Bringing care into families' homes

27 February 2020
At Martin House we have a very clear vision – that every child and young person has access to palliative care when and where they need it.

For many, that means regular stays at the hospice – most often for short breaks – but also when there’s an emergency, or as a step-down from a hospital stay, to treat symptoms, and of course, for end of life care.

But we also care for children in their own homes and when they are in hospital, with a dedicated community nursing team providing support to families across our region.

This has generally focused on infants and toddlers, children who cannot attend school due to their health needs, and families who have found it difficult to access the hospice for various reasons.

However, as more and more families need a greater level of flexibility about where they receive palliative care, we have been developing our community nursing service to ensure we can give more children support outside of Martin House.

Last January three clinical nurse specialists (CNS) joined our community team, with the aim of extending the scope of the care we can offer outside of the hospice. CNSs are nurses who have done advanced training in a specialist area – in this case children’s palliative care – and can independently prescribe medicines, and assess children with very complex needs.

The goal has been to offer seamless, integrated care for families by working together with our colleagues in the NHS and our existing community nursing team, allowing children to stay at home who would otherwise need to be admitted to hospital or the hospice.

This has involved finding out what service provision exists in the community, and developing our relationships with hospitals, children’s community teams and other agencies involved in health care.

It’s meant we have been able to care for more children and young people in the community, helping them to make an informed choice about where they want to receive care – in hospital, in the hospice or at home.

We’ve also been able to offer a wider range of care in the community, including symptom control and end of life care – allowing families to be at home with their child where they again may have needed to be in a hospital or the hospice.

Building these close relationships helps to give a more joined-up service to families; our CNSs provide regular clinical updates to community teams, attend hospital rounds and joint planning sessions with NHS colleagues.

Their input has helped children to be discharged from hospital more quickly, ensuring there are plans in place to meet their needs, and they’re providing training to NHS-based professionals to give them more confidence in supporting families in the community.

This area of our care is set to grow, and we have already recruited one of our existing care team nurses to a trainee CNS role to bolster our community team further. In the next year we are planning to develop our community service in a number of ways.

We will continue to build relationships with local teams in hospitals and the community, enabling us to tailor our role to fit the needs of specific teams.

We are looking at the need for satellite clinics in areas where there is limited local access to palliative care for children and young people, so families can access specialist clinical advice and support closer to home.

And we are building the capacity of our community nursing service, so families can access care at both Martin House and at home, providing true choice in where they receive care.

You can find out more about Martin House, and how you can support our work at

Michael Tatterton
Deputy Director of Care