Toby Porter opens Hospice UK National Conference 2025

Toby Porter, CEO of Hospice UK, opens Hospice UK's national conference with a rallying call for the sector to keep using its collective voice.

The hospice sector is truly at a fork in the road. One path takes us to the heart of the new Ten Year Health Plan and a growing national commitment – across all nations of the UK - to plan for, fund and deliver the palliative and end of life care services that our rapidly ageing population and children with life-limiting conditions will need in our neighbourhoods and communities.

This path sees hospices at the heart of the new neighbourhood health centres. Where we as a hospice sector can offer and build upon our immense knowledge and expertise, along with the trust and support we enjoy from our local communities and our health system partners. 

This path sees the hospice sector developing, innovating, collaborating and ultimately expanding into rapidly rising demand. Expanding care services, alongside other palliative care providers in hospitals, care homes, and general practice. 

This path sees less unnecessary last year of life admissions to our overcrowded and overwhelmed hospitals, shorter stays, quicker discharges.  

"This path ultimately sees more dignity, more choice, better palliative care and ultimately better deaths for our population."

You will have the chance to hear directly this afternoon from Stephen Kinnock, the Minister for Care, about his vision for palliative and end of life care in England, and how we can contribute to this new framework as a hospice sector, provided we have the fair funding to do so.

I believe this is the path that Minister Kinnock, his government, and indeed governments across the UK genuinely want us to go down.

But there is another path. And this one sees us shrinking as a sector, not disappearing altogether, but the air slowly coming out of the balloon that is the contemporary UK charitable hospice sector. 

A gradual erosion of our precious community assets, a scaling back of one of this country’s proudest achievements – the hospice movement.

This would not happen everywhere at once – just under half our members are currently having to scale back. And we know we risk losing services in poorer and socially excluded communities, serving people who already miss out. Or in remote and rural communities, where delivery costs are unavoidably higher.

"It’s a total privilege to work in the hospice sector. Tens of thousands of us do. Almost a thousand of us are here today. How often have you heard the phrase, it’s so much more than a job. It’s a vocation, a calling."

But since we met a year ago in Glasgow, and despite the generous capital funding announced by the Westminster Government in December, and additional support, albeit imperfect, in Wales and Scotland too, the ever-increasing cost of delivering our care has led to care services being cut and care staff being made redundant. 

St David’s hospice in North Wales, Shalom House in Pembrokeshire. LOROS in Leicestershire. St Raphael’s, St Catherine’s, St Giles. Ashgate, Garden House, the Kirkwood.

The list goes on.

Very different hospices and local areas. But a shared outcome where available funds have not been able to keep up with rapidly increasing costs. 

When demand for hospice care is rising so fast, the lack of logic in reducing services must feel particularly cruel to skilled and dedicated staff losing the jobs they loved. 

I’d like to take a moment to acknowledge and think about the wonderful people, human lives, behind these redundancy figures. 

We have greeted each announcement in Hospice UK with sadness, with concern, with anxiety and even with anger at the huge challenges we are facing. We have ensured colleagues in government are aware of every one.

We understand and empathise with the tough decisions that many hospice leadership teams and their Boards are currently having to take. There are a couple of “safe space” sessions on our agenda this week, where you can hear from and ask questions of CEOs or clinicians currently navigating challenges with finance, workforce, service re-design or the potential legalisation of Assisted Dying.

But optimism and innovation are guests at our conference too. The hospice sector is very obviously still a sector whose core purpose and skills are becoming more relevant, more widely acknowledged. In so many sessions over the next three days, and in all the posters on display downstairs, you will have the chance to hear examples and evidence of clinical innovation and excellence, of real impact on patients, families, health systems, of collaboration. 

So how can we best influence which of the two paths the hospice sector takes?

We must continue to harness the power of our collective voice. The hospice voice is a credible and a respected one, and it is being heard loud and clear. 

A hospice collaborative presenting a common face, service model, activity data set and commissioning pack to their ICB is a powerful proposition. So are those of you meeting and hosting at your hospices all of the MPs whose constituents you serve. Hospice representatives have been active all year in the corridors of power in Holyrood, Cardiff, Stormont and Westminster. 

Take our beautiful “This is Hospice Care” campaign film, take any one of now countless national TV news reports or BBC Breakfast sofa interviews conveying powerful images and articulate spokespeople for adult and children’s hospice care. 

Your work, and what it means to your patients and their loved ones is reaching tens of millions of people in their living rooms, or on their computer screens and mobile phones.

"What we know for sure is that the more we work together, and speak up together, the more the hospice voice will carry weight and influence."

That shared voice is based on a shared belief. 

In this time of huge challenge, and for many of us, of crisis, we all still firmly and passionately believe in just how essential, how transformational and how valued our compassionate care is, to local communities, to the NHS and to other health and care system partners. Don’t be ashamed to celebrate the quality of care you are able to provide at an adult or children’s hospice. Don’t let anyone tell you that it doesn’t provide value for money.

If we continue to put our compassion at the heart of all we do, and if we continue to let it drive us forward, and if we continue to work together, then we may just prevail.

Those of us operating in England will yesterday have read the news of the development of a new ‘modern service framework’ for palliative and end of life care. 

On ITV news last night, Stephen Kinnock made a commitment that will encourage all of you - "We are putting this issue of palliative and end-of-life care right at the heart of 10 year plan, shifting from hospital to the community and making sure this sector gets the respect it deserves”.

We are so pleased that Minister Kinnock is joining us later today and that, in this keynote speech, he will elaborate more on the vision, without doubt, one that we will all share, and will embrace.

When the government says that it wants to see more palliative and end of life care delivered closer to home, less variation in the provision of care, less unnecessary hospital admissions, greater integration, and greater accountability for ICBs and providers, these are aspirations which not only do we all share, but arguments at the centre of our local and national advocacy for years.

"Indeed, many of us will have read the government’s aspirations and said to ourselves – this is already what we do."

So in the coming months, we will engage energetically with our partners at DHSC and NHSE, and continue to provide any advice or guidance you may need to do so at a local level. It is incumbent on all of us to demonstrate, clearly and passionately, with data, with evidence, and with human stories, just how hospices can contribute to that vision. 

The care that the government is describing is not far off the foundational premise of the hospice movement. Delivering the care that matters to you, delivering when and where you need it.

And so, while as I’ve often said, the government has the right intent, it remains to be seen whether this will lead to real change that improves both people’s lives and their deaths for the better.

The central question is whether they and the health system can actually deliver this shift, ensure that funding gets to where it is needed, and invest in what we know already works.

We are seeing some really positive local examples, like north west London, where hospices have worked together long-term to secure a significant uplift in funding.

But there are disheartening and infuriating examples, too, like hospices having funding cut in Cambridge and North Derbyshire. 

We’ve heard encouraging noises in Cardiff, Edinburgh and indeed in Belfast, but a system that too often feels like it is too slow to deliver on commitments made by their political leaders.

And so be in no doubt that while we are clear with government that we absolutely welcome their intent, their ambition, their clear focus on end of life care – all of which have been lacking for far too long – we are also clear with them, in public and in private, about the scale and urgency of the challenge that many of our members are facing.

You can be sure that we will continue to make the case for additional short-term support, to avert the cliff edge, the difficult, appalling decisions that many of you face as you plan ahead for next financial year. The £100m capital funding for hospices in England, along with additional financial support given to hospices in Wales and Scotland was so important. We also warmly welcome the recent three year £80m renewal of the children’s hospice grant. 

These steps do not fix hospice funding but they have made a difference. Yesterday’s announcement is another big step in the right direction. 

The other development since we last came together in Glasgow is the continued progression of the Bills to legalise assisted dying in three of the 4 UK nations.

Whatever your view, I am sure we would agree that the debate over the Bills has prompted more national reflection on death and dying than arguably any other recent single event or process, even the pandemic.

The Bill could be a turning point for the UK public’s appetite and ability to engage with the sorts of conversations we all know are so important. 

We must work together to seize this opportunity, to really lead a different conversation about death and dying, and bust myths and misconceptions.

Let me share a brief anecdote of why this matters so much. 

Recently, a BBC team met and filmed a gentleman being cared for by Rowcroft Hospice in their IPU. He was asked about what he thought about assisted dying. He told them that were it an option offered to him back when he was in hospital and in pain, he would have gladly taken it up,

But that now that he was in the hospice – with his pain controlled, his symptoms managed, and his dignity restored, he wanted to enjoy the time he had left.

This is why our work is so important.

"This is why we must strive, now more than ever, to first protect and then extend hospice care, both directly and by training and encouraging others."

Since we last met in Glasgow, the hospice sector’s collective voice has grown stronger. 

Working together has been key to this. Working together locally through collaboratives and mergers. Campaigning together, locally and nationally.

Through the National Legacy Campaign, with more than 140 hospices – 70% of our membership – coming together to reach 18 million adults through TV ads.

This, too, is why we’ve recently launched our four point plan for fairer funding in England, with similar asks in the devolved nations.

A simple, memorable rallying cry and a clear offer to government.

• Full funding for specialist care delivered by hospices

• Proper NHS contracts for hospices

• Funding to cover the cost of NHS pay rises for hospice staff

• National accountability for equitable provision of palliative care, wherever you live.

The compassion at the heart of hospice care, and of the hospice movement, is a true superpower.

Compassionate care in communities across the country, and almighty collective strength when we work together.

Thank you once again for being here, and I hope you enjoy your conference.

Hospice UK’s National Conference takes place from 25 – 27 November in Liverpool. Over the course of the three days colleagues will come together and discuss challenges and opportunities facing the hospice sector in the UK.

National Conference will return to Liverpool in 2026, from 16 - 18 November, and you can register your interest now.