Hospices warn of reduction in care over unsustainable funding levels

Hospice UK and Together for Short Lives, which provides support to children with life-threatening or limiting conditions, warned that if hospices are forced to reduce the level of care they provide it will also have a knock-on effect on already overstretched NHS services.

They found nearly three in five (58%) children’s hospices have seen their funding either frozen or cut this year, while almost three quarters (74%) of the hospices in England overall that were surveyed said they expected to see this happen soon.

Hospice UK said demand for hospices is likely to rise due to the country’s increasingly ageing population, meaning that freezing or cutting funding is “both short-sighted and potentially damaging”.

It said that investment in hospices is actually very cost-effective in terms of reducing spend on hospital care in the last year of life, supporting more deaths at home and in care homes and at the same time, improving patient experience and choice.

On average adult hospices receive 32% of their funding from the Government, but this varies widely across the country and is “patchy and inconsistent”, the charity said.

The rest must come from fundraising, with hospices collectively needing to raise £1.9 million a day – amounting to more than £9,000 per hospice each day.

Children’s hospices receive funding from local authorities and clinical commissioning groups (CCGs) along with an annual grant from central government.

Together for Short Lives said they found the vast majority could be forced to reduce their services if this grant was not available.

The two charities warned that as a result of the “dwindling” statutory funding levels a number of hospices are subsidising the shortfall through their reserves, freezing staff recruitment or putting service development on hold.

Some of the 117 hospices they surveyed warned they are likely to have to review the services they offer and may not be able to continue to provide the same level of care in the near future if the funding situation does not improve.

Hospices in England care for around 360,000 people each year – 120,000 patients and 240,000 family members – saving the NHS and social care millions of pounds.

Director of policy and advocacy at Hospice UK, Jonathan Ellis, said: “NHS funding for hospice care is continuing to be squeezed, yet demand for hospice care continues to rise and will grow even more in the future, due to the UK’s ageing population.

“CCGs should be investing in hospice care which can help the NHS to cope with increasing demand, such as reducing the number of people who are in hospital at the end of life, with no need to be there. Freezing or cutting funding is both short-sighted and potentially damaging.

“In addition, NHS funding for hospice care is still very hit and miss, with sweeping variations across the country.

“Failure by the NHS to act will be storing up huge problems for how our society supports terminally ill and dying people in the future.”

James Cooper, interim head of public affairs at Together for Short Lives, said: “Children’s hospice services provide holistic care which can enhance quality of life for children with life-limiting conditions and their families – and can reduce unplanned hospital admissions.

“Despite pockets of good commissioning, on the whole CCGs and local authorities are still not funding children’s hospices in a way which reflects the vital role they play. A new palliative care funding system could help to address this.

“NHS England must also continue its annual grant to children’s hospices until a new system brings about fair and sustainable funding for children’s palliative care. Without it, children’s hospice services may have to scale back their life-line services which families reply on – which could put more pressure on the NHS.”

The charity Marie Curie has nine hospices in the UK and is the biggest provider of hospice beds outside the NHS.

Its chief executive, Dr Jane Collins, said: “Charitable hospices play a key role in ensuring that people with a terminal illness can get the care and support they need in the community. As the leading charity for people with a terminal illness and a provider of hospice care, Marie Curie relies heavily on funding from the NHS alongside charitable donations and the support of volunteers to provide high-quality care and support to people with a terminal illness and their families.

“Hospice UK’s findings are concerning. The health and social care system in England is already stretched, and failing people with a terminal illness and their families. We know that around 92,000 people in England are missing out on palliative care each year, and seven out of 10 carers say that people with a terminal illness don’t get all the care and support they need.

“Hospices and other community palliative care services must be well-funded if we are to meet both present and future demand for palliative care services. Without this funding, more people will miss out on the care and support they need, which could potentially lead to more people dying in hospital, exacerbating pressures on the NHS.”