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An overview of the impact of grants awarded by the Masonic Charitable Foundation to hospices in 2019 on the theme of Homelessness and Learning Disabilities.

2019 – Homelessness and Learning Disabilities

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The Masonic Charitable Foundation (MCF) has collaborated with Hospice UK since 2017, helping deliver programmes of local funding that have significant and lasting impact on communities across England and Wales. 
    
In 2019 we provided grants to help hospices meet the needs of people experiencing homelessness (or vulnerably housed) and people with learning disabilities.

Each of the projects we funded were different, but there are some common themes across the grant programme as a whole. In this report, we will explore those themes to give an overview of the impact of the funding. We will also look at how the projects are to be sustained and developed in the future, and how learning is to be shared.

How the grants were allocated

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A total of 47 applications were received from hospices across England and Wales. Collectively, the requests were worth more than £1.3m in terms of the total amount being requested. 

At a meeting of the Grants Committee, which included Masonic Charitable Foundation staff and trustees, a total 19 grants were awarded amounting to a total of £448,021. A breakdown of hospices awarded a grant, whose applications demonstrated the greatest need and proposed the most appropriate plans to meet those needs, is given below.

Masonic Charitable Foundation Grants 2019

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Organisation Masonic Province Project Title Amount Awarded (£)
Cornwall Hospice Care Cornwall Improving access to palliative and end of life care in Cornwall: St Austell project for those vulnerably housed 29,895
Garden House Hospice Hertfordshire Garden House Hospice Care and Stevenage Haven - Removing barriers to accessing palliative care for people facing homelessness in North Hertfordshire and Stevenage     13,532
Hospice at Home West Cumbria Cumberland & Westmorland Widening Access to support adults with learning disabilities 6,957
Hospice of the Good Shepherd Cheshire Supporting homeless people with advanced and life limiting Illness in Cheshire West and Chester 14,160
Hospiscare Exeter Devonshire  An end of life care plan for our local homeless community 21,225
Marie Curie, Liverpool West Lancashire, Liverpool Palliative Care Homeless  Co-ordinator 34,000
Martlets Hospice Sussex   Palliative care education and support programme for hostels, day centres and other care providers to benefit homeless and vulnerably housed people in Brighton & Hove 20,367
Mary Stevens Hospice Worcestershire No Barriers Here! Talking open about end of life care 23,550
Pendleside Hospice East Lancashire Palliative and End-of-life care for individuals who are homeless/vulnerably housed in Pendle and Burnley 28,168
St Francis Hospice, Romford Essex A phased approach to facilitate rough sleepers and vulnerably housed people within the Saint Francis Hospice catchment area, to better access palliative care services 20,704
St Michael’s Hospice, Harrogate Yorkshire - West Riding Open doors: support, guidance and training 29,103
St Ann’s Hospice, Cheadle Cheshire    To provide a Palliative Care Coordinator role for people with learning disabilities living in Stockport 24,108
St Clare, Hastingwood Essex Improving end of life care and support for people across West Essex who have a learning disability 21,332
St Gemma’s Hospice, Leeds Yorkshire - West Riding Widening access to palliative and end of life care for homeless and vulnerably housed people in Leeds 25,800
St Giles Hospice, Litchfield Staffordshire Improving palliative, end of life and bereavement care outcomes for people with learning disabilities and their carers via a new Learning Disability Support Worker role 25,355
St Leonard’s Hospice, York Yorkshire, 
North & East Riding
Prioritising support for people who are homeless at end of life 30,000
St Peter’s Hospice, Bristol Bristol To improve the access and equality of access to St Peter’s Hospice services for people experiencing street homelessness and living in hostels in Bristol 28,700
St Wilfrid’s Hospice, Eastbourne Sussex Supporting people with learning disabilities to be ready for death and bereavement 27,122
Willen Hospice, Milton Keynes Buckinghamshire Person-Centred Palliative Care for People with Learning Disabilities in Milton Keynes 23,943
Grand total (19)     £448,021

Key themes

Challenges

Sharing learning from the project

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Hospices promoted the learning from their projects in various ways:

- Internally through the intranet, staff newsletters etc

- In the local press and community newsletters

- Through local professional networks and multidisciplinary meetings

- By delivering training sessions locally

- Publishing articles in journals and professional magazines

- Submitting abstracts and speaking at conferences

- Hospice of the Good Shepherd contributed a chapter to a book 

- By writing blogs

- St Wilfrid’s recorded a podcast

- Via social media.

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No Barriers Here, Mary Stevens Hospice

Mary Stevens Hospice’s No Barriers Here project has been shared widely on social media, both in the UK and internationally. It has gained interest and positive feedback from Canada, America, Australia, New Zealand and Europe.

(left) Art workshops on Zoom;

(right) Creative advance care plan! Art work from participants from workshop 3 was collected and sewn into a quilt by Clover Leaf Community Group - a community based learning disability day service.

Future development

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Sustainability

All the hospices want to continue to support people with learning disabilities and people experiencing homelessness beyond the end of the grant funding.

For some, working collaboratively has led to further projects. St Peter’s Hospice, for example, have been approached by Bristol’s Homeless Health Service team to support the improvement of advance care planning (ACP) in their clinics. Haven First, the organisation partnering with Garden House Hospice, have recommended Garden House to the local Street Homelessness Team.

Hospice of the Good Shepherd explained how the relationships built during the project have led to additional funding and support for homeless people experiencing bereavement:

“Through establishing relationships with housing and homelessness teams from all sectors some additional funding was made available to provide counselling session to support this client group as it was identified that bereavement and loss is a significant issue for people experiencing homelessness. Through the success of the counselling service (6 months in total)  the hospice was invited to sit on a much wider more strategic multi-agency group and was given 12 months additional local authority money to continue providing counselling to people experiencing homelessness”.

- Hospice of the Good Shepherd

For other hospices, the sustainability of the project is a challenge. To keep the service going, they have had to make adaptations. St Leonard’s Hospice is proposing to integrate the service within their outreach team, while St Francis has had to reduce the hours of the service:

“Sustainability of this project was a serious risk. Although we are continually applying for new funding we have not had a positive response, however the hospice has agreed to continue this widening access project on a reduced hours basis”.

- St Francis Hospice

Conclusion – summary of impact

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The grants from the Masonic Charitable Foundation have enabled hospices to work collaboratively to support some of the most vulnerable people in their communities.

The hospices have had a key role in co-ordinating services, providing a central point of contact and widening access to palliative and end of life care.

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“We have “joined up the dots” – connecting agencies and keeping the patient and their needs at the heart of the work.”

- St Gemma’s Hospice

“Prior to our support and work there has been no formalised, structured approach to end of life and bereavement support for adults with learning disabilities or autism in West Cumbria, so our work has filled a huge void and given equitable access for this group of people. We have now become experts in our region, with the member of staff responsible for this area forging excellent relationships across the health care and learning disability and autism sector, experts by experience and those who are important to them.”

- Hospice at Home West Cumbria

“We recently received a phone call to our Hospice advice line from someone who is experiencing homelessness. We are not aware that this has happened before.”

- St Peter’s Hospice

Although this grant programme has now ended, there is a clear legacy for all the hospices involved. Willen Hospice explained how the learning from this project could influence future work to improve equity of care for other marginalised groups of people:

“[We] now have a template for how a project to support people from under-represented groups can be run. We would not necessarily use the exact same format but it can be adapted for future projects.”

- Willen Hospice

All the hospices involved have taken strides towards widening access and reducing barriers - there has been a clear shift towards a more inclusive culture of care. St Francis is pleased to report that supporting homeless people at the end of life is now recognised as ‘business as usual’ as opposed to a ‘current project’. 

Garden House explains:

“Before this project, it is unclear whether referrals from Haven First [organisation supporting homeless people] to the Hospice would have been considered or accepted. However, the Hospice team has learnt a great deal about the challenges facing people identifying as homeless…we will proactively support these patients in any of our services”.

- Garden House 

“Links and relationships with local Learning Disability organisations and practitioners will continue as a lasting legacy of the project.”

- St Wilfrid’s Hospice

Thank you…

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All hospices in receipt of a grant expressed their thanks to Masonic Charitable Foundation for the funding provided.

A small number are copied below:

“Thank for you awarding us a grant from this programme – we wouldn’t have been able to run a programme like this without it.”

- Willen Hospice

“MCF has allowed us to start important work that would have been almost impossible to fund in any other way – that will have a lasting impact on our ability to widen hospice care to an especially vulnerable patient group who are currently under-represented.”

- St Clare Hospice

“The organisation is very grateful to the Masonic Charitable Foundation and Hospice UK for the opportunity to explore and develop this important strand of inclusion health. It has provided significant insights and enabled us to further develop creative ways of working in partnership with existing and future partners and service providers for the benefit of patients and the wider community.”

St Leonard’s Hospice