Behind the cuts: how hospice services are shrinking across England

Across England, hospices are being forced to make difficult choices about the care they provide. Nearly 60% have already made or are planning to make cuts to frontline services this year, while 380 of beds sit unused due to staff shortages driven by funding pressures. At the same time, specialist community hospice visits have fallen by 150,000 in a single year. 

As demand for palliative care rises, this article looks at the hospices behind the cuts, and what these decisions mean for the people who depend on them. 

Prospect Hospice 

Prospect Hospice in Swindon has been forced to make the difficult decision to remove two of its eight inpatient beds, despite rising demand, because of ongoing financial pressures. The hospice says that limited NHS funding means it can currently operate only half of its specialist bed capacity, leaving some patients without access to the care they need at the end of life and instead spending their final days in hospital. 

Its Chief Executive, Jeremy Lune says that in a typical week the hospice is turning away about seven patients who need specialist care, and is calling for an urgent review of hospice provision. 

Jeremy continued: “These are heartbreaking decisions for our staff and devastating for families who are already facing the most difficult moments of their lives. We know there is growing need for our specialist care in our community, but the reality is that chronic underfunding means we simply cannot provide our specialist care to all those who would truly benefit from it. 

“Hospices take pressure off the NHS by providing the compassionate, specialist care patients and their families need at the end of life, yet this isn’t properly recognised or funded. Without urgent action, more patients will miss out on the care they deserve.” 

Julia’s House 

Julia’s House children’s hospice only receives eight per cent of its ongoing funding from the government, placing it among the very lowest funded hospices in the country for proportion of government contribution. It operates across two ICB areas, Dorset and BaNES Swindon and Wiltshire (BSW), yet it is commissioned by Dorset but not by BSW, despite being the only children’s situated in either area. The hospice faces a projected £1.3 million deficit in 2026. 

Dr Martin Edwards, CEO of Julia’s House, said: “Like many hospices around the country, we have had to make some very difficult decisions in looking at where and how we can reduce costs across the charity to ensure we can continue to support the families in our local community who need us the most. Our care costs are £5 million per year and demand is increasing. We rely on donations and support from our local community to provide our life-changing care in Dorset and Wiltshire - without the generosity of local people, business and organisations, Julia’s House just wouldn’t exist."

St Cuthbert’s Hospice 

In 2025, St Cuthbert’s Hospice in Durham announced 21 redundancies across multiple departments to tackle serious financial pressures, including a £1.3 million deficit and rising costs. The hospice has also taken the difficult decision to close its adult bereavement service, dementia service,  community outreach service and significantly reduce its living well service. 

As a result, around 100 fewer people each year will be able to access bereavement support, while approximately 150 people will miss out on day services. The hospice, which must raise the majority of its income through fundraising, donations and gifts in wills, says these changes are necessary to address an increasingly challenging financial position. 

Pauline Sturdy, Head of Clinical Services and Deputy CEO said: “It’s a situation no hospice would ever want to find themselves in. Not only has it been devastating to lose specialist expertise and passionate staff who have been made redundant, but our thoughts, of course, go to the people in our communities who have had a safety net unfairly taken away from them. The impact of losing these services cannot be underestimated.” 

“Everything we have done is to make the Hospice sustainable for the future. We will continue to challenge the Government to fund palliative and end of life fairly, which will allow us to meet the demand we experience now and which we know will increase in the future. We are grateful for the support the Government has pledged so far, but need a more effective funding model to address the crisis hospices are facing.” 

The Shakespeare Hospice  

The Shakespeare Hospice in South Warwickshire has been forced to reduce services as it responds to growing financial pressures driven by rising demand and increasing costs. Staffing expenses have risen due to NHS pay awards, higher National Insurance contributions and inflation, while statutory funding covers only a small proportion of the cost of care.  

Currently, only around 12% of the hospice’s income comes from the NHS, leaving it heavily reliant on fundraising and donations to bridge the gap. As part of efforts to remain financially sustainable, the hospice has taken the difficult decision to have a full organisational review to save £200,000.  

These reductions will impact the range of support available to patients and families. Like many hospices, it has also drawn on reserves to manage rising costs in recent years, a short-term measure that cannot be sustained long term.  

Tracey Sheridan, CEO and Head of Clinical Services said: “I often hear stories from our patients and their families and my heart is heavy knowing that the level of care we have always aspired to provide, and the number of people we are able to support, is now at risk of reducing. These are not abstract financial pressures - they translate directly into real experiences for people at the most vulnerable moments of their lives.  

“It is deeply painful to acknowledge that, despite the dedication of our teams and the generosity of our community, we are being pushed towards difficult decisions because of an unfair and persistently underfunded model of hospice care.  

“Every day, I see the compassion and commitment of our staff, and it is heartbreaking to think that external financial constraints may limit what we can offer in the future. We will continue to do everything possible to protect patient care, but I cannot ignore the reality that the system we are operating within is no longer sustainable without meaningful change.”  

St Helena Hospice

St Helena Hospice in Colchester has been forced to significantly scale back its services as a result of mounting financial pressures. The hospice now has only eight of its 18 inpatient beds open and has reduced its community provision, following £1.6 million of cuts to clinical services in summer 2025.

These changes have led to around 25 fewer clinical roles and the hospice is also having to limit care to those with the most complex needs, with other patients being referred back to primary care or hospitals, adding more pressure to the NHS.

Rising costs have driven these decisions, including an additional £1.1 million in staff wage bills linked to increases in National Insurance, National Minimum Wage and NHS pay, alongside around £200,000 in increased non-pay costs such as energy. 

Kate Heslegrave. Co-Chief Executive of St Helena Hospice said: “After making £1.6 million of clinical service cuts in summer 2025, we now have less than half of our inpatient beds open.

“Our waiting lists include people who will not live long enough to reach the top, and we are having to turn others away altogether. Around 15% of unplanned emergency hospital admissions and 60% of hospital bed stays involve people in the last phase of life.

“This year, the NHS is offering just a 2.03% uplift to our grant—below inflation and not even covering NHS pay increases. It amounts to another real-terms cut. Words must now turn into urgent action before the UK loses its palliative care provision. This is unacceptable.”

This cannot continue. Demand for palliative and end of life care is set to rise in the years ahead, yet hospices are being forced to do less, not more. Everyone deserves dignity, comfort and expert care at the end of their lives, and hospices should be there to provide it. Without urgent action to deliver fair, sustainable funding, more services will be lost, more families will be left without support, and pressure on the NHS will only grow.