IN March, as the coronavirus marched west from China, medics’ eyes began to turn on Italy.

The country was the first in Europe to document large – and swelling – numbers of cases. 

Lombardy, with its regional capital bustling Milan, was especially badly hit. By the start of March thousands had already tested positive for Covid-19. At the end of that month, more than 800 people were dying daily from the virus in the country. 

All eyes were on the country’s hospitals. 

All eyes, that is, except for those of Propsect Hospice medical director Dr Sheila Popert. 

“Most of the media focus was always on hospitals and how overrun they were, which is understandable,” she told the Adver in June. 

“I was in touch with some colleagues in Italy who were saying that, while the hospitals were the focus of everybody’s attention, the Covid crisis was causing huge issues for patients in the community.

“There was less access to hospital beds, there was less access to providers of care in the community and it was really, really difficult for all patients; not just patients who were ill with Covid but patients with other debilitating conditions, because they weren’t able to access the sort of care they normally would.”

The crisis marched north and west. Spain’s case load rocketed. The UK was placed on lockdown on March 23, with the prime minister falling ill within days.

In England, many hospices were preparing for large numbers of new patients to be admitted from hospital. Some were even increasing the number of beds they had.

Prospect Hospice in Wroughton took a different approach. 

Rather than open more inpatient beds, doctors at charity decided to shut them. 

“It became clear very quickly that patients were reluctant to come into hospices as they were frightened of getting Covid and also because of restrictions on visiting,” Dr Popert said.

Patients were dying quickly, sometimes within days of their condition deteriorating and them having to be admitted to intensive care wards. In many cases, there simply wouldn’t have been enough time to discharge a patient from hospital and into the care of a palliative care hospice.

The Prospect inpatient unit shut altogether, with doctors, nurses, therapists and other staff diverted into supporting patients in their own homes.

“Keeping the inpatient unit open requires a lot of staff, a lot of input, we’d only be able to help a very small number of patients,” the doctor said. 

“If for a period of time we diverted all of the staff from the inpatient unit to supporting the other care providers in the community like the district nurse and the GP I felt we could probably make a difference that meant more to patients and their families.”

For eight weeks the inpatient unit was shut. “Nurses had to have additional training because they weren’t used to looking after patients in the home, everybody had to have training on PPE and how to safely manage patients in the home. The whole team, everybody, lock, stock and barrel.” 

Dr Popert praised staff members’ flexibility. Initially, people were shocked – but soon adapted. “Whether its staff in hospice, a care home or a hospital, everybody’s main focus is the patients and families. When people realised this was providing much greater support than by keeping the inpatient unit open they all got on with it.”

Six beds reopened towards the end of May for those who wanted to be cared for at the hospice in their last days or whose medical needs made care ithe community impossible. Each patient has their own room.

But Dr Popert said the current practice, with more staff looking after patients in the community, was  likely to continue for six months to a year.

Prospect Hospice is marking its 40th anniversary this year. It is attempting to raise £2m - the estimated shortfall left by the loss of income due to, for example, shops being shut during the lockdown and fundraising events having to be cancelled.

To donate, visit or call 01793 813355.