We are always thrilled to hear the impact our training has on the learners that come to Princess Alice Hospice. 

Lucy attended our ‘Compassionate Care at end of life – An introductory course for 16-19 year olds’ in 2020 knowing she had an interest in health care but wanted to find out more.

The Compassionate Care course is run by the Education department twice a year and is attended by local students. It provides the unique opportunity to learn about the many different career avenues within the field of palliative care; from physiotherapy, nursing, speech and language therapy, to social work and medical jobs.  We are very proud of the standard of care we provide for our patients and their families and we love the opportunity to share this with the students.  Over three half days at the hospice, we encourage questions, reflection and a space to bust myths around end of life care.

Following her attendance at the course, Lucy felt inspired to continue her interest in healthcare and is now studying Medicine at Warwick University and is “finding it very exciting and interesting”.

Looking back at her time on the course, Lucy commented “I think the summer school really helped me and showed that when communicating with people who are unwell and vulnerable, you need to show empathy in different ways and that it isn’t as scary as you might think.”

I also think the summer school emphasized person-centred care in medicine and how important it is to get to know the patient as a person, not just their illness.  And I think that exposure has really helped me especially now when in the hospital and talking to patients who are scared and unwell.”

We wish Lucy all the best in her career and hope to see her again!

1. As a Doctor, have you always had a particular interest in palliative and end of life care in your practice?
No, not at all—in fact, I had the complete opposite view from the one I have today. Before I started, I considered palliative care to be an unpleasant, dark, and undesirable area of medicine. I ended up in palliative medicine almost by accident—it found me, not the other way around. At the time, a new palliative team was being formed and no one was willing to take the position for months. I was asked to join, and despite my views, I decided to take it on as a challenge and applied. Looking back, I am very happy with that decision. Through this work, I discovered a whole new, often very challenging but also deeply beautiful part of medicine that can make a huge difference in the lives of patients and their families.

2. Can you tell us how you found out about Princess Alice Hospice while you were working in Croatia?
It was combination of a colleague who had a short visit there and shared very positive impressions, and my own online research. I soon started attending your Lunch & Learn webinars, which I really enjoyed. They gave me both useful insights and a sense of the hospice’s values and approach, which made me even more eager to come and learn in person.

3. Please share your main reflections of your time visiting Princess Alice Hospice
The whole hospice is unlike anything I can compare to in Croatia. Where to start? What stood out the most for me was your teamwork and multidisciplinary approach. It is truly the core of excellent palliative care. You are mastering it, while in Croatia we are still lacking this level of collaboration. It was both inspiring and enjoyable to witness, but at the same time a little ‘painful’, knowing I would soon return to a system where such teamwork is still only developing.

I especially appreciated your MDT meetings, which showed me what it really means to take a holistic approach and to assess someone’s needs in a comprehensive way. I also enjoyed the discussions in your Journal Clubs, you have shared one of your own research — it was both practical and inspiring.

The support you offer through the Wellbeing Centre is amazing. Both patients and their loved ones can benefit from the wide range of complementary therapies available. Watching and learning from your young residents in the In-Patient Unit was also very beneficial. Their opportunity to have experienced consultant doctors in palliative care available for any doubts or discussions is something I can only dream of at my workplace.

Your Community team was another highlight. I especially enjoyed our discussions and the home visits we made together—it gave me the chance to compare it directly with the way we work in Croatia.

I was also struck by how many regular meetings you have that focus on staff wellbeing. That emphasis on caring for your own people is something I admire and hope to encourage more of at home.

And then there are so many other things that left a lasting impression on me: your incredible team of volunteers, bereavement support, the ‘Man Shed’, and even the architecture of the Hospice itself. It’s really hard to pick just a few main reflections, because the whole experience was so rich.

4. Were there significant differences in the way we deliver palliative and end of life care compared with your experiences in Croatia?
Yes, there are many significant differences. Palliative care in Croatia has only started developing more significantly in the last 10–15 years, and it is still not well incorporated into the health system overall. Resources are much more limited. For example, there are only two hospices in the entire country of 3.8 million people—and none in the capital, where about one million people live. Since only a few clinical centres have palliative teams, the main model of palliative care delivery in Croatia is through mobile teams. These are usually based in county health centres and typically consist of just a doctor and a nurse. That is why multidisciplinary work depends much more on individual enthusiasm and commitment than on the system itself.

One area where I noticed a clear difference is advance care planning. In Britain it is strongly encouraged, both through conversations and through formal documents, while in Croatia we are still lacking both the culture and the structures for this.

That being said, there are also some positive sides. One of them is that less paperwork and administrative work around patients can sometimes enable us to deliver care more quickly.

Because 24/7 palliative care is lacking—most services are available only during morning shifts—we often have to empower patients and carers to take a more active role, for example through (self-)administration of medicines. 

5. How have you applied what you learned in your work back in Croatia?
I have focused on providing as much holistic, multidisciplinary care as possible within our limited resources. Most challenges stem from broader issues in our health system and lack of national support, which is why few of us have repeatedly appealed to the Ministry of Health.

We have consistently advocated for stronger support of palliative care in Croatia, stressing the need to expand access to essential medicines, strengthen mobile teams with more equipment and multidisciplinary staff, and provide proper education and specialization for doctors and nurses. National standards must be aligned with EU guidelines, with digital integration and quality monitoring to ensure equal access across the country. 

Thanks to financial support from Switzerland, which has granted 5.5 million CHF for improving palliative care in Croatia, a national program for nurse specialisation in palliative care and digital integration will begin next year.

6. Have you shared your learnings with other colleagues?
Yes. I have given presentations at symposiums in hospitals and organised talks in different health centres. Of course, I also took the opportunity to share what I learned in less formal settings—through discussions with colleagues and in teaching sessions with younger doctors.

7. What was the most powerful lesson you learned in your time observing people at end of life at the Hospice?
That investing in knowledge and gaining high-quality experience in order to provide the best possible palliative care is always worth it many times over.

8. Is there anything further you’d like to share?
I would just like to express my gratitude to the entire team at Princess Alice Hospice for welcoming me so openly. I greatly appreciated the hospitality and effort you dedicated to preparing my visit—the way my agenda was thoughtfully arranged made me feel very welcome. Everyone was taking care of me and my schedule!  
The whole experience has strengthened my commitment to palliative care. 

Sylwia is Care Home Manager at Birtley House in Bramley, Surrey.  Here she explains how she has working with Princess Alice Hospice to expand her knowledge and skills regarding palliative and end of life care.

”The quality of training and knowledge delivered to us over the years by Princess Alice Hospice has been absolutely brilliant. We see them as being the ‘go to’ experts in End Of Life Care and the courses attended by my colleagues have been outstanding. 

I’m extremely proud to have been involved in setting up this Share and Learn Network for everybody who works in care homes within Princess Alice Hospice’s care area. The need for sharing knowledge, skills, practical advice and support – and sometime just a listening ear – has never been greater. The effects of the pandemic have been enormous on all care homes and we know we have to do more to support everybody involved in helping deliver the care to the people we look after and their families. I love the idea of people from different care homes, in different roles, all coming together easily and regularly to learn from each other and being able to provide support and guidance, too. I’d really encourage you to join us and begin your own sharing and learning journey in a supportive and friendly environment, both online and in person.”