Unsustainable funding puts Welsh hospice care at risk

Welsh hospices currently provide essential care and support to 20,000 adults and children affected by terminal illness every year, and demand is growing. However, due to rising costs, workforce pressures and increasing need, hospices are already struggling to provide the same level of inpatient and community services they have in recent years - and are facing a worrying future.

Just this year, Shalom House Hospice in Pembrokeshire has fully closed, and a four bed inpatient unit at St David’s Hospice in Holyhead has been shut temporarily. Both of these were due to the combination of increased running costs and funding difficulties.

Now, a new survey of all 14 voluntary hospices in Wales conducted by Hospice UK has found that:

• Nearly 30% of Welsh hospices are reducing the number of inpatient beds or wider services as a result of increasing cost and workforce pressures.
• Over 70% of those with in-patient units agree that cost of living pressures are likely to result in one or more inpatient beds becoming temporarily or permanently unavailable.
• Three-quarters of Welsh hospices agree that cost of living pressures are likely to result in reduced support being available to the wider system, such as hospitals and care homes.
• All charitable hospices operating in Wales are budgeting for a deficit in 2025/26 and are drawing on reserves to meet a forecast £9.2m shortfall.

On average, 70% of the care costs of delivering hospice services are funded by charitable donations (approximately £30m), with the remaining 30% provided by Welsh Government. But as hospices continue to face these unprecedented challenges, this reliance on the generosity of the Welsh public to deliver essential palliative care is not sustainable. Local communities treasure their hospices and their generosity is a vital part of hospice funding, but with financial pressure intensifying hospices fear this generosity can’t keep up. Hospices need financial certainty to ensure that they can continue to provide support for people closer to home for years to come.

This financial year (2025/26) Welsh Government provided £3m in funding for hospices to help them meet financial pressures. It also committed to developing a commissioning framework and sustainable funding solution for the sector. However, Welsh hospices are concerned that the £3m does not constitute an ongoing sustainable funding solution and that the framework - due to be completed by March 2026 - will not address the financial challenges facing hospices this year or next.

In the short term, Wales’s charitable hospices need Welsh Government to provide additional funding for the rest of the financial year and include provision in its 2026-27 budget to cover the forecast shortfall for next year too. The money needed is not optional - it is essential to keep existing services running.

Looking to the future, the way hospices are funded needs to be fully addressed as part of the new commissioning framework.

Matthew Brindley, Policy and Advocacy Manager for Wales at Hospice UK, said: “Hospices are a cornerstone of Wales’ health and care system. They provide essential clinical care that ensures people have dignity at the end of their lives.

“Without urgent action, we could be looking at a future where service capacity is further reduced, specialist staff are lost and - crucially - people with life-shortening conditions and their families have less access to the compassionate and high quality care they need.

“We greatly appreciate the support Welsh Government has provided to hospices in recent years, and are committed to working with them to get hospice and palliative care services on a more sustainable footing - but that work to safeguard services and prevent any further closures has to start today.

“Hospice services are not optional. Financial support in the coming weeks and months is going to be essential if we want to make sure that hospices can be there for everyone who needs them.”

Liz Booyse, Chair of Hospices Cymru and Chief Executive of City Hospice, said: “Welsh hospices are grateful for the support they receive from the people of Wales through charitable donations and fundraising. The level of recognition of the important work we do for people and families, and how these are intrinsic community services, is incredible.

“But we are now in a situation where the everyday costs of running our vital services have risen to a point where many charitable hospices cannot continue to provide the same level of service going forward with its current funding.

“Everyone in Wales should have access to the same high quality, compassionate end of life care that they need. That’s why the essential, specialist care provided by hospices should have the option of being fully funded by the current and next Welsh Government, and made a guaranteed part of healthcare provision in Wales.

“The demand for palliative care is estimated to increase by 25% in the next 25 years. We have a chance to make sure people will be able to access this help for a long time to come, and further improve to help people with more complex illnesses - but we have to act now.”