Fragile outlook on statutory funding for hospices in England

Jul 14, 2015

Statutory funding for adult and children’s hospices in England is fragile, unfair and unsustainable according to findings released today by national charities, Hospice UK and Together for Short Lives. More than two thirds of the hospices surveyed report that their statutory funding was frozen or slashed in 2014/15 – largely because of financial restrictions on NHS commissioners or stand still budgets.

Hospice UK and Together for Short Lives are calling on the Government to set out how it will bring about fair and sustainable statutory funding for hospice and palliative care.

Charitable hospices in England care for around 360,000 people each year – 120,000 patients and 240,000 family members – providing 26 million hours of care and potentially saving the NHS and social care millions of pounds every year. Yet funding for hospices from clinical commissioning groups (CCGs) and local authorities in England remains patchy and inconsistent.

There are early signs that the lack of fair and sustainable funding is already having an adverse effect on hospice services. This could lead to more pressure on already overstretched NHS services if hospices are forced to reduce the level of care they provide.

Fragile

  • The survey of 117 hospices in England shows that nearly a fifth of hospices surveyed (17%) – both children’s and adult hospices – had their funding reduced.
  • For more than half of hospices surveyed (52%) funding has remained static. For many hospices this comes after several years of freezes in statutory funding.
  • Some CCGs have increased funding, although this has been predominately to develop new services rather than to increase funding for core services

Unfair

  • More than eight in ten hospices surveyed (85 per cent) do not think their hospice is being funded fairly and sustainably by the NHS.
  • CCG funding for adult hospices varies widely; across England, CCGs make contributions to hospice care costs which range from less than one per cent to more than 50%.
  • For children’s hospices, CCG funding contributes an average of just 10% of their care costs – compared to an average of around 30% for adult hospices.
  • Nearly nine in 10 children’s hospices surveyed (89%) said they could be forced to reduce their services if the annual NHS England grant to children’s hospices was not available.
  • In spite of providing a range of social care services, less than a quarter (23%) of hospices surveyed reported receiving funding from local authorities to fund social care services.

Unsustainable

  • Almost three quarters (74%) of hospices in England surveyed expect their funding to be either frozen or cut again during this financial year (59% are expecting a funding freeze and 15% a cut).
  • As a result of 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 hospices have 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.

Jonathan Ellis, Director of Policy and Advocacy, at Hospice UK, 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.

“Hospices are effectively in limbo until a new funding system for palliative care is implemented. As NHS funding comes under increasing pressure, we need a fairer, more sustainable system in place and we need this introduced soon.

"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. As a priority, however, the government must set out how those elements of children’s palliative care currently outside the scope of the new system - including short breaks and bereavement care - should be funded by the state.

“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.”

There is emerging evidence that investment in hospices is 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.

Notes to Editor

  • Hospice UK and Together for Short Lives jointly undertook a survey among charitable hospices between April and May 2015. The survey included both adults and children’s hospices in England and achieved an overall response rate of 67 per cent (117 out of 175 English hospices). Among the 33 organisations which provide hospice care to children and young people, 26 responded to our survey (79 per cent). 
  • The full findings of the survey can be found on our commissioning support page.
  • Demand for adult hospice care is growing. The number of people aged 85 and over is expected to double in the next 20 years
  • Demand is increasing for children’s hospice care. It is estimated that more than 40,000 children (0-19 years) were living with a life-limiting or life-threatening condition in England in 2009/10 - compared to 30,000 in 2000/01.
  • Over half (58%) of children’s hospice organisations had their funding frozen (35%) or cut (23%) from 2013/14 to 2014/15 by NHS commissioners. Over half (54%) of children’s hospice organisations expect to have their funding frozen by NHS commissioners in 2015/16.
  • If the NHS England children’s hospice grant was stopped, more than half (58%) of children’s hospices would reduce their short break services and nearly half (46%) would have to reduce the family support they offer.
  • In March 2015, following its inquiry into end of life care, the House of Commons Health Select Committee  recommended that future funding proposals of palliative care fully recognise the importance of the voluntary sector - and specifically set out how it intends to ensure sustainable, long term funding for the hospice sector.
  • In 2011, a government-commissioned Independent Palliative Care Funding Review published a series of recommendations on how palliative care in England should be funded; the Government is yet to formally respond to these recommendations.

About Hospice UK

  • Hospice UK is the national charity for hospice care and the only membership body for organisations providing hospice care. We support and champion the work of more than 200 of these organisations across the UK.
  • Hospices, and other organisations which provide hospice care, offer vital care for people with terminal or life-limiting conditions and also support their families and carers.
  • For further information about hospice care follow us on Twitter @hospiceukPA.
  • Get all the latest news from the hospice and palliative care sector, as well as patient stories, on ehospice UK at: www.ehospice.com/uk This service is managed by Hospice UK. You can also follow ehospice news on Twitter at @ehospicenews

About Together for Short Lives

Together for Short Lives is the leading charity for UK children’s palliative care. We support those who help, love and care for children and young people who are unlikely to reach adulthood. We work with children’s hospices and a range of other services across the country to ensure that every child, young person and their family has the best possible care and support whenever and wherever they need it. From the moment of diagnosis, for whatever life holds, we help to ensure families make the most of their precious time together. 

Visit www.togetherforshortlives.org.uk for more information.

For media enquiries for Hospice UK:

Contact Suzanne Stevenson on 0207 520 8296 or by email at s.stevenson@hospiceuk.org For out of hours media enquiries please call 07881 940318.

For media enquiries for Together for Short Lives

Contact Jo Barrell (Communications Manager) on 01179 897 832 (direct dial) or 07539 507 028 or by email at jo.barrell@togetherforshortlives.org.uk

Together for Short Lives Press Office can be contacted on 0117 989 7820.

Back

Back

What does hospice care mean to you?