Thames Hospice chief: marathons, bake sales and the fight to deliver a 'basic right'

Delivering high-quality end-of-life care relies on community support, fundraising and volunteer commitment. The Advertiser spoke to Dr Rachael de Caux about her first year leading Thames Hospice and her vision for 2026.

“High quality end-of-life care should be a basic right for everyone.

“Yet still in this country we have to run marathons, bake cakes, rely on donations, in order to be able to fund that care.”

Despite the industry’s heavy financial pressures, the ‘huge potential’ at Thames Hospice remains a source of great pride for its chief executive officer Dr Rachael de Caux.

The dedication of staff and volunteers across the charity featured prominently in her reflections on ‘the most complex and rewarding job I’ve ever done’, one year on from her appointment to the top job.

Thames Hospice patron Anita Dobson and Dr de Caux at an event celebrating the charity's volunteers in June

Having previously held senior leadership roles within the NHS, including as a regional ICB chief medical officer, Dr de Caux said running Thames Hospice was unlike other clinical jobs.

“The organisation delivers outstanding clinical care, but that's just one part of what we do,” she said. “In order for us to do that, we have these two other massive parts of our organisation which are fundraising and retail.”

Unlike most healthcare settings, hospices operate as a charity model that requires significant income to be generated from the community.

At Thames Hospice, that means raising £39,000 every single day to sustain services that support thousands of people across Maidenhead, Slough, Windsor and beyond each year.

And a hospice chief executive must balance responsibility for nurses, doctors and counsellors with oversight of charity shops, corporate partnerships and community fundraising.

Staff and volunteers at Thames Hospice's Homestore in Boyn Valley Road, Maidenhead

Dr de Caux said: “We’re very dependent on our community for donations and for them shopping in our shops.

“All of that is underpinned by the 1,100 volunteers that support all aspects of our operation, driving people to outpatient appointments, for example.

“When I say this job is complex, it is because it's almost like running three different organisations at times, and you need all those parts to be working really, really well.

“And rewarding? I work with the most extraordinarily committed, passionate people across every part of our organisation that are absolutely striving to keep improving.”

That commitment, she added, was reflected in staff morale, with almost all employees saying they were proud to work at Thames Hospice and would recommend its care to loved ones.

However, behind that pride sits a growing financial challenge.

Dr de Caux told the Advertiser that worries about balancing books across the hospice sector were leaving some senior leaders with ‘sleepless nights’.

Financial pressures weigh heavily on hospices across the country (pictured: Thames Hospice's base in Bray) 

Those pressures have been compounded by successive Government Budgets, which have seen national minimum wage rises and a hike in employers’ national insurance contributions.

And while the funding pressures show little sign of easing, she believes the ‘huge potential’ at Thames Hospice lies in its people – helping it to deliver when families need it most.

Last month, the Advertiser explored the work of hospice nurses and how many of them entered the hospice world following their own experiences. It is a story similar to many people working at Thames Hospice.

“I feel really privileged to have people who are so driven and motivated, often from personal reasons, working within the organisation,” Dr de Caux said.

“If you’ve walked in similar shoes to some of our relatives and families, I think therefore you can understand how hard it can be being a carer.

“How hard it can be, for example, if you're a young family and your husband is dying - you're looking after two young kids, you're managing your own grief as well as theirs.”

Thames Hospice nurses work night and day to deliver free end-of-life care to thousands of people a year

The dedication shown by staff in caring for patients made the hospice’s many milestones and community successes over the past year all the more meaningful for Dr de Caux.

The near ‘impossible’ challenge of choosing highlights from 2025 included the Royal Windsor Flower Show and special visits where the King met the hospice’s mascot elephant.

Dr de Caux said every event was a reminder of the dedication of staff, volunteers, and the wider community who support Thames Hospice throughout the year.

Looking towards 2026, Thames Hospice is set to launch its Trunks Across The Thames arts trail.

The trail will feature a ‘herd’ of 30 elephant sculptures displayed at landmarks between Slough and Windsor.

Dr de Caux said the trail was both a celebration of the hospice’s work and an opportunity to engage the next generation in supporting local care.

Former Prime Minister Theresa May, Dr de Caux and Thames Hospice fundraising director Jane Symmons 

Overhanging everything, though, are the finances – and the ongoing need for volunteers and fundraisers to continue supporting the hospice’s work.

Dr de Caux said: “We have a half-million-deficit budget this year.

“It's a bit like if you keep being overdrawn in your bank account, that's not something that can continue indefinitely.”

She continued: “What we can't do as a charity is live beyond our means because otherwise that really would be a problem in years to come.

“I've always said I'm a custodian here for the period of time that I serve Thames Hospice. I will always want to make sure that the charity is here for a very long time.”