Can I tell you how your care is funded?

In a recent Linked-In post, Martin Edwards, CEO of Julia’s House asked why building a culture that’s conducive to fundraising isn’t a priority for all charity leaders. I couldn’t agree more. From my experience, the first step in doing so in hospices is ensuring that care staff understand the need to raise money.  

I have discussed this many times with Rebecca Trower, the Clinical Director at St Raphael’s Hospice. Becca recently ran a questionnaire with the care team about their views on talking to users around funding. She has very kindly let me share some of the responses. I have started at the negative end and moved on to the more positive!

I do feel uncomfortable when patients feel they want to make a donation. I want to make sure we give them care freely without them having to feel they need to give. If they insist, we make this happen. (Nurse)

I think I would be reasonably comfortable talking about money and the costs of Hospice care if they raised the topic, but I think it would be very hard to raise it in the context of a clinical discussion/ relationship. (Doctor)

I think it would be helpful to learn how to bring it up casually once rapport developed with patients/families. (Doctor)

Having a session with fundraising as a trainee at my previous hospice and considering the ethics etc really helped me get my head around this. I think it would be good for the clinical teams to have a session with fundraising around this. (Doctor)

Patients and their families often are not aware that we are a charity and heavily relying on donations/ legacies, fundraisers and our shops. I often make a point of mentioning this at my first assessment. I feel comfortable discussing this. (Nurse)

These comments reveal fascinating aspects of hospice culture. The first reflects the paternalistic view sometimes held in hospices about knowing what is in the best interests of users - even if they feel otherwise! It also suggests such donations are a purchase of care, not a heartfelt way to show gratitude and empathy for others. 

The second is more positive, though the key here is being aware of what it is appropriate to say. The third and fourth reflect the importance of such training, whether it be formal, or just having conversations with the fundraising team. I always find it interesting that fundraisers often shadow care members as part of their induction, but this happens less often the other way round. Ditto that fundraisers have training in how to support bereaved relatives, but care staff often have little idea of how the hospice is funded.

The last of the quotes is obviously the most positive. The nurse is comfortable mentioning that the hospice is a charity and how it is funded. This is as true and as integral to the hospice as the services it offers.  

Becca tells me that undertaking the questionnaire has led to the fundraising team running  ‘lunch and learn’ sessions for care colleagues to explain more about their work. That reflects the kind of culture that Martin talks of.