Caring with compassion - St Christopher's Hospice

About St Christopher’sVisionSt Christopher’s, the first modern hospice,was founded by Dame Cicely Saunders in1967 to promote and provide compassionatepalliative care of the highest quality.Our vision is of a world in which all dyingpeople and those close to them have accessto appropriate care and support, when theyneed it, wherever they need it and whoeverthey are.CareSt Christopher’s care services are deliveredto around 2,000 people each year in theirown homes, our Inpatient Unit and theAnniversary Centre. Our services include:• palliative care from specialist doctors andnurses• physiotherapy and occupational therapy• social work and welfare support• adult bereavement services• psychiatric support• creative therapies and activities• complementary therapies• spiritual care and• specialist support for bereaved children.2We serve a population of 1.5 million in theLondon boroughs of Bromley, Croydon,Lambeth, Lewisham and Southwark,reaching some of England’s most deprivedand ethnically diverse areas.Our support extends to families andfriends both during the illness and intobereavement. Our services are free topatients and families.Education and researchDame Cicely‘s vision and work transformedthe care of the dying and we continue thispioneering tradition today.The ongoing impact of St Christopher’sclinical innovations and extensiveprogrammes of education and researchimprove care for dying people locally,nationally and internationally. Last year wetrained almost 12,000 health and social carestaff from all settings.FundingSt Christopher’s services cost more than£15 million each year. Just over a third comesfrom the NHS which means we are indebtedto our local community and trusts andfoundations for helping us to raise£10 million each year.“Thank God! There is a place where peoplearen’t treated as inconvenient pieces ofmeat – but are in life and death given thelove, care and respect they deserve. I cannever thank you enough for the love andcare you showed my wife.”“Your professionalism and tender caringmade our journey with mum bearable.”Find out more online aboutSt Christopher’s Hospiceby scanning this QR code orvisit via tinyurl.com/stchrev

Caring with compassionChief Executive’s messageIn the past year a series of documentaryreports laid bare a shocking deficit of careand compassion in many health and socialcare services. The warning bells rang againwhen Andrew Dilnot’s Commission onFunding of Care and Support concludedthat the current system was “not fit forpurpose”.We cannot afford to ignore these starkmessages. Of course many care providersdeliver excellent services that respect thewishes and dignity of the individual butit is important that, as a society, we striveto ensure that all health and social careproviders, particularly those for the elderlyand vulnerable, deliver the compassionatecare that we would wish for ourselves andour own families.Our greatest challenge ahead lies in thecare and support of older people and theone in three over 65-year-olds who will diesuffering from some form of dementia. It isvital that we improve and integrate widercare systems so that compassionate endof life care is embedded in social as well ashealth care. The scale of the challenge isenormous and while hospices cannot mendthe system, they have unique expertise.St Christopher’s in particular has much tocontribute.Our response to these challenges is centredaround four strategic objectives:• Improving the care of older peopleeverywhere.• Supporting the development of confident,competent, compassionate care from thewhole health and social care workforce.• Spearheading efforts to change publicattitudes about death and dying andthe development of compassionatecommunities.• Delivering high quality, cost-effective,evaluated care and service innovationeasily accessible to those most in need.You will read more about these objectivesand our work towards them in this annualreview.I would like to take this opportunity tothank all the people and organisations thatmake it possible for St Christopher’s toachieve so much, both in the provision ofend of life care for our local community andthrough our training, education and researchprogrammes. The knowledge that we aresupported by a caring community is a sourceof strength to everyone at the hospice.I would like to thank our staff, volunteersand trustees for their extraordinarycommitment and dedication throughoutthe year.I would also like to thank our patientsand those close to them for sharing theirexperiences so openly as these personalviewpoints help to improve our services andalso contribute to our influential work inraising the standards of end of life care foreveryone.Finally, I hope you enjoy the Hockneyinspired paintings that illustrate this year’sreview. You will read about them later – wethink they are wonderful!Dame Barbara Monroe DBEChief Executive, St Christopher’s Hospice3

A simple yet caring approach for peoplewith dementiaInspired by the pioneering work of ProfessorJoyce Simard in the USA and Australia andher support during a recent visit, our newNamaste project with six nursing homesaims to improve the quality of life of peoplewith end stage dementia.It is about reducing anxiety and agitationin people, who may have lost the abilityto speak and recognise those aroundthem, by gently stimulating the five sensesthrough, for example, soft music, birdsong, pleasurable aromas and interestingtaste sensations. Namaste is an Indian termmeaning to honour the spirit within.• BBC Radio 4 and BBC London recentlybroadcast items about the needs ofpeople with end-stage dementia andhighlighted our project.• We launched an evaluation into theapplication of Namaste. This study buildson our earlier dementia research and thepublication this year of the first textbookon palliative care for dementia patients.“We introduced Namaste End of Life Care for our residents with end stage dementia afterJoyce Simard’s visit and workshops. Now we’re doing it independently and it is part ofour daily routine. Everyone in our team including our maintenance people and domesticstaff are aware of what it is and how to progress it. Namaste End of Life Care allows ourresidents to be well cared for, groomed, treated with respect, have their rights maintainedand pain controlled. And also, most importantly, have a respectful and dignified end to lifein a peaceful environment – unlike casualty admission where patients may spend their lasthours in pain and on trolleys.“We use various things for Namaste End of life Care like scents, soft touch, hand and footmassage using cream, sensual oils and music. Relatives participate in caring for their lovedones and they are welcomed. These soothing activities have reduced residents’ moodswings. Now there is a much calmer environment with people sitting comfortably andpeacefully instead of pacing the corridor or staring at the walls. It’s not stressful for any ofus any more – that includes our staff, our residents and relatives.”Naj Mudhoo, Manager, Lakeside Nursing Home6

Compassionateand caringworkforceSt Christopher’s is one of the largest end oflife care training and education providersin the world with a local, national andinternational programme. Our focus locallyis on supporting the skills development offrontline staff in a range of settings includingGP practices, district nurse bases, hospitalsand care homes, as well as in hospices.Health and social care professionals are nodifferent to the rest of us in that many findit difficult to talk about death and dying.Too often the subject is avoided until itis too late to put in place care plans thatreflect and respect the needs and wishesof individuals. Many care staff will havereceived little or no end of life training priorto their contact with St Christopher’s andmost embrace the opportunities to learnand develop new skills.The evaluation average across all our coursesis 4.4 out of 5 which rates as ‘very good’.Local and national training and education• Last year 2,344 delegates attended 136courses and conferences in our EducationCentre.• Our external training and conferenceprogramme reached a record number of9,524 health and social care professionals.We trained 700 medical students and ninenursing students from Guy’s, King’s and StThomas’ Hospitals came on placements.• 18 post-registration nurses took part in ourend of life programme placements.• We provided 23 clinical placements forother professionals.• Three newly qualified nurses successfullycompleted our new one-yearpreceptorship programme to support theirfirst year in practice as a Registered Nurse.• St Christopher’s is providing trainingand our Advance Care Planningdocumentation for the London roll out ofCoordinate my Care, part of the NationalEnd of Life Care programme. The aimis to ensure that the end of life wishesof individuals are recorded on a registeraccessible by health and social careprofessionals in all settings. The project willbe rolled out nationally in due course.“I really enjoyed my year at St Christopher’s.The transition from student to staffnurse was made easier in a supportiveenvironment. The experience andknowledge gained has been invaluable.I will take what I’ve learnt into my futurerole and into different healthcare settings.I will endeavour to educate and encourageothers to carry out palliative care tothe same outstanding standard that Iwitnessed at St Christopher’s.”“This course gave me an opportunity togain more confidence in end of life careconversations.”7

Training for health and social care providersIf end of life needs and wishes are to be met,it is essential that planning starts earlier andthat social care providers are able to take aconfident lead. This is the drive behind ournew initiatives to help develop the skills ofthe social care workforce at all levels.• Our social care training pilot of 11 courses,funded by the national End of Life Careprogramme, was completed successfullywith 162 adult care professionals inLambeth and Southwark. We found acommitted workforce eager to learn butlacking in knowledge and confidence.• Southwark has since commissionedfurther support and we are training staff atall levels in settings that include shelteredand extra-care housing, day services andcommunity and hospital based teams.• We have ongoing contracts to train staff inSouthwark, Lambeth and Bromley.• In partnership with Croydon SocialServices we are running a pilot projectto develop a new social care agency todeliver care to people at home in the lastyear of life. We have recruited and traineda team of social care assistantsto deliver this.8“I just wanted to formally express mysincere gratitude on behalf of all 16delegates, for a superb, mind-altering andinsightful training course. Each and everytrainer was excellent in their own right,and the passion for the subject was hardto disguise… Hospitality was second tonone and we felt cared for and important.If that’s how training delegates feel, itmust be great to be a patient in yourhospice even under the most difficultcircumstances.”Home Group – supported housing managerTraining the trainersFunded by the Daisy Foundation andworking in partnership with the Departmentof Health and Help the Hospices, we aredelivering the national roll out of the‘Training the Trainers’ course for the QualityEnd of Life Care for All programme (QELCA).The course trains hospice staff to formpartnerships to deliver end of life training totheir local acute trusts. 21 hospices are nowrunning programmes for 18 acute trusts.“I found this course very thought provoking,particularly the way you helped us toidentify the skills we already had within us.”“Interesting, very informative andimaginative way of teaching people toreally think about what’s happening aroundthem, what they are doing and about waysthey may be able to make a difference forthe better.”

Supporting our overseas colleagues• Delegates at our Education Centre coursesand conferences included 482 studentsfrom 41 overseas countries.• We supported six bursary students fromIndia, Lithuania (two), Romania, Rwandaand Sudan.• We trained six nurses from overseas.• Our staff delivered training coursesthroughout Europe as well as in Curacao,Canada, India and the USA.Research into what worksOur research programme explores newways to deliver high quality care that iscost-effective and sustainable. The strengthof our research partnerships enables us toachieve much more than we could if weworked in isolation.• Working with the Institute of Psychiatrywe completed data collection on a studyto examine the effectiveness of a shortversus standard length course of CognitiveBehavioural Therapy (CBT). This built onearlier work showing that clinical nursespecialists with basic CBT training aremore effective than their colleagues insupporting people with anxiety.• A legacy enabled research with the CicelySaunders Institute at King’s College todevelop a tool to assess the quality of lifeof patients with myeloma (a type of bonemarrow cancer) to be extended to peoplewith late stage disease.• Our major study on depression,conducted jointly with psychiatristsfrom the Maudsley Hospital, led to fourpublished papers in leading peer reviewedjournals. Two more have been submittedfor publication.Information and publications• St Christopher’s staff once again produceda wide range of professional publicationsincluding 73 journal articles, chaptersand books as well as 19 internationalconference papers.• Our newly redeveloped website atwww.stchristophers.org.uk has improvedthe quality of information available topatients and families, health and socialcare professionals and our supporters. Weintroduced new technologies enablingonline course bookings and payments andprofessional colleagues in all settings nowhave easy access to supporting materials.During the year the website received95,000 visits.• Our End of Life Journal is now availablefree online and has over 4,000 subscribers.• Our specialist Library responded to 4,000enquiries in addition to supporting ourEducation Centre’s course delegates.9

Art forging community cohesion• Our established schools programmehas now worked with over 40 schoolsusing creative arts to get pupils, teachers,parents and patients together to talkabout death and dying.• Building on the success of our schoolsprogramme, we now bring localcommunity groups and care homestogether and use arts projects as afocus to change attitudes towardsolder people and develop communitycohesion. With funding from ArtsCouncil England, we began work with afurther eight nursing and residential carehomes.• St Christopher’s artists and studentsfrom the BRIT School worked with youngpatients from the Teenage Cancer Trustat University College Hospital, Londonto explore creative ways to deal withthe difficulties young people face whenmoving from children’s to adult services.Together as a multi-faith community• After a memorable private visit to patientsand staff The Archbishop of CanterburyDr Rowan Williams spoke about theimportance of community during a servicein the Pilgrim Room.• Shared rituals can be healing andtherapeutic as well as playing an importantrole in strengthening communities:• 2,000 local people holding candlesgathered around our Remembrance Treeand took part in a service to rememberthe special people in their lives.• 600 bereaved family members took partin our memorial services.• Pastoral care continues to be an importantand valued area of our work. We areindebted to the local clergy who workwith us, including the Muslim and EgyptianOrthodox priests who recently completedour training and joined us as AnniversaryCentre volunteers.Archbishop Rowan gave a short addressand spoke of the importance of the sharedwork we do together in our communities –sharing the joys as well as the sorrows.He said ‘that is what a good society is like’.11

“I came to this after my kids had gone toUni. For the first time in my life I’m able tothink of giving something back and alsodeveloping my own lifelong interest inbecoming a social worker.”Volunteer“I view myself completely differently –I know I now have the capacity to developmyself for a future professional role.”Volunteer“I have not felt ‘listened to’ before.”Patient comment on volunteer support“Nobody else just sits with me.”Patient comment on volunteer supportThe generosity of strangers – how ourcommunity supports usThe exceptional generosity of ourcommunity and the trusts and foundationsthat support St Christopher’s enabled usto maintain funding for our care servicesdespite the challenges of the recession.We thank each and every one of oursupporters for their energy, hard work andinspirational ideas.Some of the highlights in our fundraisingyear included:• Our Midnight Walkers raised £30,000.• The ever-popular Grand Raffle raised£116,000.• Our Fun Walk raised £200,000 thanks tothe 3,000 people who took part and raisedsponsorship.• Go Active! runs and challenge eventsraised £221,000.• Go Social! events raised £300,000 bygetting friends, family and workcolleagues together for all kinds ofentertainment.• Gifts in memory of someone specialcontributed £637,000.• A magnificent effort by our lawyersupporters raised a record total of£870,000 from the annual Goldsmiths’ Halldinner.Our new website with regularly updatedfundraising event listings has provedinvaluable in relationship-building with ourlocal community and is helping us to raiseour profile on Facebook and Twitter.We are very grateful to the generousindividuals in our community who left£4.7 million to St Christopher’s in their Wills.Community shopsStaffed by volunteers and selling goodsdonated by our local community, our 10high street shops generate vital income forSt Christopher’s. The support of our caringcommunity helped us to turn over£1.4 million which earned profits of £543,000.That’s an increase of more than 40%compared with the previous year.“There’s so much more to be done.”Dame Cicely Saunders (1918-2005),St Christopher’s FounderWith your help we can do it.13

St Christopher’scare withcompassionOur patient and family services are availablecompletely free of charge. This is madepossible by the caring individuals, groupsand companies in our community who giveso generously and the support of trusts andfoundations.As well as specialist consultants and nursesSt Christopher’s multiprofessional teamsinclude social workers, welfare advisers,psychiatrists, physiotherapists, occupationaltherapist, spiritual care leaders andbereavement service volunteers.“Thank you for coming in the middle of thenight and staying till the morning – thankyou for going the extra mile.”“Each member of the Home Care teamwe encountered treated us with respect,understanding and compassion.”14Care at homeOur home care services enable people to becared for in the familiar surroundings of theirown homes with the reassuring knowledgethat St Christopher’s support is available 24hours a day, seven days a week.• At any moment in time our home carenurses are caring for around 650 people.• We provided specialist nursing care to1,969 patients in the comfort and securityof their own homes and support for theirfamilies too. Hospice at Home, providingadditional hands-on practical care in thelast days of life, supported 186 patientsand those close to them.Planned day care at our Anniversary CentreIn addition to specialist nursing and medicalcare we provide a range of supportiveservices on an outpatient basis at ourAnniversary Centre, including welfarerights advice, emotional and practicalsupport, physiotherapy, spiritual care andbereavement services.• We cared for 1,046 people as outpatients.• Our physiotherapy and occupationaltherapy team supported nearly 900 newpatients.• Social workers delivered 1,500 sessions.• The complementary therapy team ran1,266 sessions.• Our creative arts team ran 1,515 individualsessions and 384 group sessions in additionto their work in care homes.• 762 people were supported by our welfareadvisors.• Bereavement service volunteers deliverednearly 1,100 sessions.Turn to page 12 for more about ourAnniversary Centre as a social hub at theheart of our community.

“Following my visit to the hospice onTuesday for physiotherapy I feel I mustwrite to say how kind and courteous thestaff were. Please pass on my gratefulthanks to those concerned for the gentleand understanding way I was treatedduring my day visit.”“I have been lucky enough, followingthe death of my wife, to have receivedbereavement counselling. I would justlike to register my thanks for the help ineasing me through a very difficult periodof my life. Whilst my grieving continuesI now feel much better equipped to faceall of my tomorrows.”Inpatient careLed by palliative care consultants andspecialist nurses we provide expert medicaland nursing care in our 48-bed InpatientUnit.• 964 people were cared for on our fourwards.• Our Inpatient Unit continued to be animportant training site.Support for bereaved childrenThe Candle Project, our specialist childbereavement service, provides individualand group support, a national telephoneadvice line and consultancy and trainingservices.• We gave support and advice to more than250 children and their families. Two thirdsof these young people had experiencedthe sudden death of someone importantin their lives.• We ran 35 training courses with schools,the Metropolitan Police, the British Armyand others.“My daughter’s time with your projecthelped her to express her feelings abouther father’s death and has helped her indealing with these feelings. It has alsohelped me to discuss various topics withher that I had felt unable to broach beforeher sessions at your project.”15

Understanding the real costs of careWe were successful in our bid to lead oneof the pilot projects for the Palliative CareFunding Review. Funded by the Departmentof Health, the project aims to collect activitydata and develop a per patient tariff for endof life care and to provide a realistic pictureof service delivery costs and economics.Our partners are King’s, Guy’s and St Thomas’Hospitals, University Hospital Lewisham,University Hospital Croydon and thePrincess Royal University Hospital.St Christopher’s is committed to workingcollaboratively with the NHS and otherhealth and social care agencies, includingcare homes, to ensure that appropriate andcost-effective care is available to everyonewherever the bed in which they die. OurMedical Director is interim Chairman of theLondon palliative care strand of the LondonCancer Alliance and our Chief Executive isVice Chairman of the Help the HospicesCommission into the Future of HospiceCare.Quality and standardsHow do we know if we’re getting it right?The measurement of quality and outcomesis a source of on-going debate in healthcarebecause good care matters to us all andnone of us, including St Christopher’s, canafford to be complacent.Our patient outcome measure, SKIPP(St Christopher’s Index of Patient Priorities),reveals a high level of satisfaction with ourservices and we are working to embedthis and our Views of Informal Carerssurvey (VOICES-SCH) into practice. SKIPPhas attracted strong interest from otherhealthcare providers and is now used in 10organisations.SKIPP provides a deeper and more nuancedinsight into patient concerns and the impactof care than has previously been availablefrom more traditional measures.Drug error rateThis continues to be very low andcomparable to other hospices.Prompt admissionsWe met our targets for admitting patientspromptly in more than 82% of cases.“Even in her last few days your standardof care for her never wavered, you alwaysensured she had a clean fresh nightie, herhair was brushed and she had her lotion on,which made her smell so lovely. Once againto every one of you, my sincere thanks.”“Coming here helped me to discover who Iam. I am not treated like a cancer patientbut as a person, this care extends to myhome. Although I’ve got cancer and I knowI’m going to die soon, they are not focusingon the dying but on what matters to me.St Christopher’s has the art of helping youfind yourself without realising you’re doingit.”“She [the home care nurse] listened to meand as a result, my dad had a peaceful,dignified death that was everything I couldhope for. I can’t thank her enough.”16

Key goals for theyear aheadIncome andexpenditureLooking ahead – our key goals for 2012/13 are to:• Deliver and evaluate our social care training pilot project run in partnership with CroydonSocial Services.• Implement and prepare an evaluation of our new Anniversary Centre Community Team.• Complete the implementation and integration of electronic patient notes betweenSt Christopher’s and Harris HospisCare.• As the lead partner, commence the NHS-funded palliative care funding review pilot.• Refurbish our four inpatient wards.• Prepare a capital appeal to update our Education Centre facilities.• Further develop our Community Volunteer Programme.• Purchase and open a new shop in Bromley town centre.• Disseminate the findings of our care home studies through publications and a majorconference.• Develop our partnership with the Royal Academy of Arts and deliver the next joint annualart project.• Train care homes across London in the use of the new electronic Coordinate My Careregister to give involved healthcare professionals access to consented information aboutthe end of life needs and wishes of the individuals in their care.17Voluntary donationsand fundraising 21%Legacies 28%NHS 34%St Christopher’s shops 9%Other 8%Where our moneycomes fromGovernance0% (

Thank youSt Christopher’s thanks wholeheartedlyall the kind people, families, groups andorganisations who support us. We would liketo thank the following trusts, foundationsand companies for their generosity.We can’t list everyone due to spacelimitations but are grateful to you all.185 Stone BuildingsAffinity SuttonArts Council EnglandBarclays Bank plcBill Brown’s Charitable Settlement of 1989Bircham Dyson Bell SolicitorsBlick Rothenberg Chartered AccountantsBlythe Hill TavernBoodle Hatfield SolicitorsCazenove Capital ManagementCharles Park Search and SelectionCharles RussellCHK Charities LimitedCollins Stewart Wealth ManagementCorinne Burton Memorial TrustDixon WilsonDonald Forrester TrustFarrer & CoF E UllmannFidelity Worldwide InvestmentsForsters Solicitors LLPHalcrow FoundationHarcus Sinclair SolicitorsHarebell Centenary FundHelp the HospicesHicks Estate AgentsLiverpool VictoriaMansell Construction Services LimitedMcKinley VintnersMichelmores Solicitors LLPMrs E G Hornby Charitable SettlementNational Grid plcPauline Pierce Cancer Research FundPeter Stebbings Memorial CharityPi ConsultingPrudential plcR & H Trust Co. (Bermuda) LimitedR & J’s Scaffolding LtdRothschildSociety of Trust & Estate PractitionersSotheby’sStreeter MarshallTallow Chandlers CompanyTesco Charity Trust

The Albert Hunt TrustThe Alfred and Peggy Harvey CharitableTrustThe Bartholomew Charitable TrustThe Betty Baxter Charitable WillSettlementThe Blyth Watson Charitable TrustThe Bothwell Charitable TrustThe Burdett Trust for NursingThe Castle Public HouseThe Ceniarth FoundationThe City Bridge TrustThe Daisy FoundationThe Dominique Cornwell and Peter MannFamily FoundationThe Elizabeth & Prince Zaiger TrustThe Freemasons’ Grand CharityThe G D Herbert Charitable TrustThe Goldsmiths’ CompanyThe H B Allen Charitable TrustThe Kathleen Hannay Memorial CharityThe Kathleen Smith FoundationThe Mercers’ Company CharitableFoundationThe Monument TrustThe Mrs Smith and Mount TrustThe Richard Lawes FoundationThe Robert Holman Memorial TrustThe Wolfson FoundationThe Worshipful Company of CharteredAccountants in England and WalesGeneral Charitable Trust (CALC)Title ResearchToop Brothers Independent FamilyFuneral DirectorTowryWedlake Bell Solicitors LLPWellers Solicitors LLPWilsons Solicitors LLPWithers Solicitors LLPOur local Masonic lodgesOur local Rotary clubs19

Find out more online aboutSt Christopher’s Hospiceby scanning this QR code orvisit via tinyurl.com/stchrevOur thanks to Circle Services Group who have kindlycontributed towards the print of this annual review.Telephone 01702 600 680www.circleleafletprinting.co.ukPatronHRH Princess Alexandra,The Hon Lady Ogilvy, GCVOPresidentLord Ian McCollVice PresidentsDr Gillian Ford, CBMiss Sheila Hancock, OBEDame Pauline Harris DBE, DLMr Colin RussellMr John RhodesMrs Lucie WallaceCouncil of ManagementChairman: Mr Rodney BennionHon Treasurer: Mr Jonathan HoultonChairman of Services Committee:Dr Tyrrell EvansChairman of Resources Committee:Mr Richard RaeburnChairman of Governance Committee:Ms Phyllis Cunningham, CBEChairman of Audit Committee:Ms Helen HughesMrs Marie BarclayMs Judith Beard Resigned 25 July 2011Ms Violet Beazley Appointed 26 April 2012Mr Martin DavisMr Jonathan HosieMrs Judith Hutton Resigned 26 April 2012Ms Marjorie Jackson, OBE Resigned 21 July 2011Canon Rev Hilary JohnsonMr Morgan JonesMr Barry KidsonMrs Barbara NobleMr Richard SaundersDr Elizabeth SawickaMrs Jane WaltersMembers of Council CommitteesServices CommitteeGovernance CommitteeResources CommitteeAudit CommitteeInvestment CommitteeChief ExecutiveDame Barbara Monroe DBECompany SecretaryMr Andrew MeadowsRegistered office51-59 Lawrie Park Road, Sydenham,London SE26 6DZBankersHSBC Bank plc, 165 Fleet Street,London EC4A 2DYSolicitorsFarrer & Co, 66 Lincoln’s Inn Fields,London WC2A 3LHAuditorsMazars LLP, Times House, Throwley Way,Sutton, Surrey SM1 4JQSt Christopher’s Hospice51-59 Lawrie Park RoadSydenham, London SE26 6DZTelephone 020 8768 4500Email info@stchristophers.org.ukwww.stchristophers.org.ukRegistered charity number 210667Company number 681880VAT registration number 523 6139 61© St Christopher’s Hospice July 2012