Out of Hours Service Lead Ros Brown explains why specialist support is vital at night

July 2, 2021

When we arrive at a home at 2am we are often faced with distress and sometimes anger at what is happening but we are specialists in the last phase of life and a patient and their family’s anguish is eased when we arrive, because they know support is here

Clinical Nursing Specialist Ros Brown leads North London Hospice’s Out of Hours community service, which helps patients and their families, often in the last weeks of life, with telephone support and home visits throughout the night.

The hospice launched the service in October 2018 after identifying a growing need for specialist palliative care and advice at a time of day when it was least available elsewhere and has received more than 10,000 calls for support during that time and made over 550 home visits.

However, funding for the service – which employs three community nursing specialist and three health care assistants – comes to an end in November and the hospice has launched a funding campaign to support it in the future. You can make a donation here 

“It’s the specialist element of what we do that isn’t accessible in other medical settings at night,” says Ros. “It can be a very lonely time for our patients and their families. But they gain enormous comfort from knowing they can call the hospice 24 hours a day. If we weren’t available, the immediate understandable alternative is often to dial 999 and the patient often ended up in hospital, distressed and in unfamiliar surroundings.

“When we visit a patient, we do offer pain relief but this isn’t the main benefit of our night-time visits. The relief often comes as soon as we say we will go. We provide psychological support to both the patient and family members, supporting and advocating for them if needed.

“When we arrive at a home at 2am we are often faced with distress and sometimes anger at what is happening but we are specialists in the last phase of life and a patient and their family’s anguish is eased when we arrive, because they know support is here

“When someone’s breathing starts to change in the middle of the night we have hopefully prepared a patient and their support network for this so they will call us rather than dial 999.”

Demand for the Out of Hours Service has increased by 316% over the last 12 months and the team have achieved a high success rate (97%) of helping people to die in the place that they choose.

Ros added: “10 years ago only 25% of people across the country died in their preferred place. Thanks to advanced care planning and the fact that at North London Hospice we are available 24-hours a day, the majority of people that die in our care, do so peacefully in the place that they choose.”

The team are also able to support other medical professionals. “We also receive a large number of calls from nursing, GPs and other medical professionals from within and outside the boroughs we serve, including the London Ambulance Service, who are seeking specialist advice and support for families, and we will always provide this where we can.”