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Data from Hospice UK reveals that hospices in Scotland are budgeting for an unprecedented collective deficit of £16m in 2023/4, as the cost of paying their dedicated staff a fair wage increases and statutory funding fails to keep up.

Spiralling staffing costs due to NHS pay increases plus rising running costs are stretching hospice finances to the brink, with many being forced to consider cutting vital services and draw on limited reserves to meet the shortfall.

Scottish hospices spend over 70% of their costs on staff. They recruit from the same pool of staff as the NHS so must match NHS salaries to ensure they are able to attract and retain staff to deliver their vital services for people at the end of their lives. But as matching NHS pay sends costs soaring, without additional statutory funding hospices have to rely on fundraising to pay for every penny.

In Scotland, hospices provide care and support to 21,000 children and adults a year, and with demand for palliative care predicted to increase by 20% by 2040 the support they need will become increasingly important in the future. They play an integral part in the health and care system, supporting people to stay at home and out of hospital, but remain largely funded by charity. On average, two thirds of hospice income is raised through fundraising. The remaining statutory funding is government funding that is primarily allocated and distributed through local Health and Social Care Partnerships. But with the cost of living crisis meaning local communities may not be able to give so generously, rising costs pose a threat to the sustainability of the sector as statutory funding fails to keep pace.

These funding pressures are compounded by huge variation in the levels of local statutory funding that hospices receive across the country. This leads to inequity for patients and families and creates a postcode lottery in terms of how palliative care is funded. It is not fair that the public has to foot more of the bill for palliative care services in some areas of Scotland compared to others.

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Helen Malo, Policy & Advocacy Manager for Scotland says: "Hospices care for some of the most vulnerable people in society, but many are now worrying about the future of their services. Hospices need urgent support to ensure they can continue delivering high-quality care for people at the end of life – without worrying about how to pay their hard-working staff a fair wage.

To expect hospices to match this through further fundraising, at a time when their local communities may be struggling themselves is increasingly untenable. Scottish Government must commit additional funding for hospices in its upcoming budget to help address the huge £16m deficit facing the sector and ensure hospice funding is sustainable in the long term, so hospices can continue to support the people who need them most."