Annual Report

and Accounts 2020-21

Download Annual Report and Accounts 2020/21

A year of

transformation

The last year has been a momentous one. As a society, we have learnt to adjust many aspects of our lives to deal with a global pandemic. When the virus first hit and the UK lockdown was announced our focus at St Christopher’s was on keeping core services running: making sure we could still support the people who needed us most, whilst keeping everyone safe; trying to secure adequate PPE during a national shortage and supporting people to work in very new and different ways. But, just a few weeks in, we could see the transformational impact that COVID-19 was going to have.

During this period we have reached more people than ever before – in fact we supported 11% more patients, carers and family members than the prior year. Most patients prefer to be cared for at home, in line with people’s preferences, and we have cared for an even greater proportion of patients in their homes during the pandemic. We stepped in to support the growing numbers of people needing end of life care as hospitals struggled to cope with rising numbers of COVID-19 admissions and increasing number of deaths. Care was provided over the phone, through video consultation and online group sessions as well as face-to-face when needed. The combination of support in these proportions was new to us, but had many unexpected benefits. For example, feedback to our bereavement teams showed that many felt more comfortable and able to speak openly over the phone; our community teams were able to support many more people without the travel time between people’s homes and people were joining our online wellbeing groups who, previously, may have been unable or fearful of coming into the hospice in person.

We have witnessed a strong spirit of innovation – not just in how we provide care but from all areas of the organisation. Our Fundraising Team pivoted to livestreaming events online when we couldn’t meet in person. Our Retail Team upped our presence on eBay when our shops were unable to open. We also set up community aid initiatives at speed, such as delivering essential medication and food to people who had to stay at home as they were self-isolating.

Our approach to education and training was similar, as virtual learning quickly assumed a central role. Nearly 3,500 people tuned in across the year, giving us an opportunity to affect real, widespread change. This included developing a webinar series to mark the launch of the first palliative care nursing model in three decades, the dissemination of a new toolkit to improve end of life care for those with No Recourse to Public Funds and a session exploring Dame Cicely Saunders and her legacy. In early 2021, we took ownership of a new state-of-the art building, St Christopher’s CARE (St Christopher’s Centre for Awareness and Response to End of Life), a real achievement given the uncertainty and restrictions throughout 2020.

We want to acknowledge our colleagues whose ‘nothing can stop us’ attitude really pulled us through and provided insight about new ways of working to stay ahead. We also couldn’t be more grateful for the outpouring of support we experienced from our community. Beyond financial donations, our local community provided donations of PPE, food, letters of support and other thoughtful items to keep staff morale high. These kind gestures were so appreciated, and left us truly humbled.

This year has not been without its losses for individuals, our partner organisations and indeed the hospice sector. We want to acknowledge, in particular, the death of Dr Mary Baines, a pioneer in palliative care and supporter of St Christopher’s over many years, most recently as one of our valued vice presidents. Her legacy in terms of home-based palliative care, management of distressing symptoms and the value of education live on in much of our organisational life. Thank you, Mary.

In what has been an impossibly difficult year for everyone, thank you to everyone else also, for keeping us going and being there for the people of south east London when they needed you most.

Heather Richardson and Shaun O’Leary

Heather Richardson and Shaun O’Leary
Joint Chief Executives, St Christopher’s Hospice

Our year in numbers 2020/21

People

5,000

Number of people we provided care for (approximate)

Home visits

10,664

Number of home visits we made

Education events

3,275

Number of people who attended one of our learning events

Rehabilitation

6,142

Number of rehabilitation sessions we delivered

What we do

with your money

We’re here thanks to the generosity of our supporters.
Your kindness means that we are able to continue to provide vital services to people in south east London and beyond.

Where our money comes from

An incredible 54% of income is down to you; be this through fundraising activities, leaving gifts in Wills or buying goods in our shops. We are so very grateful for the money you donate and we are careful to invest it wisely, in ways that will best serve the people who need our support.

Where our money goes

It cost £22.9m to run St Christopher’s in 2020-21. Here’s a breakdown of how we spent the money that you gave us. Please also see our full financial review in the downloadable Annual Report and Accounts 2020/21.

What our patients and

carers say

In December 2020, we sent questionnaires to patients and carers so we can better understand what we are doing well and where we need to improve, to ensure we’re providing the best possible end of life care.

We were heartened by the results and have included a few key highlights below:

  • 97% of patients said they were very satisfied or satisfied with our care
  • 92% of carers said they were very satisfied or satisfied with our care
  • 99% of patients felt they were treated with respect and helped to feel dignified always or most of the time
  • 94% of patients and carers felt we had listened to their needs always or most of the time
  • 91% of patients thought our online wellbeing group was very good or good
  • 90% of carers thought our online clinical consultations were very good or good.


We can better understand what we are doing well and where we need to improve, to ensure we’re providing the best possible end of life care

Our vision, values

and ambitions

Our vision is a world in which all dying people and those close to them have access to care and support when and wherever they need it. Through our key themes of community, inclusivity and sustainability, our ambitions are:

Adapt our care services to meet people’s changing needs

London

…to improve
people’s
experience of
end of life locally

Invest in hospice-led innovation related to death, dying and loss

…to strengthen hospices’ contribution nationally

Increase public and professional confidence and knowledge about end of life

…to transform end of life care globally

When we started 2020-21, we were just at the beginning of the COVID-19 pandemic and its duration and impact were unclear. This year, despite continued and unprecedented challenges, we’ve thrived and made significant progress against our 2020-23 strategy:

  • Increased our community support (both locally and nationally) and successfully adapted our services maintain and extend our reach
  • Continued to contribute to wider conversations about death, dying and loss, encouraging discussions about end of life preparation and care
  • Transformed our professional education and training with a new curriculum, new partnerships and have a brand-new centre
  • Continued to highlight and redress inequalities in healthcare, both in practice and through our investment into research and training
  • Supported those bereaved with online services, unique events and new partnerships.


Care home staff, in particular, have really felt the pressure, as they found themselves supporting many more people at the end of life

How we’ve met our

strategic ambitions in 2021

London

Strategic ambitions

Adapt our care services to meet people’s changing needs to improve people’s experience of end of life locally


“[The chats] make her feel better. [The] two-way relationship is a real joy and they have lots in common, despite [a] large age gap”
Relative of a community member matched as part of Community Aid

We launched the first ever Snowdrops for St Christopher’s to give people the opportunity to celebrate the lives of friends or relatives by dedicating a Snowdrop in their memory

Strategic ambitions

Invest in hospice- led innovation related to death, dying and loss to strengthen hospices’ contribution nationally


This year, more than ever, we’ve relied on family and at-home carers to be our window into the daily needs of many patients

Supporting people’s choices

Part of being independent for every individual is the right to choose the environment in which they die. Many people, given the choice, would like to die at home and we make every effort to support those decisions through a variety of initiatives.

  • Funding from the Burdett Trust enabled us to launch Choose Home, a service which aims to help people with a prognosis of two to three weeks left to live to improve quality of life, reduce isolation and help them to stay at home in surroundings they are comfortable in, where this is their wish. In the first three months we supported 79 people, receiving positive feedback from patients and families
  • We made available a consultant nurse and doctor to work in specific care homes in Bromley and supported several care homes with outbreaks of COVID-19 to ensure the immediate response was working closely with Public Health England, the NHS Bromley CCG and the local council
  • We embarked on a joint venture with Marie Curie and Nesta to better understand how we can harness our learnings from the last year to reshape future experiences of death and bereavement and found the following are essential:
    • Ensuring care is equitable and person-centred
    • Supporting people to feel comfortable talking about death
    • Encouraging community-led response
    • Fostering greater opportunities for collaboration
    • Increased use and access to digital tools.

Working in partnership

We know that part of delivering the best care and support is through collaboration. This year, more than ever, we’ve relied on family and at-home carers to be our window into the daily needs of many patients.

In an effort to improve communication between carers and members of our multi-disciplinary teams (MDT), we’ve developed the Carers’ Diary initiative. Its purpose is to be a reflective tool for carers’ experience of end of life care, help ‘fill in the gaps’ for carers when they are not present and to gain useful feedback from carers to influence daily care.

Highlighting and redressing inequalities

Death does not discriminate but, unfortunately, sometimes the system of care does. As people live longer and develop more complex needs, it’s important that we consider the needs of all those in the communities we support.

In pursuit of our mission to offer high quality, holistic care to everyone who needs it, whenever and wherever that may be, we embarked on several initiatives to tackle challenges and support this vulnerable groups.

  • After 18 months of research and collaboration with expert partners as well as the generous support of Hospice UK and St James’s Place Charitable Foundation, we published Do You See Us?, a guide to help hospice and palliative care teams, migrant centre workers, social workers and welfare teams be better prepared to support those who have No Recourse to Public Funds (NRFP) to access the same quality of end of life care extended to the rest of the UK population
  • Cascade – a two-year project funded by the Burdett Trust for Nursing – which aims to increase the quality of end of life care for older people with severe frailty, has identified key skills for nurses in a variety of settings and provided training for 28 individuals in the last year to support the development and growth of these essential skills and improve care
  • During the pandemic, 253,000 people in England have been identified as homeless and are living in temporary accommodation, the highest figure for 14 years. Staff from St Christopher’s were one of the first two hospices to partake in a new model to improve end of life care for homeless people, focussing on embedding person-centred care and support for sick homeless people, by bringing together palliative care and multi-disciplinary support into homeless hostels and day centres.

Choose Home is provided by trained volunteers, carers and registered nurses who are supported by consultant nurses, clinical nurse specialists and doctors, over phone and video, as needed

Strategic ambitions

Increase public and professional confidence and knowledge about end of life to transform end of life care globally

Demystifying death through

public education

At St Christopher’s, we often use the term ‘death literacy’ to describe the knowledge and confidence people have when talking about death. One of our core ambitions is to support that literacy to reduce fear and demystify taboos.


“St Christopher’s CARE gives us new opportunities to really make a difference; drawing on the alchemy of learning, research, innovation and expert practice made all the richer through partnership between professionals and the public”
Heather Richardson, Joint Chief Executive

Transforming professional

education and training


“I am excited about the future of St Christopher’s CARE because it will equip, enable and empower ordinary people living in families and local communities to talk more about death dying and loss, thereby increasing understanding about ways we can all make a difference to our fellow human beings by helping them through some of the most challenging times in their lives”
Shaun O’Leary, Joint Chief Executive

How we’ve been

able to do it

Community

partnering with those around us to become stronger together

Inclusivity

encouraging everyone to be their authentic self, feel valued and get involved

Sustainability

remaining resilient and ensuring our future

Community:

partnering with those around us to become stronger together

Increased community support

We’re proud of how we’ve continued to support those most vulnerable in our communities during a global pandemic, but nothing could have prepared us for the incredible generosity from our community to us.

Living through a pandemic has placed a strain on all of us and, at St Christopher’s, we also felt the challenges imposed by the pandemic. When the virus first hit, our main priority was continuing to support people living with a terminal illness whilst making sure we kept the people we were caring for and our staff safe.

This became increasingly difficult as we, and the NHS, struggled to secure adequate PPE for staff.

After exploring all avenues, we put out a plea to the local community on social media and were overwhelmed by the response. Deliveries arrived each day of surgical masks, aprons, visors and goggles (including swimming, cycling and science lab goggles!).

We also had local people making gowns and scrubs for staff (some made from costumes from cancelled theatre shows) and deliveries of everything from food parcels to hand cream kept staff morale high during some of the most stressful conditions we have ever experienced.

Then, a few weeks later as we started to feel the financial pinch of closing our charity shops and cancelling our fundraising events, we saw an outpouring of financial gifts in response to our Emergency Appeal which raised over £130,000. One family sent in a donation of £500 – the amount they would have spent on their annual holiday which had been cancelled as a result of the virus. Not only did these gifts mean we could keep supporting the growing numbers of people who needed us, they also highlighted how St Christopher’s is very much part of the local community.

And as we’ve already mentioned, our Community Action Team supported people to volunteer their time to help others and, in some cases, even took some strain off of our clinical teams. It was a genuinely reciprocal partnership.

Inclusivity:

partnering with those around us to become stronger together

Learning and growing together

It’s only through education, discussion and understanding that we can truly say we stand for equality and diversity at St Christopher’s.

2020 was a tough year as we battled an international pandemic and people gathered around the world to stand up against racism following the death of George Floyd. In response to this, many organisations, including St Christopher’s, made a commitment to improving equality, diversity and inclusion within the workplace.

We began by holding two externally facilitated workshops, open to all staff, to explore what it means to be a truly inclusive organisation and understand what we are doing well and where we need to focus our efforts to improve. These workshops were attended by more than 30 people and their recommendations formed a roadmap for our newly formed Steering Committee known as FREDIE (Fairness, Respect, Equality, Diversity, Inclusion and Engagement).

We also continue in our commitment to ensure people from Black, Asian and Minority Ethnic (BAME) groups are represented across our workforce with processes such as anonymised shortlisting for vacancies, thus removing any unconscious bias and active encouragement to people from BAME groups to apply for our new roles as they become vacant, especially those on our Trustee Board and in more senior positions.


Staff and volunteers at St Christopher’s Hospice had vital outlets to vent, relax and find support during an incredibly difficult time.

Sustainability:

remaining resilient and ensuring our future


The rise of a global pandemic meant that we weren’t able to host… mass events but, undefeated, we did things a little differently


We made sure people still had the opportunity to remember those they have lost which, due to restrictions on funerals, was more important than ever before

Structure, governance and management

and Financial review

Structure, governance and management

The downloadable version of the St Christopher’s Annual Report and Accounts 2020/21 contains information:

  • How we are governed
  • Trustees’ duty to promote the success of the Charity – Section 172 statement
  • Recruitment and appointment of new Trustees
  • Public benefit
  • Fundraising disclosure
  • Pay policy for senior staff
  • Disabled people
  • Equality and diversity
  • Gender pay gap
  • Employee information
  • Streamlined energy and carbon reporting (SECR)
  • Principle risks and uncertainties
  • Risks associated with the United Kingdom’s decision to leave the EU

Financial review

The downloadable version of the St Christopher’s Annual Report and Accounts 2020/21 contains information:

  • Income
  • Donations and gifts
  • Legacies
  • NHS contracts
  • Income and performance of trading subsidaries
  • Investment income
  • Education, fees and other income
  • Expenditure
  • Staff costs
  • Costs of generating funds
  • Reserves policy and going concern
  • Investment policy
  • Statement of Board’s responsibilities
  • Statement as to disclosure of information to auditors
  • Independent auditor’s report to the Members and Trustees of St Christopher’s Hospice
  • Financial statement and balance sheets

Download annual report and accounts 2020-21

What we are going

to do next

Along with the rest of the world, our work during the recovery from COVID-19 will be alongside continued uncertainty as to future stages of the pandemic.

However, we want to build on the momentum for change and the transformation that we’ve made in the last year.

Outlined below are our plans for what we will do in the second year of our three-year strategy for 2020-23.

We will commit to building on our learnings to ensure we continuously evaluate what we need to stop, start and continue. In the coming year, we will:

  • Continue virtual consultations to reflect patient and family preferences
  • Continue our work with care homes, including the addition of a new rehabilitation offer
  • Build on the success of the Community Aid initiative and investigate emerging opportunities for our Community Action Team
  • Ensure the health and wellbeing of our workforce with the implementation of a new strategy, flexible working policy and ongoing wellbeing initiatives
  • Invest in IT to ensure that we’re technologically sound as an organisation and always looking out for new opportunities in this space
  • Invest in innovation to address inequalities and gaps in provision, particularly for our bereavement services
  • Work with the NHS to confirm our role and funding to support it going forward
  • Make the most of the new St Christopher’s CARE and its state-of-the-art facilities to educate for the transformation of end of life care going forward.

A year of

transformation

I am excited about the opportunity to support the increased influence of St Christopher’s, positioning the hospice as a major player in national conversations about death, dying, palliative care and bereavement support.

I also see the potential for international influence with the role of St Christopher’s CARE to educate about and promote the hospice movement, as well as continue to be a leading voice in clinical innovation wand palliative education.

As one of the leading providers of palliative care, St Christopher’s is already punching well above its weight and has clearly thrived during the last year, despite extraordinary challenges. In the coming year, I am keen to ensure St Christopher’s has a sustainable recovery post-COVID-19 across all aspects of the organisation. At the heart of this is ensuring that we continue to have an outstanding delivery of care.

While we’re aware that this is not exhaustive of everyone that we need to thank, to all of the supporters mentioned on pages 60-61, please accept our gratitude.

I’d also like to extend a personal thank you to my predecessor, Morgan Jones, for 19 years of dedicated service to the St Christopher’s Board of Trustees, the last seven years as Chair.

Whether you’re a donor, a volunteer, a member of staff or someone in one of the communities we serve, we could not have survived, much less thrived, over the last year without you. Thank you for being part of the St Christopher’s journey so far and here’s to the future!

Neil Goulden
Chair of Trustees

More information

Thank you to all our supporters

We are hugely grateful to the individuals, corporate sponsors, trusts and all those who have so kindly chosen to remember St Christopher’s in their Wills. Thanks to you, we’ve been able to provide care and support to approximately 7,000 people in the last year. Thank you for making this possible.

Who’s who

For information about our Executive Team and to find out who’s on our Board of Trustees, just click on the button below.

Get involved

Could you help St Christopher’s make a difference? If you can give your time, money or expertise we’d love to hear from you.

Downloads

Download Annual Report and Accounts 2020/21