Heritage for the future – compassion & collaboration in crisis


Lunar Society member Tina Swani, Chief Executive of Birmingham St Mary’s Hospice for 18 years, reflects on the challenges faced by the crisis resulting from COVID-19 – and the longer-term issues facing hospices and end-of-life care.

This blog was published in The Lunar Society Newsletter, May 2020

This time last year, Birmingham St Mary’s Hospice began its 40th anniversary celebrations; a monumental milestone and major opportunity to celebrate the progress of care and support to people living with life-limiting illness across Birmingham and Sandwell.

When our founders realised their vision for a hospice for Birmingham, they achieved what seemed like the impossible. The hospice movement was still a revolution with a single hospice beginning its pioneering work in south London. The sheer determination of our founder Monica Pearce and the generosity of our local community made Birmingham St Mary’s Hospice a reality and the first patient was admitted in March 1979.

Back in those days, the hospice was as a single ward that could care for 25 people; we are now a specialist palliative and end of life care provider caring and supporting 500 people on any given day across Birmingham and Sandwell, mainly in people’s homes, in GP surgeries and at the Hospice itself. Today we respond to a highly diverse population, supporting individuals and the people that matter most to them to live better with illness from the point of diagnosis, through death and bereavement.

Changes in demographics mean that people are living longer with increasingly complex conditions. Whilst the numbers of patients we see have increased year on year, we know that we are only reaching half of those who could benefit from our care. The funding we receive from the NHS has not risen to match the increase in people we support. As 60% of funding coming from voluntary donations, our challenge has been to transform our services so we can meet this ever-growing demand.

We have done so by bringing together leaders from health and social care organisations across the area to form a shared vision and plan.  The plan involves better coordination of care; education of more individuals, communities and organisations in sharing that care; and enabling more people to have conversations about illness, death, dying and bereavement.  This way more people will be able to access the care and choices they need more readily in their home environment, rather than hospital being the default position that it is currently for many.

Last March, we hosted a Lunar Society panel debate to ask influencers from the City for their thoughts on the future of hospice care. Panellists and members affirmed that to create a sustainable model of hospice care – and therefore to help meet growing demand – education and sharing expertise should play a leading role alongside a new funding model for hospices.   

Fast forward twelve months and we are now in the midst of a global pandemic. In the fight against Covid-19, Birmingham St Mary’s is part of the frontline response and our expertise is more in demand than ever before.

In addition, over the past year, Birmingham St Mary’s has educated over 1,700 health and social care professionals across the city, including upskilling care home staff to better support their residents and reduce avoidable hospital admissions.  The hospice also has an award-winning research Centre.  During the pandemic, education and research continues through digital channels and webinars.

Transformation, however, can only go so far in the current climate; funding is urgently required. With some hospices closing services across the country, and our local children’s hospice holding a crisis appeal to keep its unit open, the financial sustainability of the hospice sector has become a hot topic. We having been using our position of influence to call for better financial support for hospice care. Alongside national voices in the sector, we have been making the case that access to palliative and end of life care should not depend on the ability of the local community to fund it. 

You could say that it is scandalous that specialist, vital services are so reliant on the generosity and commitment of people running marathons, donating goods to shops and holding cake sales. No other healthcare specialism is funded this way.  Voluntary fundraising should enhance, not sustain our care.   These challenges and the consequences for our community were put forward as evidence in recent debate in the House of Lords on funding for palliative care and end of life care.

In spite of the increased need for hospice care right now, the pandemic is causing us to lose crucial funds. We have had to postpone fundraising events, community and corporate activities as well as temporarily close our 17 charity shops. We are pleased to have received the first payment of the emergency funding for hospices announced by the Chancellor, which was desperately needed.  However, we are by no means not out of the woods.  We need government to keep investing in the crucial support the hospice sector provides, though this crisis, and beyond.

We continue to offer round the clock care on our inpatient unit, as well critical support in people’s homes, on the phone, and via digital consultations. We are also working in partnership with local hospitals, GPs, District Nurses, care homes and more to share our expertise and ensure more people get the care they deserve during this uncertain time, many of whom also have Covid-19.

In the whirlwind of the pandemic, we have accelerated implementation of our shared vision.

In a matter of weeks, we joined forces with other local hospices to establish HoBS (Hospices of Birmingham & Solihull) – a central coordination hub run by Birmingham St Mary’s Hospice, John Taylor Hospice and Marie Curie West Midlands.  A single phone number and 24/7 service enables more people to get the care they need, as quickly as possible.  As more people are now dealing with grief, our newly established telephone bereavement service offers bereavement support during these unprecedented times. 

Last year we set out to create a sustainable future for hospice care.  We are now entering a new era.  We are delivering the shared vision.  Birmingham St Mary’s Hospice and John Taylor Hospice have also recently announced joint leadership of a CEO and Chair across these two major Birmingham Hospices – a ground-breaking leap forward for the City.

The pandemic has had devastatingly tragic consequences.  It has also brought new learning, new ways of delivering care, and new ways of connecting.  Collaboration has raised the prominence and profile of hospice care.  We are already putting in place transformation for a better future.

Remembering the words of Winston Churchill, we will not let this crisis go to waste.

The opinions expressed in this article are those of the author.

The pandemic has had devastatingly tragic consequences. It has also brought new learning, new ways of delivering care, and new ways of connecting. Collaboration has raised the prominence and profile of hospice care. We are already putting in place transformation for a better future.