I first met Dr Richard Lamerton in Nevill Hall Hospital when he came to talk to senior staff of Gwent Health Authority about his desire to expand Hospice of the Marches (which was based in Hereford) down to Abergavenny and Blaenau Gwent. Dr Lamerton was the Medical Director of the Hospice and had vast experience in Palliative Care.
When I met him he already had 2 full time nurses, a part-time Social Worker and a host of complimentary therapists already in post.
He explained it would be a Hospice at Home service with patients able to access a qualified Doctor or Nurse 24hrs a day.
I was extremely interested in this service and what he had to offer, especially therapists to meet the psychological and emotional needs of patients and families.
In 1990 I had recently lost my husband who was just 42 and who I had nursed at home to the end. The service that Dr Lamerton was offering was certainly very much lacking in Blaenau Gwent at that time and on a personal note I would have given anything to be able to access such a service for my husband and sons.
I was a Nursing Officer for District Nursing in Blaenau Gwent, managing 80 + staff and at that time and I had 2 teenage sons living at home.
My husband had been a very fit 39yr old when he was diagnosed with Cancer, and had complex palliative care needs. If I needed specialist advice I’d ring the Oncologist in Velindre and he’d always say ‘bring him down’. I was very grateful to Velindre for such tremendous support but it is a 60 mile round trip and not many families in Blaenau Gwent can afford to take their loved ones down at such short notice.
I learnt so much on a personal note during the time I nursed my husband, I felt that the expertise and empathy I had gained could only help patients who had a potential life limiting diagnosis and offer emotional support to their loved ones.
I met with Richard again and he asked me if I would consider working with him. He could only offer me a salary of 2 grades lower than I was on at that time. I would be based at home with all staff meetings would be held in Hereford and I would be on-call every week night for Blaenau Gwent whilst he would be on for Hereford, but always available for advice. Week- end on-call covered from Hereford down to Blaenau Gwent was on a rota basis. I took the plunge and started work for the Hospice.
I set out visiting every GP practice in the Borough to make them aware of what service we were offering. I was warmly received they were not accustomed to having anyone available at for 24-hr support for their terminally ill patients, and in those days GP’s were on call for their practice only (the district nurse service finished at midnight at that time).
The next step was for me to visit every agency in the Borough: Social Services, home care, mental health teams and local cottage hospitals to make them aware of the service available for advice or to help get their terminal patients home. After this referrals came in thick and fast!
I then visited every organisations to try and get financial support, from the Free Masons to the Mayor of Blaenau Gwent. All these visits were in the evening and this was in addition to working on patch by day.
Richard and I always did a joint first visit then he made a clear plan for the patient and the ultimate goal. I followed up on the patients daily and reported back to him on the patients progress.
My boys soon learned skills in dealing with distressed patients and relatives and took time to reassure them that they would convey their messages to me and I would contact them without fail. There were no mobile phones at that point.
Richard had established a Day Centre at Nevill Hall Hospital where patients could benefit from all the therapies that were on offer. This was appointment only and had immeasurable benefits but some patients found the full day a little too long, so I set about looking for venues to start drop-in clinics which were mornings only, firstly in Tredegar.
Referrals came in thick and fast, I went out all hours of the night even though I’d worked all day! Families were so grateful, my aim was to meet the needs of the patient in their time of need and whenever I went along to speak to professionals I stressed patients weren’t only ill 9-5 pm and unless we made a difference, we were of no use to them.
In 1992 after much pressure on the Board of Trustees in Hereford they agreed I could have an office base in Tredegar with a telephone and an answer phone. Nothing else but I was excited. The only drawback was there was no toilet, but not to worry there were public toilets across the road.
I knew our next door neighbour as I’d nursed his mother, and he had just taken over the funeral directors business in Tredegar. He was grateful for the help his mother had and was eager to help me in any way he could. I was also undergoing a four month course in Velindre at this time and offered to type up any course work I had to submit, he was like my secretary at that time albeit unpaid. He later gave me a key to use his toilet which was a great help especially when staff from Hereford came down or when new staff were appointed.
The Hospice grew from strength to strength and we had a brilliant chairman in John Taylor who was also Mayor of BGBC and had lots of connections, we would travel together to the Trustees meetings in Hereford and he recognised the number of referrals in the Valleys was enough to serve Blaeanau Gwent alone, while referrals in Hereford and the Marches had dwindled greatly. I needed more nurses in Blaenau Gwent and John fully supported me in that aim. My ideal would be one full time Sister per valley.
Initially when a patient died I visited their relative weekly it was our policy to attend their funeral, much to the delight of the bereaved.
Donations to the Hospice became the norm instead of flowers at funerals, as relatives wanted to show their appreciation to us and this was one way they could.
It was soon apparent we needed benefits advice to help patients access benefits whilst they couldn’t work, and to help the bereaved get their entitlement.
This again was put to the Trustees.
It was becoming clear that I couldn’t keep up the weekly visits to the bereaved as the numbers were increasing but neither could I abandon them so I set up bereavement groups per valley (I had to secure premises first though).
I forged links with the Palliative Care team and was soon invited to their meetings which was a great help.
As the number of referrals increased so did our drop-in clinics, I could monitor far more patients in one setting than have to travel around every home, but to hold these clinics I needed volunteers. I started off with my sister and sister-in-law supporting the Tredegar clinic, making tea and cake. The aim was to make patients feel welcome and comfortable. Richard and I attended each session along with at least 2 therapists and the Social Worker.
As time went on and money became more available I was able to appoint more staff. I started up more drop-in clinics, the next was in Abertillery and as I had a Sister living in Abertillery she was my next hospice volunteer. Ebbw Vale, then Blaina followed, each clinic being nurse led with support from local volunteers .
I started to enrol a many the bereaved relatives to be volunteers, to give them a purpose again which they embraced fully.
We had lots of charitable events going on ,we had a float in Tredegar Carnival where staff, volunteers and patients took part (Sister Act) so the local communities didn’t just see us as doom and gloom but a happy and loving organisation out to help patients from diagnosis onwards at absolutely no cost to the patient.
As an organisation I was always mindful we were not the NHS so our funding was never guaranteed. I think we were always on the lookout for ways to raise funds. I always felt strongly that if you deliver a service that is effective the money will follow!! The difficulty I had was the Trustees weren’t always in agreement with that philosophy.
Having more Nurses meant that I could do less on-calls but was always available to be contacted should nurses need any advice. As time went on our staff compliment grew, roles changed and progress continued, but our principle aim on serving our patients didn’t falter.
Nurses had to keep up their expertise and I was keen for them to attend the advanced Palliative Care course in Oxford University which I attended for many years. New drugs were emerging for pain and symptom management and we wanted the best for our patients. Any fundraising events the nurses would attend if they were able, and take part on the stalls or just have a presence. Visitors at these events loved to catch up with the staff that had made such a difference to their lives.
In 1999 we finally changed the name to Hospice of the Valleys and had a new home with plenty of rooms in Morgan Street, Tredegar. Neil Kinnock MP who was also our Patron visited his home town of Tredegar to do us the honour. We appointed more admin staff and held our Trustees meeting in Tredegar at long last. Things moved on quickly from this point.
Each year I sent 2 volunteers or staff to the Queen’s garden party as a thank you for their long service. I nominated volunteers to be recognised by the Borough or Town Mayors. From 3 members of my family as the only volunteers to start it soon crept up to the hundreds – an army of such reliable un-paid heroes.
In 2005 we were nominated for the Great Britain IMPACT Award for innovative practice. This was an award funded by The Kings Fund in conjunction with GSK (a pharmaceutical company). I was stunned, I was more shocked when they announced we were one of the 10 organisations to be shortlisted out of the whole of the UK in my eyes we were already winners. We were invited to attend The Art Gallery in London’s Trafalgar Square. I invited as many staff as I could without depleting the service too much. We attended the presentation and a film was shown of the 10 finalists, and the service they provided, we listened intently then at end of the evening they announced the overall winners was THE HOSPICE OF THE VALLEYS from Wales!! I was absolutely thrilled. Andrew Richards CEO and I was called up onto the stage, to receive a £30,000 cheque and a bouquet of flowers. What a recognition for all the hard work and never agreeing to compromise any detail of care our patients should receive. Every member of my staff had helped me achieve this award I thanked them all and said how grateful we were to them. This was the same year that Wales won the Grand slam in rugby, a year I’ll never forget!
I left the stage to Andy asking me where the cheque was – in my excitement I’d left the cheque on the stage… but I soon retrieved it. When we left the gallery we were having messages from home congratulating us – we were on the National News!!
Life became a little easier with more staff and we employed a part-time doctor who wanted to study for her Palliative Care qualification.
In the Queens New Year Honours list in 2007 I was awarded an MBE, for Services to Health Care – an honour I graciously received on behalf of myself and all my team.
Staff at the hospice were special. We all had the same aim to provide holistic support to anyone diagnosed with a life- threatening illness, at any time of the day! Every member of staff would go above and beyond their pay grade to enable the service to survive.
I always felt if I’d got things right the service would go on without me and so in 2010 I made the difficult decision to retire. The Hospice continued to grow and develop to meet ever increasing demand from the local community and I am so incredibly proud of the service I helped create and the service that exists today to support people within our local community at a time when they need!!
Jayne Medlicott MBE