Hospice chief warns demand is growing for its care services

THE chief executive of a hospice charity says the work it does is as vital as it has ever been.

Rachael de Caux, who lives in Stoke Row, heads up Thames Hospice, which provides end-of-life care and supports about 3,000 people a year.

She said: “I think everyone thinks about the NHS looking after you from cradle to grave and, actually, in the vast majority of cases, that last year of life is very heavily supported by charities such as ourselves.

“I feel it’s a fundamental, basic right that everyone should have access to that excellent care in their last few months and days and for their families to be supported.”

The hospice, which was founded in 1987, is based in Windsor Road, Maidenhead, in a £22 million purpose-built facility, which serves people in East Berkshire and Buckinghamshire.

It features a 28-bed inpatient unit, outpatient facilities including a wellbeing centre, and adjoining it all is a centre with a café open to patients, their families and the public.

It has around 20 patients in its inpatient beds at any given time, and each day looks after around 380 patients in their own homes.

Dr de Caux, 47, who is married to Dan, became chief executive of the hospice in December and wants to dispel the myth that hospices are “dark or gloomy” places.

“It’s light, it’s lively and we are a really important space for the local community,” she said.

Dr de Caux has worked in the medical sector for more than 20 years, specialising in emergency medicine, including a seven-year stint as an air ambulance doctor.

Most recently, she held senior leadership roles, including deputy chief executive and chief medical officer of the Buckinghamshire, Oxfordshire and Berkshire West Integrated Care Board.

Dr de Caux said that she was keen hospice care was seen as a key partner in the healthcare system rather than an add-on.

The care it provides is free of charge to its users and it is a struggle in the wake of mounting costs. The hospice receives a third of its funding from government with the rest coming from donations and the income from its shop in Bell Street, Henley.

To continue to operate, the hospice must fundraise £39,000 every day to fund its specialist services, which this year will cost 20.5 million.

Dr de Caux is concerned that the hospice may struggle to meet growing demand in the years ahead, as the population ages and becomes increasingly unwell.

She said: “My vision is that we’re able to continue to evolve and provide services that our community needs and that we are funded properly so that we never need to turn anyone away.

“At the moment, we are managing the amount of demand for our services just about with the right capacity and staffing.

“But in two years’ time, because the population is getting older and more unwell, that will not be the case.” The hospice has also seen an increase in younger patients. Cancer rates in 25- to 49-year-olds in the UK increased by 24 per cent between 1995 and 2019, according to analysis by Cancer Research.

About nine in 10 cancer cases still happen in people over 50 but early-onset cancers are a growing cause for concern.

The hospice also cares for a number of young patients that have formally been looked after as children in the Children’s Hospice and have since transitioned into adult services.

Dr de Caux said: “People who are living longer, are living longer with lots of other conditions. We have a combination of older patients that have lots of chronic conditions, so that makes them much more complex to look after in terms of our care here.

“Then you also have younger patients coming through with bowel cancer, brain cancer, motor neurone disease that again require a different type of care and services and different family support.”

All of this has been compounded by last year’s Autumn Budget, which increased employer National Insurance contributions starting from April.

Dr de Caux said it had been a decision which had increased the hospice’s costs by nearly £1 million.

She said: “When the budget came out, lots of charities took a really big hit with the National Insurance and minimum wage changes, and we were no different.

“Collectively, that added just shy of a million in recurrent costs, and we just have to fundraise that.

“We have no other way of closing that gap and what I don’t want to do is to have to restrict our services or make people redundant. People buying stuff in our shops or using our café really helps.”

Dr de Caux said that hospice care held a special place in her heart after losing both her parents to cancer several years ago.

She said: “I have first-hand experience of the value hospices bring and I think until you need them, you don’t really realise how important it is. The relief when I was able to go back to being a daughter, rather than a carer or a doctor, was immense. I’m really, really proud and humbled to be able to support this organisation to deliver that for our community.”

Central to the services the hospice provides are counselling and pastoral support for patients and their families, alongside a specialised children’s and family team. From her own experience, Dr de Caux said she wanted to make navigating the hospice care as user-friendly as possible.

She said: “We try very hard here to make sure our services are as easy as possible to navigate, because the health system landscape is just really complex for people. Even as someone who actually works within it, I found it really hard when I was trying to navigate my dad through it. That’s why we have a phone number that’s a single point of access for people that fall within our catchment area to use because it just takes the guesswork out of it.”

Dr de Caux remains a practising medic and is a consultant in emergency medicine at the Royal Berkshire Hospital.

She said: “That’s really important because, at my core, I still like that face-to-face interaction with patients and it keeps me incredibly grounded.”

She trained as a doctor at Imperial University in London, graduating in 2002 before completing her training in emergency medicine and surgical training in Oxford.

From 2008 until 2015 she served as a doctor with Thames Valley Air Ambulance flying out of RAF Benson.

Dr de Caux said she wants to foster a positive environment for those who work at the hospice.

She said: “I want to create a culture that is open, transparent and supportive and where everyone feels included and that they belong.

“I really feel like this is where I’m meant to be, and I have genuinely never felt that in terms of a management role before. That’s a pretty good place to be.”