Hospices face a ‘critical’ £47m shortfall as cost of end of life care spirals, experts warn

By Jane Kirby, Reporter26th September 2023News EnglandAdult Care, Business / Funding / Finance, End Of Life Care, Hospices, News England, Older People, Palliative Care

Hospices are facing a “critical” £47 million shortfall in funding as the cost of caring for dying patients and their families spirals, experts have warned.

Hospice UK used Freedom of Information laws to gather data from England’s Integrated Care Boards (ICBs), which manage budgets and plan care for local people.

The data, obtained from 40 out of 42 ICBs, suggests adult hospices have experienced a real-terms cut in their Government funding amounting to £47 million in the past two years, Hospice UK said.

Its chief executive, Toby Porter (pictured), said: “This state of affairs is unfair and short-sighted. Hospices care for some of the most vulnerable people in society, those at the end of their lives or grieving.

“But they are increasingly worried about the future of their services, with nearly every hospice in the UK spending more than it brings in.

“Hospice UK tracks hospice finances closely, and we estimate that hospices are currently on track to spend almost £200 million more on delivering their care than they will receive in income. This is highly alarming and clearly not sustainable.

“While hospices are mostly funded by charitable donations, NHS contracts represent around a third of the income of a typical adult hospice.

“But with the cost of caring for dying patients and their families spiralling, for Government support to fall short by £47 million means hospice care services are under threat.”

Mr Porter said ICBs, which receive Government cash, have a duty to ensure palliative and end-of-life care in their area is well funded but the data suggests funding is failing to keep pace with inflation.

“Our data shows that some hospices are still being paid the same in 2023 as they were two years ago to deliver services that now cost significantly more to provide, due to increases in things like salaries and energy bills,” he said.

“We’ve been warning for over a year about the impact that insufficient Government funding will have on essential hospice services. It’s getting critical.”

He said some ICBs have provided funding uplifts but this is not in keeping with the pace of rising costs.

While hospices are trying to plug gaps with fundraising, it is not enough to make up the shortfall, he added.

“Surely we all want to see end-of-life care and bereavement services properly funded, and available to anyone that needs it.

“We need ICBs to properly plan to meet the demand for palliative care in their area and provide fair funding to do so.

“And we need those ICBs to be properly funded by central Government. End-of-life care should not be determined by a postcode lottery.”

Baroness Ilora Finlay, co-chair of the All-Party Parliamentary Group (APPG) on Hospice and End of Life Care, said: “It is one year since guidance was issued as part of the Health and Care Act for ICBs in England to commission specialist palliative care services, yet we’re seeing that all too often ICBs aren’t giving hospices the funds they need to help deliver this in the face of rising costs.

“We’re undergoing an inquiry into whether this national duty has had its intended impact, and will be making recommendations for how the system can improve.”

Dr Sarah Holmes, chief medical officer at the end-of-life charity, Marie Curie said: “Imagining what will happen to dying people if hospices across the country cut back services breaks my heart.

“Without services like ‘hospice-at-home’, people with pain and other distressing symptoms are forced to make the impossible choice between struggling on alone or having to rush to their local A&E and be admitted to hospital. This is highly distressing for them and very expensive for the NHS.

“Demand for end-of-life care is rising fast due to our ageing population. It is a critical moment for the Government to make sure hospices have the funds they need to play their part alongside the NHS.

“As we head into winter, it is really worrying to think what will happen to the people who rely on hospices if they disappear, and the heavy load that would place on the NHS.”