Integrated services review

2020: a year of challenge, change and new beginnings.

As we start another year where community is more important than ever, we wanted to take a moment to reflect on our thriving partnerships and the good work they have delivered over the last 12 months.

The integrated Support, Welfare and Bereavement team is a true reflection on partnership working consisting of staff from St Andrew’s Hospice and Care Plus Group with support of the CRUSE Bereavement service.

At the start of 2020, the integrated support welfare and bereavement team had four staff vacancies; following a review of posts, we recruited a Bereavement Service Coordinator, Bereavement Caseworker, Hospice Senior Palliative Care Social Worker, Macmillan Assistant Social Welfare Officer (cover for maternity leave) and a Macmillan Palliative Care Social Worker. These new team members along with existing staff make up our current team. In March, with the arrival of COVID -19 little did we know the virus would substantially change working practices requiring the team to adopt remote working and a reliance on telephone / virtual means of communication. We were introduced to zoom and teams, virtual platforms enabling us to see colleagues and patients face to face and keep in touch in a virtual way.  Face to face visits in the community and hospice necessitated risk assessments and wearing of PPE, only indicated when all other means of communication had been tried. Some interviews and staff inductions also took place in a virtual way.

The team quickly bonded despite the difficulties we faced, a can do attitude emerged to delivering pre bereavement, social welfare, spiritual care and bereavement services albeit in a Covid Safe way. There are numerous case examples of the integrated team working together with other end of life services and external agencies to improve life experiences of patients and their family during the COVID – 19 pandemic.

Integrated Team achievements this year include:

During the early months existing staff continued to deliver services despite a high level of staff vacancies.

Social Workers, Bereavement Coordinator and Spiritual Care Lead completed PAABS suicide bereavement training. (Specialist training funded via Humber Coast and Vale Suicide Prevention Steering group.)

Emotional and Bereavement support provided to care home staff during first and second waves of COVID – 19 helping support staff and managers with loss and the sudden death of a large number of residents due to the virus.

Social Welfare team supported patients to claim relevant benefits and families who had substantially reduced income due to Cancer, palliative illness, furlough or loss of jobs due to COVID -19.  They also increased support to families experiencing funeral poverty after a family member’s sudden death, with no provision to pay for their funeral in place. The Local Lions charity provided vouchers at Christmas to a number of vulnerable families enabling them to buy food. The team also supported with benefit appeals and housing in complex cases.

The Spiritual care lead and volunteers continued to support patients (adults and children) emotionally with existential issues, questions relating to their illnesses and impact of life with COVID – 19.  The Spiritual care lead led reflections for Andy’s Children’s Memory Day and St. Andrews light up a life, both sessions delivered for the first time via You Tube and Facebook. The Spiritual care lead has also input to NHS England service mapping process to ensure spiritual care is included and improve provision of End of Life Care and established an inter faith forum locally to improve spiritual care support provided by all faiths in the community.

The Bereavement team have continued to support adults and children with bereavement issues including losses from many years ago and losses which either involve deaths directly related to COVID -19 or are impacted by changes to procedures and rituals necessitated to keep individuals safe from the virus. The team have supported a number of adults and children emotionally distressed and who indicated a real intention to end their life, this has involved working closely with suicide prevention partnership group members, mental health and psychology services to enable the individuals to access the help and support they required.

The social work team have supported patients (adults and children) and their families’ pre and post bereavement to cope with the emotional impact and coming to terms with illness and its effects on family and individuals. Dealt with complex family circumstances including relationship issues, domestic violence, adult and children’s safeguarding and mental capacity issues and to legally secure a child’s carers following the death of their parent.  The team have provided bereavement support to parents who have experienced the death of their baby or child which often sudden or unexpected.

The integrated team also provides education and although face to face training has not been possible generally due to COVID -19 members have continued to deliver education to staff in Andy’s children’s unit, schools, other agencies including Open Minds, Older People’s mental health team, Yorkshire and Humber Vale bereavement webinar, HYMS medical students, Macmillan Teams and Hospice staff (part of learning at work week.)

Dawn Trigg – Support, Welfare and Bereavement Service Lead                    


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