need palliative care on the Isle of Wight.

 

Specifically,

 

The Philosophy of the Hospice

For patients who have a progressive and life-threatening illness the staff at Earl Mountbatten Hospice are committed to achieving the highest attainable quality of life, through skill and understanding. During the time that remains for that person the staff ensure that as life comes to an end the hospice environment offers dignity, assurance and love.

 

The needs of each individual should be assessed, so that a holistic approach is adopted with regard to total care – holistic meaning here, appreciating every facet of the patient’s care, medical, nursing, social, psychological and spiritual, as well as looking at alternative ways of treating physical and mental suffering. We encourage both patients and their carers to take an active role in their care, as appropriate, accepting that each carer, patient and professional is a unique individual.

 

We believe that it is necessary to create a caring environment where feelings and aspirations can be shared by all and that supporting each other is vital.

 

Status

The Earl Mountbatten Hospice Company is limited by guarantee and is a registered charity. The Company Registration No is 2929267 and the Registered Charity Number is 1039086. The Registered Office is at Earl Mountbatten Hospice, Halberry Lane, Newport.

 

The objective of the Company is the provision of palliative care for the residents of the Isle of Wight together with all associated support to the patients and their families as detailed below. It has the responsibility for the management of the Hospice, including the provision of staff and the provision of education for staff and others in palliative care. During the year the Company was contracted to the Isle of Wight Primary Care Trust for the provision of palliative care services. The contract was in the form of a block grant against an agreed standard of performance. Because of the arrangements that existed whereby the Hospice was part of the Health Service until 1992, a sub-contract existed for the whole of this year with the Healthcare Trust on the Island to provide most of the staff and some services.

 

In order to meet the Charity Commissioners’ rules concerning trading, the Earl Mountbatten Hospice Company decided to establish a separate trading company. The Earl Mountbatten Hospice Trading Company Ltd was registered at Companies House on 24 July 1995 and the Registration No is 3083127. The Hospice Trustees are Directors of the Trading Company, which has been incorporated as a private limited company. To meet the requirements of the Charity Commission it has been agreed that at least one director of the Hospice Company and the Trading Company should not be appointed to the other.

The Trading Company has responsibility for all the trading activities of the Hospice, including the shops and items of retail goods, which are sold through the Hospice.

 

Organisation

The Trustees as Company Directors meet six times each year with a co-ordinating sub-committee meeting on six occasions. The membership of the Co-ordination Committee is the Chairman, the Honorary Treasurer and four other Trustees attend the meeting by rotation. Senior officers of the Hospice attend the Co-ordination Committee meetings and the Chief Executive, Medical Director and Head of Finance also attend each Trust meeting. The Hospice Chief Executive is Company Secretary for the Hospice and Trading Companies.

 

At the beginning of this year it was agreed that additional Trustees should be recruited and an ad-hoc recruitment sub-committee was established for this purpose. It was also agreed that an audit of the skills of the existing Trustees should be carried out first to identify those skills and experiences required to maintain a balanced Board. This audit was carried out in September 2005 and the Board of Trustees agreed to seek to recruit four additional Trustees.

 

In examining the need for additional Trustees the recruitment sub-committee identified that this could not be considered in isolation from other structural matters. In November 2005 the Board of Trustees, having received reports from the sub-committee, agreed:-

 

 

The objects for which the Trust is established are:-

 

The provision of palliative care both on the Trust’s premises and elsewhere within the Isle of

Wight to persons diagnosed as suffering from a terminal illness or exceptionally from a

non-terminal illness the symptoms of which are both severe and responsive to the treatments

provided by the Trust to terminally ill patients; the relief of relatives and dependants of

such persons both before and after bereavement particularly by the provision of

counselling; and the provision of palliative care education and training of nurses and others.

 

An opportunity has been taken this year to review the role of the Co-ordination Committee as it was felt that it was not as effective as it might be. The committee now considers specific services on an annual basis allowing more time for discussion with the officers on aspects of the service.

 

There is a Personnel Sub-Committee, which meets at least twice each year to carry out the salary review and consider other on-going personnel issues such as travelling expenses and staff conditions of service. It is also responsible for the annual appraisal of the Chief Executive.

 

The Finance Sub-Committee meets six times each year to review the management accounts and approve the annual budgets, to review the annual accounts, to receive the auditors report and the investment manager’s report on the long term investments. The Committee also carries our regular reviews of the financial performance against the budgets. The terms of reference of this sub-committee were reviewed this year to ensure that they meet the changing and developing role of the organisation.

 

A Clinical Governance Committee of Trustees and Officers has been established. The Committee’s role is:-

 

 

With the increased need to raise funds and the creation of retail activities as a separate division, the following has been agreed:-

 

 

During this year the membership and terms of reference for all sub-groups continue to be reviewed. No sub-committee has delegated powers over expenditure and all recommendations are referred to the full Trust.

 

The existing Trustees appoint new Trustees to the Trust. They are appointed for the personal qualities, skills, knowledge and experiences they are able to bring to the Trust. Whilst individual Trustees may be members of a particular profession, they do not represent that profession on the Trust.

 

The Trustees review their roles and responsibilities on an ongoing basis to ensure they conform to the requirements placed upon them by changing legislation, the environment in which the Hospice operates, and the developing service provision. A framework has been adopted and this was formally reviewed in July 2005.

 

The framework:-

 

 

The key areas of responsibility are identified as:-

 

Financial Arrangements

Budgets are prepared and approved prior to the start of the financial year. Reports on the income and expenditure are submitted to each meeting of the Trustees, together with the views of the Finance Sub-Committee, enabling them to monitor the financial activities of the Trust. All Trustees participate in the signing of cheques on a rotational basis. The Hospice company and the trading company bank with the HSBC. Each cheque requires the signature of two of the Trustees or one Trustee and the Chief Executive. Accounts paid using electronic banking also require two signatures. The Trust has agreed that to enable ease of ordering of some goods that charge cards may be used on a limited basis. The authorising officers for the use of the cards are the Head of Finance and the Chief Executive.

 

The agreed investment policy for the Trust is one of a cautious approach with a reduction in the current risk holdings. At the meeting in May 2003 it was agreed that no more funds be placed in equities and that the Trust should move away from direct investments and into collectives. This policy is being implemented on a phased basis by the investment managers. The policy was reviewed in July 2005 and confirmed as appropriate to meet the ongoing needs of the Hospice. An extract from the reserves policy is attached to this report.

 

The long-term investments have provided cash income of £51,062 during this year, an decrease of £5,776 (10 %) over the previous year.

 

The money for the running costs of the Hospice is held in interest-bearing accounts with the HSBC. Money not required immediately for the revenue costs of the Hospice are placed in a money market account which gives a higher interest rate than would otherwise be available from a routine interest- bearing account.

In this year money was required for the capital scheme to redevelop the Hospice. The money therefore held on long term deposit was released for this purpose during the year, however at the 31st March 2006 £303,195 was still held in a time deposit account with the Abbey National.

 

Risk Assessment

Throughout the year the Trustees have continued to assess the risk that the charity faces, especially when making major decisions relating to expenditure and policy. The Trustees are confident that systems are in place to mitigate the identified risks. A review of the risk policy took place in March 2006. The Trustees felt that they had taken account of the foreseeable risks and identified solutions.

 

In November 2005 the main insurance policy for the Trust and Trading Company was renewed. The Trustees are of the view that the cover provided will meet the needs during the ensuing year.

 

Strategic Plan 2006 – 2011

In November 2005 the Trustees agreed the Strategic Plan for the five years commencing April 2006. It was agreed that because of the long term nature of the Plan and the ever-changing circumstances in which the Hospice services are provided it is appropriate to review the Plan every three years.

 

In preparing the Plan the following key influences were acknowledged:-

 

 

Within the Plan there is acceptance that the services provided will be affected by a range of clinical factors, eg:-

 

 

The Plan contains financial projections on income and expenditure. The Trustees considered the projected cashflow position at 31 March 2006 and 2011 before agreeing the Strategic Plan is achievable.

 

Opening of additional beds

The Strategic Plan included the proposal that the opening of the three additional beds provided as part of the capital scheme to build the new ward should be considered separately. In March 2006 it was agreed that a plan be prepared for the phased opening of these beds, allowing for the demand for palliative care services for patients with non-cancer diseases and the financial position of the Trust.

 

At its meeting on 5 June 2006 the Trust agreed that money should be made available for the opening of the first two of these beds, demonstrating the commitment to increasing services and in recognition of the support that Islanders had given to the Hospice in its fundraising for the capital development.

 

It was agreed that the first bed be opened on 1 October 2006 at a full year cost of £35,000 and that the second bed be opened in the Summer of 2007 at a full year cost of £103,000.

 

The Hospice is generally meeting the demands of people with cancer on the Island, although it is accepted that on some occasions alternative arrangements have to be made when all the inpatient beds are full. It has been agreed that the first additional bed should primarily be used to increase capacity and allow a service to be offered to people with end stage heart failure.

 

SORP 2005

The accounts for 2005/06 have been prepared on the basis of the recommendations contained within SORP 2005. To allow adequate comparisons with the year ended 31 March 2005 the figures shown within the accounts for that year have been adjusted to take account of the revised arrangements within SORP. An opportunity has been taken to the costs associated with governance and fundraising to more accurately reflect the costs incurred and to form a basis for future year costing comparisons.

 

Income & Expenditure - 2004/05 and 2005/06 compared

The income of the Hospice is derived from voluntary sources and the grant from the Primary Care Trust. The grant from the Primary Care Trust is made up of money that has historically been given to the Hospice by the Central Government Hospice Drug Funding, the Palliative Care Grant and the general contribution made by the PCT towards the cost of the service based upon the cost to the then Health Authority in 1992 when the charity accepted responsibility for the hospice service. The PCT reviewed the grant paid to the Hospice and increased the figures to take account of the known pay rises for staff and uplifted the non-pay element of the grant in line with the NHS cost formula. Overall the grant increased by 5.2% allowing for the PCT’s cost improvement deduction.

 

The Hospice continued to receive their share of the £50 million specialist palliative care monies made available through the Cancer Plan. This money which is earmarked for the continued funding of the Hospice Extended Care Team when the Big Lottery (formerly New Opportunities Fund) grant expires in June 2006. The money was used non-recurrently to assist with the information technology associated with the re-development of the Hospice, alterations and extension of the Day Hospice and the general costs of providing end of life care.

 

The donations and gifts received by the Hospice decreased by 5% in this year (£26,655). This was attributable in part to the £1 million building fund appeal being closed in the Autumn of 2004.

 

The income for the Hospice increased by £335,893 (11.67%) over that for the year ended 31 March 2005. Of this increase the Lottery grant of £200,000 was a significant factor. The balance of £135,893 was made up in the increased grant from the PCT, increases in the Big Lottery (formerly the New Opportunities Fund) contribution and there was a general increase in giving to the Hospice of £43,168.

 

The legacy income during this year rose to £266,048, being an increase of £43,717 (19.66%). It has to be accepted that the figure for the year ended 31 March 2005 was particularly low and the actual income for this year is much nearer the target set by the Trustees of an income of £300,000 per year from legacies.

 

The overall salary bill increased by 8.75% (£155,218), attributable to increased costs associated with Agenda for Change, including the back pay to October 2004. There was also a small increase in fundraising salaries due to the decision to split the department into the separate divisions of fundraising and retail.

 

With the opening of the new ward on 30 April 2005 the revenue consequences of this have been almost wholly borne during this financial year. These have included increased heat, light and power, costs of cleaning and the replacement costs of some of the smaller items that do not feature on the balance sheet. These figures were taken into account in the planning of the ward and have not come as a surprise to the Trustees. Additionally, however, there have been significant increased costs in energy with the result that the budget forecast made in April 2005 based upon previous years was an under-provision by some £20,000. The costs of drugs rose by 16% during this year and also the volunteers’ expenses increased by some 26%, reflecting the changed patterns of working and the greatly fluctuating costs of public transport and petrol.

 

As a result of the increased assets of the new ward, depreciation increased by £83,222 (117%) and this is also included within the increased expenditure figure in the annual accounts.

 

The fundraising income has increased over the previous year by £76,835 (37%). A significant part of this figure was the increased sum received from Walk the Wight and the balance was due to the general increased activity in fundraising.

 

The overall expenditure for the year increased by £389,990. The majority of this expenditure related directly to increased staffing costs for staff working in the direct patient services, including the increase in superannuation contributions and the full year costs of the Hospice Extended Care Team (funded by the Big Lottery). There was a significant increase in the cost of X-ray and pathology services etc which are levied by the Healthcare Trust but are covered within the grant paid to the Hospice by the PCT.

 

Capital Expenditure

On 13 April 2005 the first phase of the redevelopment of the Hospice was handed over by the contractors and was brought into use on 30 April 2005. This phase comprised a new ward block, providing 18 ensuite rooms, one of which will be used initially as relatives’ overnight accommodation. Fourteen of the bedrooms were brought into use immediately. The ward additionally contains two patient lounges (one for smoking), bathrooms, clinical rooms, doctors’ and nurses’ offices, chapel of rest and stores etc. On the first floor staff changing facilities, a library and office bases for nursing, management, medical staff, Macmillan nurses and administrative staff, together with a meeting room, have been provided.

 

On 18 April 2005 the Healthcare Commission carried out an inspection of the new ward and agreed to the transfer of the licence from the old building.

 

At the end of March 2005 tenders were invited for the carrying out of alterations to the vacated ward building and to the other existing buildings within the Hospice. The tenders were returned and opened on the 22nd April and were considerably higher than expected. A detailed analysis of the prices took place and revision of the plans led to some savings. After very detailed consideration the Trustees agreed at a meeting of the Trust on the 15th July 2005 to proceed with the alterations to the building at a cost of approximately £750,000. This figure includes consulting parties’ fees and VAT, which has to be paid on the alterations to existing buildings. To proceed with this scheme the Trustees had to make the decision to utilise some of the cash being held to provide the services required by patients. The Trustees, having examined the cashflow projections, were of the opinion that whilst this action reduces the cash reserves sufficient funds will remain to finance in excess of one year’s service provision. The Trustees, however, felt that having made the commitment to the Islanders to provide a Hospice fit for the 21st century they should honour that promise. The proposal is to look at opportunities over the coming two to three years to increase the cash reserves in order to better deal with any variations in giving. This work has been completed on a phased basis with the alterations to the previous ward being completed on 10 February 2006 and the remaining work on 12th May 2006.

 

Certain monies had been donated for furniture and equipment as part of the new ward and this money was expended during this financial year. However, other sums had been donated towards the redevelopment of the existing buildings, including the alterations and extension to the day unit and as this work had not been completed by 31 March 2006 not all this money had been expended. At the meeting held on 27 March 2006 the Trustees reviewed all specific donations to ensure that they are being spent as required by the donors and that the policy of spending these specific donations is achieved as quickly as possible.

 

Annual Inspection

The Healthcare Commission, which had assumed responsibility for inspections under the Care Standards Act 2000 with effect from the 1st April 2004, carried out the annual inspection on 16th August 2004. The summary of the Inspector’s findings is as follows:-

 

The Inspection was carried out on 16th August 2006 and throughout the whole inspection process all staff showed commitment to improving patient services and providing high quality care. The Earl Mountbatten Hospice has undergone a major rebuild, with the transfer of all inpatient beds to a purpose-built ward in April 2005. It was evident that a considerable amount of preparation and work had gone into the planning of the new ward area. This resulted in a very modern yet welcoming and relaxing environment for all patients and carers. The new build was decorated to a high standard.

During the Inspection the Registered Manager showed compliance with the majority of Core Standards and the whole Inspection team felt that despite all the changes that had occurred in the last year, all staff should be commended on their hard work.

The patients interviewed were extremely complimentary about the care and environment and felt that staff could not do enough for them. Patients stated that they were made to feel very welcome.

There were only two standards that were not met and both were due to lack of policies. There was no Human Resource Policy in place; however, the Hospice has now employed a Personnel Manager who is at present working on a new policy for Human Resources. The other was in relation to a risk management policy.

 

Achievements

There are several areas of notable achievement that were identified at this inspection. Firstly the Hospice has, with all the changes that have occurred, continued to ensure compliance with the Core Standards and Regulation. They have introduced a new needle-safe system for syringe drivers, which has significantly reduced adverse incidents associated with this piece of equipment. The Hospice has also produced a new Drug Policy document that is extremely comprehensive and provides clear guidance for all staff.

 

Annual General Meetings

The Annual General Meetings of the Earl Mountbatten Hospice Company and the Earl Mountbatten Hospice Trading Company Limited were held on the 26th September 2005. Mr G Hibberd was re-appointed Chairman of both companies and Mr J Warner was appointed Honorary Treasurer. Mr A Munds was appointed Deputy Chairman of both companies. All appointments are for the period to the 31st March 2007.

 

Mr J Warner, Mrs E Davies and Dr J Rickard, whose period of office as Directors of the Hospice Company expired on the 31st March 2006, offered themselves for re-election and were appointed until the 31st March 2009.

 

Messrs Bright Brown were appointed Auditors for the financial year ended 31st March 2005 for the Earl Mountbatten Hospice Company and the Earl Mountbatten Hospice Trading Company Limited.

 

Voluntary Services

The service provided by our volunteers continues to be a very important part of the hospice care. Volunteers work within all the patient service areas and in fundraising, administration, driving, gardening etc. They also man our three retail outlets and without their input the shops would not be able to raise the amount of money they do each year, which is donated to patient care.

 

During the year the number of hours worked by our volunteers was 49,696 and of these 21,664 were worked within the retail department. A further 1,486 hours were worked within the fundraising department, assisting the team in such areas as preparation of events, acknowledging donations etc. These hours relate to people who have registered with the Hospice as a volunteer committed to giving regular hours. In addition to these hours there are of course hundreds of volunteers who work on one-off events and through other organisations, for example Rotary, in supporting the Hospice.

 

The number of miles travelled by volunteers transporting patients was 86,810. Of these miles 10,678 were travelled in our three specially adapted vehicles which allow us to transport patients in wheelchairs. Our drivers worked 8,681 hours, the majority of which were transporting patients but also includes the regular trips to St Mary’s Hospital, the retail shops etc.

 

Volunteers giving their time to the Hospice are entitled to claim travelling expenses. Some volunteers choose not to do so and in this financial year this has resulted in the volunteers’ expenses being some £16,062 less than they would otherwise be. This is a very significant contribution that individuals make towards the funding of the Hospice and the Trustees very much appreciate this support.

 

During this year the number of volunteers has fallen slightly from 320 to 310. This is for a number of reasons, but there is still a steady stream of people making applications who are prepared to commit themselves to supporting the Hospice as a volunteer. We have had an unprecedented number of volunteers retiring through age and ill-health. This has been particularly noticeable within our retail outlets where the work is strenuous and many of our long-serving volunteers, having reached the age of 80+, have felt that they must now retire.

 

March 2006 saw the introduction of the new service of the chaplaincy volunteers. These volunteers carried out additional training over and above the normal introduction and induction that all volunteers undergo. Early indications are that patients and staff find this service of value and the Trustees are grateful that this small group of individuals have felt able to use their skills and knowledge in this way.

 

2005/06 saw an unprecedented increase in the number of younger volunteers within the age group 25 to 45. These have mainly been within the complementary therapies department and we now have a whole team offering the full daytime cover from Monday to Friday. It is also envisaged that with the full team we will be able to expand the service into supporting patients and their carers within the community. One of the long term aims is to provide an evening service to inpatients but we have not yet been able to recruit the individuals with the time available to make this possible.

 

A continued pleasing aspect of the voluntary services is the applications from local sixth form students for volunteer placements to assist them in gaining experience of working in a health environment and as a means of assisting them with university applications for medical/nursing careers. We are very pleased to support these applications as we welcome people entering professions with some knowledge of palliative care.

 

During this year we have offered six to nine month voluntary placements to overseas students on a gap year. We have provided the first placements at hospices in this country for the GAP organisation and they are watching with interest the experiences of the students. We have supported two students from Germany and one from Argentina. It is hoped in the near future to also support two students from New Zealand and this will complete this pilot study before GAP makes a decision to approach other hospices in the UK.

 

Within the voluntary services section we have a number of volunteers who work within various office locations and we have been able to develop a bank of clerical staff who will undertake holiday cover, thus saving the Hospice agency fees. In developing this service we have recognised that all our volunteers come to us with skills from their previous working life and they are very willing to allow us to use those skills for the benefit of the Hospice.

 

All volunteers on joining the Hospice undertake training and during this year we have developed a further training role in that two volunteer drivers are now qualified under Midas to train and re-assess other drivers, thus saving time and resources and providing specialised training for new volunteers.

 

The Trustees are of the view that without the contribution the volunteers make to the Hospice the service we would be able to give to our patients would be of a much reduced quality and the value of voluntary services is recognised by our patients, staff and the Board of Trustees.

 

Administrative systems and appointments

2005/06 saw the retirement of a number of key staff like Wendy Young, Hospice Tutor, and Anita Jeffery, Business Manager. Consideration was given to how best the replacement of these individuals should be made to take account of the changing needs of the service. It was agreed that a post of Head of Education be created and Mr Phillip Warren commenced duties on 1 July 2005. Having reviewed the duties of the Business Manager, it was agreed that the post should be split and a separate Support Services Manager’s post was created, with Mrs Marion Thorpe commencing duties on 1 August 2005. The remaining parts of the Business Manager post, being primarily of an administrative nature, have been combined with the information technology services and Mrs Erika Campbell-Burt commenced as Head of IT and Administration on 1 July 2005.

 

A very significant event during this financial year was the notification by Dr Ian Johnson, Medical Director, that he wished to retire on 1 February 2006. There is a national shortage of Consultants in Palliative Medicine and unfortunately we were not able to recruit a successor to Dr Johnson. He therefore kindly agreed to continue on a part-time basis until a successor is found. The Trustees are very grateful to Dr Johnson for continuing to support the Hospice.

 

A review was carried out in Summer 2005 of the workload within the fundraising and retail departments and it was agreed that it is appropriate to split the retail administration from that of fundraising. Miss Julie Clifton has therefore assumed the role of Head of Retail and Mr David Cheek commenced as Head of Fundraising in October 2005. This division of duties also reflects the Trustees’ concern over the need to increase the income to the Hospice in a very difficult market situation.

 

Following the creation of the two separate divisions of retail and fundraising, it was agreed that it is appropriate for the fundraising team to be based at the Hospice. It was agreed therefore that as part of the redevelopment of the Hospice the space on the first floor of The Lodge, which was to have been left vacant, would be occupied by the fundraising team. This move occurred on 18 May 2006.

 

During the year a number of procedures were reviewed. These included the procedure in the event of the long-term absence of the Chief Executive and the delegated spending limits.

 

Transfer of services

The Hospice was approached by the Healthcare Trust and the Primary Care Trust to seek our views on the possibility of transferring the management of the Macmillan and Marie Curie nursing services to the Hospice. Having given the matter due consideration the Trustees were of the view that whilst the integration of all arms of the palliative care service is to be welcomed, they cannot assume additional responsibilities that will require the raising of more funds. Following discussion it was agreed by the Healthcare Trust and the Primary Care Trust that if the Trust was prepared to accept the management of these two services they would ensure that the budget for these services should transfer in full and that all future increases in costs as a result of the continuation of the existing services would be met by these two organisations. The Trustees therefore agreed to the transfer of the services and this occurred on 1 February 2006.

 

The Department of Health, through Strategic Health Authorities, have funded the establishment of end of life care facilitators to review the most appropriate care being provided in all settings for people as they approach the end of their lives. In view of the restrictions on the number of staff that can be employed by the Healthcare Trust it was agreed that the Hospice would employ a end of life care facilitator and the Strategic Health Authority agreed funding for a three year period. Macmillan Cancer Support also agreed that the money included within their budget for the funding of the palliative care community nurse facilitator should be made available to support this post with a view to ensuring that the best services are offered to people across all care settings. This post has therefore been included within the Earl Mountbatten Hospice establishment for the duration of the funding by the Strategic Health Authority and Macmillan Cancer Support.

 

The laundry services were originally provided by the Healthcare Trust but they subsequently sub-contracted this service to an independent contractor. Following concerns over the quality of the service provided, the Trustees agreed that it is appropriate, in line with most other voluntary hospices, to have an on-site laundry facility. As part of the redevelopment of the previous ward, a space has been made available for this facility. It was originally intended that a laundry would be provided on site when the first phase of the redevelopment occurred. However, the space allocated to the laundry was required as part of the temporary accommodation for the day unit and therefore this service is scheduled to commence in August 2006.

 

Since the Hospice became independent in 1992 domestic services have been provided under contract by the Healthcare Trust. Following consideration by the officers a recommendation was made to the Trustees that for operational efficiency it would be advantageous for the domestic services to be transferred to the Hospice. In February 2006 negotiations commenced with the Healthcare Trust concerning this matter and it is hoped that a resolution will be achieved by the Autumn of 2006.

 

Clinical Services

Following a review of the physiotherapy services the Trustees agreed, in November 2005, that a further 18 hours per week of physiotherapy time should be provided. This will be an appointment through the Healthcare Trust on the same basis as our existing physiotherapy service and will double the present hours available to the Hospice patients.

 

Replacement vehicle

At the end of 2005 it was accepted that the minibus, which had subsequently been converted to an equipment transportation vehicle, was beyond its economic life. It was agreed therefore to allocate £12,500 plus VAT for the cost of a replacement vehicle. Subsequently the vehicle failed its MOT test and it was accepted that because of its age and condition there was no second-hand retail value.

 

Motor Neurone Disease Association

The Motor Neurone Disease Association has worked closely with the Hospice in supporting people on the Island with Motor Neurone Disease. The local committee of the MNDA approached the Hospice in the summer of 2005 with a suggestion that it would be advantageous for people with MND when admitted to the Hospice to be cared for in a room with full Possum controls. These controls allow the patient to continue to be independent for as long as possible with the minimum of movement to be able to operate lights, television, open and close windows, curtains and doors, and call for assistance. The MNDA agreed to fund this proposal and the work has proceeded at an approximate cost of £12,500. A gentleman raising funds for the local branch of the MNDA indicated that he would like to see some of the money used to support people being cared for in the Hospice and it was agreed that a turning bed should be purchased, which allows severely disabled people to turn themselves without the need to call for assistance on each occasion. This bed has been provided and is now incorporated into the Possum controls.

 

The Trustees are very grateful to the local branch of the MNDA for providing this facility within the Hospice for the benefit not only of MND patients, but also other severely disabled people admitted to the Hospice.

 

Fundraising

The Trustees are grateful for the continued support of the public which enables us to raise the £1.5 million which is required each year to continue the provision of our patient services. We continue to wonder at the ingenious ways that the Islanders have of raising money for us.

 

This year the Hospice was fortunate once again to have the support of Mr Robert Stigwood who allowed us the use of Barton Manor grounds on four occasions. This was the seventh year of our ‘Barton Manor Days’ and during that time we have raised in excess of £250,000 towards our patient care. The Trustees are very grateful to Mr Stigwood for his continued support.

 

Walk the Wight took place on the 15th May 2005 and over 4,000 walkers took part. £143,000 was raised from direct sponsorship by the walkers who took part. In addition, numerous sponsors had agreed to Gift Aid their sponsorship money with the result that the total income from Walk the Wight was £154,000. The Gift Aid money received is included within the total for donations and gifts along with all other Gift Aid money and therefore does not appear in the Statement of Financial Activities under the Fundraising Activities.

 

The Hospice Lights of Love service was again held at St Thomas’s Church in December 2005 and was well attended. We are grateful for the support of Reverend Canon Dr Stephen Palmer and the Church Council at St Thomas’s for their continued support. Other Lights of Love services and events totalling 19 in number were held across the Island and it is amazing how the Island communities have taken this theme on board, for which we are very grateful.

 

The Hospice continued throughout the year to receive great support from Isle of Wight Radio and the Isle of Wight County Press in advertising the fundraising events and reporting on them afterwards. We are very grateful for this support and the publicity that is given to our events thus attracting a wider range of supporters than could otherwise be achieved.

 

We are pleased that the Hospice continues to have the support of the organisers of the two Shorwell Mammoth Jumble Sales and the funds raised during this financial year have been placed towards the furnishings of the new ward building. We also received continued support from the Old Smithy at Godshill, Moreys, The White Lion at Arreton and its sister public house, The Sun at Hulverstone, and the Masons at national and local level. We also have unfailing support from clubs, associations and individuals across the Island who organise events with the proceeds coming to the Hospice. The Trustees would like to formally record their appreciation of all the support that is given to the Hospice. A special mention must be made to the Rotary Clubs of the Isle of Wight who support the Hospice not only in fundraising but in the provision of car parking attendants at Barton Manor, marshals on Walk the Wight and in so many other ways.

 

Service Departments

The separate lymphoedema service which commenced on 1st April 2004 has seen a steady increase in demand for its services. The service is provided by a senior staff nurse who has had specific training in lymphoedema care. The service has had 85 patients referred to it during the year which has resulted in over 900 patient contacts and home visits. This workload reflects the decision taken to fund a further five hours per week from 1st June 2005.

 

An essential part of hospice care is the provision of bereavement support. During this year 70 people received formal support, which led to some 563 individual support sessions. Of these sessions 382 were carried out within the person’s home. Now that the redevelopment of the Hospice is complete, including the provision of increased facilities for the family support team more sessions are being held within the Hospice rather than at people’s homes, which will give a more economic use of the staff and volunteer hours.

 

In addition to the individual sessions some people prefer and can manage with telephone support. This is a very valuable means of keeping in touch with individuals who do not require a one to one session. During the year there were 558 telephone support sessions.

 

In addition to the bereavement service the family support department also provides pre-bereavement sessions for relatives of the patients at the Hospice and support to patients as they face the end of their lives. This service is very much valued by the patients and their families and often enables them to resolve some of the outstanding issues facing them.

 

Patient Survey

A requirement of the Care Standards Act is that we should routinely review the services we provide and obtain the views of patients. In 2005 a patient survey was carried out by the use of a questionnaire. The survey involved patients who had been inpatients and also patients who attended the day unit. The survey covered such areas as the information the patients received, the attitude to staff and the confidence they had in them, how involved they felt in their care, the aspects of dignity and respect they received and also the hotel services of catering, cleaning etc. For the day patients the survey, whilst covering most of these headings, also included consideration of the transport provided for them.

 

The overall survey indicated that the patients felt they were well cared for when attending the Hospice and whilst there were some criticisms contained within the report these were of a minor nature and have been addressed.

 

Quality Forum

Quality Forum is a meeting held four times each year where all staff are invited to attend and receive information of audits and surveys carried out into aspects of the care that is provided. During this year Trustees have attended most of these meetings and it has proved very valuable for them to see the aspects of care and the systems of work being reviewed and to meet jointly with the staff for the discussions.

 

Trading Company

The trading company had a turnover of £411,022 during this financial year – an increase of £9,701 (2.4%). The operating profit increased by £16,584 (4.4%).

 

The staff working within our retail outlets are to be congratulated in maintaining the turnover and increasing the level of profit. From the profit £229,462 was donated to the Hospice.

 

As part of the audit process in 2005 it was identified that staff working within the retail activities are not directly employed by the trading company and therefore should be considered as a recharge from the Hospice. Likewise the volunteers working within our shops agreement to give their time is with the Hospice. It has been decided therefore that staff salaries, pension payments and volunteers’ expenses will be identified as a management charge from the Hospice. This has no impact on the figures included within the accounts and is a purely administrative arrangement to ensure accuracy.

 

The Trustees, in considering the role of the Trading Company as a valuable contributor of money toward patient care, agreed at the end of 2005 that the present arrangements of all Trustees except one being appointed Directors of the Trading Company did not give due weight to the considerations required by the retail activities. It was agreed therefore that the Board of the Trading Company should be restructured with a smaller Board which could be more focused. At the meetings of the Board of Directors of the Trading Company are, with effect from 1 April 2005, to be held on separate occasions to those of the main Board of Trustees and it was agreed that opportunities should be taken to see to recruit additional directors with specific retail skills.

 

Hospice website

The Hospice website became operational in March 2006 as a result of considerable consideration by the officers of the Trust. The aims of the website are to give the public access to information relating to the Hospice in all its areas and especially in fundraising. Websites are now recognised as a valuable source of information and are widely used by members of the public. The Trustees felt that the website designed for the Hospice is particularly attractive and easy to use by those accessing it and all involved in its production are to be congratulated.

 

Dedication of the Chapel

As a result of the redevelopment of the Hospice we now have, for the first time, a dedicated Hospice Chapel. The Chapel is located between the inpatient unit, the outpatient departments and the day hospice and has a particularly welcoming and serene atmosphere. The Chapel was dedicated on 12th April 2006 by the Reverend Trevor Reader, previously Archdeacon of the Isle of Wight, who had a personal involvement with the Hospice.

 

Gift Aid audit

The Hospice was visited by HM Revenue & Customs for three days to carry out an audit of gift aided donations. At the end of the audit the Hospice was able to prove to the officer concerned that all claims submitted were legitimate, as was all income arising from them. The Trustees would like to congratulate all the staff involved in increasing income to the Hospice through gift aid and especially to the staff within the finance department for the meticulous way they maintain records to ensure that all claims are appropriate.

 

Conclusion

The Trustees would like to thank the Islanders for their continued support of the Hospice which through their generosity has ensured that the hospice services can be maintained. We would also like to specially record our appreciation of the staff who have worked under difficult conditions during this year whilst the building project has been underway and have been prepared to adapt to the new working environments and systems which have been introduced. The Trustees would also like to thank the IW Primary Care Trust for its continued financial support.

 

Earl Mountbatten Hospice

Report of the Trustees

For the Year Ended 31 March 2006

__________________________________________________________________________

 

Statistics 

2005/06
2004/05
2003/04
New Patient Referrals:
458
468
471
Inpatient: Admission
446
439
471
Occupied bed days
4263
4043
3848
% Bed occupancy
85
80
75
Number of discharges
244
241
275
Number of deaths
185
202
192
 
Day care: First attendances
114
138
120
Total attendances
2914
2757
3382
 
Physiotherapy: Patient contacts
1544
1213
1728
 
Occupational Therapy: Patient contacts
1584
2075
 
Outpatient: First attendances
132
225
159
Re-attendances
798
874
1016
Extended Care Team: Patient referrals
192
131
85
Home visits
715
756
335
 
Lymphoedema Service: Patient referrals
85
75
Patient contacts
900
710

 

Statement of trustees’ responsibilities

 

Company law requires the Trustees to prepare financial statements for each financial year, which give a true and fair view of the state of affairs of the company and of its profit or loss of the company for that period. In preparing those financial statements, the Trustees are required to:            

·       select suitable accounting policies and then apply them consistently;

·       make judgements and estimates that are reasonably prudent;

·       state whether applicable accounting standards have been followed, subject to any material departures disclosed and explained in the financial statements;

·       prepare the financial statements on the going concern basis unless it is inappropriate to presume that the company will continue in business.

 

The Trustees are responsible for keeping proper accounting records which disclose with reasonable accuracy at any time the financial position of the company and to enable them to ensure that the financial statements comply with the Companies Act 1985. They are also responsible for safeguarding the assets of the company and hence for taking reasonable steps for the prevention and detection of fraud and other irregularities.

 

Earl Mountbatten Hospice

Report of the Trustees

For the Year Ended 31 March 2006

____________________________________________________________________________

 

 

Extract From Reserves Policy (reviewed July 2005)

 

1. Introduction

 

The policy of the Earl Mountbatten Hospice Trust is to expend all income meeting the criteria set out in the Trust Document, which is:

 

"The relief of persons suffering from a terminal illness by the means of the provision of residential and day accommodation, the relief of relatives and dependants of such persons and the provision of education and training of nurses and others in the care of the terminally ill".

 

However, the Trust must ensure that it has sufficient funds to continue the provision of services in those years when income from general giving falls.

 

2. Designated Funds

 

From time to time the Trust may wish to embark on specific projects. It will need to identify how these projects will be funded and they may designate general funds for this purpose. Designated funds are not part of the reserves.

 

3. Reserves

 

The aspired level of reserves is a sum of money equal to the Trust's share of the cost of the Hospice Service for two years. The factors borne in mind in arising at this decision are:

 

a)     the need to ensure that reduction in general giving in any year can be covered;

 

b)     that a buffer exists to cope with any significant reductions in NHS funding;

 

c)     that any significant down-turn in the economic situation in the country can be balanced;

 

d)     the provision of an income that can be applied towards the revenue costs of the service, especially those arising from service development.

 

4. Achieving the Reserves Target

 

The Trust will review at least annually the opportunities to place funds on long-term investment until the reserve target is met. The needs of increasing reserves will be balanced against the needs of increased service provision and the longer-term business opportunities available to generate revenue funds.

 

5. Review Arrangements

 

This policy will be reviewed annually, normally at the time that the draft accounts are considered by a full meeting of the Trust.

 

_________________________________________________________________________________

 

Trustee List

 

 

Earl Mountbatten Hospice

Report of the Trustees

For the Year Ended 31 March 2006

____________________________________________________________________________

 

Extract From Investment Policy (reviewed July 2005)

 

General Objectives

 

The objective of the fund is to ensure that the Hospice is able to function at all times, bearing in mind that its revenue from donation, legacies and other fundraising can fluctuate substantially year to year. The fund could be used to meet short term outgoings or longer term expenditure, such as asset renewal or refurbishment.

 

Estimated Expenditure

 

The Trustees may draw on capital or income without distinction.