Learning from the Strathcarron Hospice Experience

I graduated as a nurse from The University of Edinburgh in 1983 and have worked in health care for almost 40 years. For 20 of these years, I worked as a Community Clinical Nurse Specialist in Palliative Care with Strathcarron Hospice in Scotland’s central belt. It was my dream job. It combined a high level of specialist clinical knowledge and skill with my experience of working in the community as a District Nurse. I have always had a particular interest in supporting people who are approaching the last chapter of their life. Enabling people to die at home, if that was their wish, has always been very important to me. I have long been aware of the support which is provided by friends, family and neighbours that cannot be equalled by any professionals. The value of a pot of soup placed on the doorstep, or the offer to walk the dog or pick the kids up from school has never escaped me.

In 2013 Strathcarron Hospice took its first steps on a journey into community development. We started with a government-funded project under the banner “Reshaping Care for Older People” with the aim of “increasing community capacity”. I have to admit, at that time I had no idea what that meant! This project marked the start of a journey of learning. We recruited and trained volunteer befrienders to support people living with life-limiting illnesses in their community. It was successful. People loved the connection. Carers enjoyed a break. GPs saw a reduction in consultations with people who were clearly lonely. But the most surprising thing for us was how much the volunteers got from what they did. Both volunteers and patients reported that they quickly moved from “befriender” to friend. We had discovered the power of reciprocity. The magic of human connectedness had become visible to us. We also began to understand that there is more to life than health, and that professionals supplement the community rather than the other way round.

We then moved through many different projects, always funded by external grants and trusts. We learned that we had to move at the speed of trust in the communities we were working in, and had to listen to their agenda. There were tensions between working at the speed of the trust they had in us and delivering outcomes set by short term funding.

I was developing a sense of the potential that existed within our communities but was unsure what the hospice’s place in this should be. Strathcarron senior management, who were very much aware of the strategic landscape and that community services were increasingly important, were interested in where this road might take us. In the summer of 2019 they supported me and a member of my team to attend an ABCD masterclass arranged by Hospice UK.

My colleague Hannah Gray and I listened to Cormac and both thought “this makes sense, this fits with what we feel is right.”

We took our enthusiasm back to Strathcarron. After some discussion, and with funding from the National Lottery Community Fund, we became a Nurture Development Learning Site in January 2020.

As a result of the pandemic, Cormac was confined to barracks and so we had the immense privilege of being mentored on our journey by the man himself. Mentoring included sessions with the “on the ground” community builders, sessions with the wider community development team, sessions with me as project lead, and sessions with the Hospice Leadership Team.

We have journeyed together from the very basics of realising that community life is a rich tapestry in which health is but a few threads, to learning how to convene a space where citizens can come together to discover, connect and mobilise their talents gifts and skills.

The pandemic forced most professionals out of the communities, but Strathcarron Hospice made a brave decision not to furlough the community development team. We grasped this opportunity to discover new ways of working. We found ways to walk alongside and encourage communities as they rediscovered their capacity to come together and care for each other during times of crisis.

I have stewarded the development of a team of skilled community builders during extraordinary times.

The road has not always been smooth. We have navigated through doubts and dilemmas of various kinds. We have faced the question of “mission creep” many times and we do not have all of the answers. However, we now have a body of knowledge and experience and complete commitment to this on-going journey.

I am delighted to have been invited to share my experience and learning as an Associate of Nurture Development.

I am currently working with Cormac to put the finishing touches to our offers to Hospices.

We will offer supports at four levels:

1. Rapid Reviews aimed at developing a baseline understanding of current community-centred approaches within your Hospice, and scope for deepening and proliferation of current good practice.
2. Training & Development for practitioners across Hospice care in ABCD and community-centred approaches.
3. Leadership and Service transformation through the lens of ABCD, where we train and get alongside executive and senior leadership teams to support strategic planning and operationalising more community-centred approaches.
4. A longer-term mentoring/journeying alongside relationship tailored to your individual requirements, to build strong foundations and deepen practice over time.

If any of the above is of interest to you, you can contact me directly for an informal conversation, email: shigh@blueyonder.co.uk

Susan High