BLOG: Pilot service takes expert St Luke’s hospice care to Cornish doorsteps

St Luke’s Hospice Plymouth’s end of life Urgent Care Team ventured across the Tamar last week to visit their first patient at home in East Cornwall as part of a pilot service running until the end of March 2024.

We followed senior health care assistant Bee Daniels and nurse Jo Davis as they went to meet a very grateful Paul Treeby and his daughter, Jude Kitt.

It’s less than half a kilometre from one side to the other but crossing the Tamar Bridge represented a significant milestone for St Luke’s pilot East Cornwall Urgent Care Service.

Until last week it had been a bridge too far for the hospice’s “at home” teams who already clock up more than 80,000 miles a year taking our specialist care to the doorsteps of patients in Plymouth and surrounding areas of West and South Devon.

In a ground-breaking move, a four-month trial service has been launched to visit end of life patients and their families at home in a largely rural stretch from Saltash to Torpoint and the Rame Peninsula, up the Tamar Valley towards Callington and Launceston and across to Liskeard.

Patients in this area have benefited from St Luke’s care at Derriford Hospital and in the charity’s specialist unit at Turnchapel, but there has previously been no service available to support them either to remain at home or to care for them on discharge from hospital.

Senior healthcare assistant Bee and nurse Jo were thrilled and proud to be pioneers on a mission to make a positive difference to people’s lives, working closely with NHS healthcare colleagues across the water.

“The whole team are really excited to go there,” said Bee, in the driving seat as they passed the Welcome to Cornwall sign in the centre of the bridge. “It’s another big area for us to cover and it’s going to be a lot more rural nursing, but we’re all up for the challenge.”

That stalwart can-do attitude certainly came in handy as they turned off the A38 to snake through the Cornish countryside to meet Paul Treeby, the team’s first patient on the service’s first day.

Beneath bleak black clouds and intermittent heavy downpours, Bee drove carefully, bumping along increasingly muddy lanes until she hit Tarmac with grass growing down the middle, her view hemmed in by high hedges on either side.

Suddenly a beautiful rainbow and a glimmer of blue sky appeared in the distance beckoning Bee and Jo to one of the small farming communities that pepper the hinterlands between Liskeard and Callington.

“It’s a typical journey, really,” said Jo. “We’re based in the city, but we have a lot of isolated people to visit out in the countryside. We keep going come rain or shine, grass or gravel!”

St Luke’s Urgent Care is a healthcare assistant led service, so Jo wouldn’t normally be out visiting patients herself, except when there’s an urgent need for her nursing expertise.

“I put myself down for the first shift so that I can see what the challenges are and support the team while they are getting used to the area,” she explained.

With the satnav out of range, they managed to arrive in roughly the right place, but Paul’s tucked-away home wasn’t easy to find in the pouring rain, despite his instructions. Luckily, he lives in a friendly hamlet where everyone knows everyone, and hardy folk who walk their dogs in all weathers were eager to point Bee in the right direction.

There was an almost palpable sense of relief as Paul’s daughter, Jude Kitt, opened the door of her father’s bungalow and, along with black Labrador Harvey, welcomed Bee and Jo inside.

Any apprehension Paul had felt before their arrival vanished immediately as they asked him gently about himself, how he was feeling and what they could do to help.

“We build a rapport with patients very, very quickly,” explained Jo. “Going in on a daily basis you can quickly see how someone is and if there is escalation of symptoms you can deal with that. The patient can get what they need from us in a timely manner. We make sure everything is as easy as possible.”

Their role is also to liaise with the other health professionals involved in his care, including his GP and the NHS Cornwall palliative care nurse who gives Paul and Jude advice over the phone.

Paul, 75, has been living with prostate cancer for 10 years. After an operation, chemotherapy and radiotherapy, he was put on long-term chemotherapy to control the disease. But, in July this year – just a month after his dear wife Elizabeth’s death from leukaemia – Paul’s oncology team told him that the treatment had run its course and there was nothing more they could do.

It means the world to him to now be able to spend his remaining time at home in the community he knows and loves, with reassuring support from St Luke’s.

“I’ve been a country lad all my life. I was brought up on the farm. I was born at Blunts, down the road. Dad was killed in a tractor accident and Mother had three of us to look after so she took a job as a housekeeper for another farm at Menheniot. That was tough, but you just got on with it. When I was old enough, I went out to work and started digger driving, which I loved,” he said.

Paul and Elizabeth brought up their family on a smallholding near Trewidland – a tiny hamlet between Liskeard and Looe – and he made a living operating diggers for several local companies.

“We had around 40 acres and kept sheep through the winter and cut hay in summer. When we couldn’t cope with that any more, my son Tim took it on and bought us this bungalow to retire to.”

Paul was quick to praise Bee and Jo at the end of their visit.

“I was very impressed with St Luke’s team. It’s good to have them coming in to help me with any problems I’ve got. I think it will be a big benefit having them down here in Cornwall,” he said. “I think it’s something that’s got to be done. There’s a massive demand.

“They came in and made me feel at home. They talked about my tablets, and they took me in to have a wash. It was all very relaxed and no stress. That suits me down to the ground because I don’t do well with stress. That’s why I wouldn’t want to go back to hospital again.”

Jude, who lives four miles away at Pensilva, has been juggling her own family life with caring for her dad, with no real chance to grieve for her mother, who was the first person she would usually have talked things through with.

“It feels like a huge relief already. Dad deserves the best care and now we have got somebody coming every day who can help us. I feel like I have a team behind me now,” she said.

“The main thing is the continuation of people coming in so they will get to know Dad and recognise any day to day deterioration. I feel like it’s all been on me, and it’s been a bit overwhelming at times.”

Jo added: “There must be a lot of families who have been struggling up until now and it’s good to be able to tell them there is help on the way.”

The final word goes to Bee, who said: “Dying is a massive part of life. Everyone deserves to have the best death they can have, and we can help with that journey.”