Inequalities in the health system are something Professor Matt Makin sees, quite literally, every day – even on his morning commute.

“I get the tram to work, and in that one journey from the South to the North of the city, there’s a 12-year life expectancy gap. Because our hospital (North Manchester Greater Hospital, where Matt is Medical Director) covers one of the most deprived areas in the UK, we were particularly impacted during the COVID-19 pandemic. I’m conscious that there are a lot of hospitals and hospices that don’t have equity of access to palliative medicine support – so we set up Supportive Care UK (SCUK) to try and bridge that gap”.

But what, you might ask, does a Manchester-based Professor and Medical Director have to do with ellenor – a hospice servicing life-limited patients and their families within the Kent and Bexley communities – over 230 miles away?

ellenor engaged the services of SCUK – a team of highly qualified, hand-picked palliative care consultants – in 2020. SCUK’s consultants – Professor Makin among them – support the doctors and nurses of ellenor’s Northfleet-based inpatient ward (IPW) with expert guidance and advice in palliative medicine, as well as providing a rigorous system of governance.

By hosting weekly virtual meetings with ellenor’s staff, SCUK’s consultants offer ellenor’s doctors a sounding board, allowing them to present the cases and patients they want to discuss.

“We meet via Microsoft Teams to have a catch-up, and to check in”, Matt explains. “The first conversation, from me to them, is ‘how are you guys – how’s your week been?’. We check in on each other’s wellbeing, first. We talk about the deaths, the discharges, any incidents, and any things they need to reflect on – then we talk about the patients.”

It’s an innovative approach that works for all parties and helps ellenor fulfil its ultimate mission and promise – to provide high quality care to life-limited patients, and their families, within the local Kent and Bexley communities.

“The really nice thing about ellenor’s relationship with SCUK is that it’s based on mutual trust and respect – that’s the very foundation of it. I’ve travelled down to ellenor – met the staff, visited the units – and seen through my own eyes the kind of fantastic work ellenor does. 

“From that perspective, I see myself as augmenting what’s already there. I put a check and a challenge in. ‘Why have you decided to do that? Have you thought about doing this differently? Have we considered the question of mental capacity, and the issues around the Deprivation of Liberty Safeguards (DoSL)?’. Invariably, they have”.

In addition to this extra layer of assurances and governance, ellenor’s doctors have also benefited from SCUK’s integrated teaching – much of which is provided by Professor Makin himself.

“He really helps us go over the whole case – both the medical problems, and the social problems”, says one Speciality Doctor currently working on ellenor’s IPW. “For me personally, he delivers teaching sessions, which I’m grateful for – he knows what my level is. From Matt, I’m getting a lot of learning that I wouldn’t otherwise have got, such as how to manage pain, how to deal with palliative emergencies, and how to conduct difficult conversations with patients and families”.

Two years into SCUK’s relationship with ellenor, the partnership is already flying high – particularly when it comes to the model Professor Makin dubs ‘the quadruplane’.

“For me, our involvement with ellenor hits all the things I talk about in North Manchester, which is a quadruplane. Do the patients benefit? Yes. Do patients get a better experience? Yes. Is it good value for money – that is, are patients seeing better health outcomes per pound spent? Absolutely yes. And are staff developing, and enjoying a better experience? Yes!”.

Crucially, though, ellenor’s coalition with SCUK also satisfies one of Professor Makin’s lifelong career missions – increasing access to high quality care for patients, while narrowing down health inequalities. This is something ellenor has already been involved in when, at the onset of the COVID-19 pandemic, it opened up the beds of its IPU to ‘step down’ patients, helping relieve some of the pressure on the NHS.

“I think it demonstrated a real degree of courage”, Matt says of ellenor’s decision to accept this overflow of patients. “It spoke to the values of ellenor. Whether it be providing this extra bed capacity at a time when the NHS was desperate for it, or through the fantastic work ellenor’s done in education – which has been recognised nationally – ellenor’s work has been great for expanding the universal reach of palliative and end of life care. ellenor looked beyond the walls of the hospice, while some organisations were looking inward”.

Two years on, ellenor is not only looking outward, but looking forward – to a future in which its innovative approach can serve as a model for other local charities and community-based hospices.

“I think this relationship could be a beacon for other units, nationally, to see that there’s an opportunity to strengthen their services – to demonstrate that there’s a different way of doing things. External organisations have already recognised that there’s real excellence in this alternative model, ellenor is rated outstanding by the Care Quality Commission (CQC) and has been shortlisted for the prestigious HSJ awards.

“What we’re doing shows that if you’re proactive, forward-thinking, and brave in the way you do things, you can provide better services for patients, cultivate an improved working culture, and approach palliative care medicine in a different way. 

“We’ve taken a leap to do things differently – and it’s working.”