Get ready for a thread about hospice care....

This afternoon I sat in on the MDT meeting at @TeessideHospice. A charity that relies on public donations for 2/3rds of its income. The session was led by a medical consultant with another doctor, nurse specialists, OT, physio, social worker, mental health support all there....

The group spent 15 minutes of so checking in on everybody staying on our inpatient ward. Physical, medical, social, spiritual, emotional. Not just the individuals, their families and carers too....

It was impressive to see this level of knowledge directed to problem solving for the family as a whole. Not just looking at what @TeessideHospice could do but also how other services can be drawn in/worked alongside....

Equally impressive was the focus on emotional wellbeing and spirituality. Unsurprisingly these are huge issues in palliative/end of life care that cannot simply be dealt with by 'referring' to another team. This was truly integrated care....

Some of the conversations were tough. Complex symptoms, complex lives. Dying is an uncertain and unpredictable event. How/When to discharge, when to prepare family, how long will people need us for. Some guesswork but based on skills, knowledge and solid past experience....

At no point did anybody talk about money. The decision making was based purely on what was in the best interest of the individual and their family. Length of stay, drugs, additional support. It was an exemplar model for integrated and holistic healthcare....

After the meeting I'm back in my office, looking at management accounts. I need to find ways to allow @TeessideHospice to continue doing this amazing work and feel the weight of that responsibility. Most people think the NHS pay for all of our work. That's not the case....

Despite the cradle to grave mantra we often hear, the NHS only funds about 30% of our costs. The NHS itself sets the 'reference cost' for a bed in a hospital at £742 per day. Ours cost £671 per day. A good chunk less for very specialised care....

Unfortunately though, our CCG only pays us £157 per day per bed. With ten beds that means we have to fundraise £5140 EVERY DAY to keep our inpatient unit alone running....

We don't think its fair that specialist palliative/end of life care for people with a terminal illness should rely on the goodwill and charity of local people. Hospitals don't have to sell second hand books to pay their staff and neither should we....

We are proud to be working with @hospiceuk who are leading the campaign to change this historic, bizarre and unfair practice. The donations and support from the amazing people of Teesside should be the icing on the cake....

The reality is that if something doesn't change hospices like ours wont be able to do what we do for much longer. Rising costs, increasing competition for funds, growing demand. Somethings needs to change and we believe that change should be how the NHS supports us....

If you have the opportunity to influence, to speak out, to raise this with you MP, Councillors or commissioners please take it. Its not just @TeessideHospice - 82% of UK hospices have a deficit budget this year. We need to change this now before its too late. #ThankYou