Hospice funding falls short by £47m

Insufficient NHS funding means many hospices are struggling to keep up with inflation and rising costs.

Hospice UK has gathered data from Integrated Care Boards (ICBs) across England which shows that there is not a single part of the country where Government funding of local hospice services has not fallen in real terms in the last two years.

Hospice UK calculated that for adults’ hospices, this means there is now a £47m gulf between the actual funding received and what the figure would have been had it kept pace with inflation.

The state funding hospices receive is primarily distributed through regional ICBs who have a statutory requirement to provide funding for palliative and end of life care appropriate to the level of need in their area. ICBs should provide ‘uplifts’ in contracts with organisations like hospices who provide those services, to reflect growing costs – though ICBs themselves ultimately rely on central government for the funds they have available.

Whilst some ICBs provided uplifts above the standard 1.7%, this still falls well below the increase needed to keep pace with inflation and help hospices keep pace with rising costs.

Over the past 2 years:

• No ICBs provided uplifts to hospice contracts to match inflation.
• 5% gave no uplift at all.
• 28% of ICBs offered uplifts below the basic NHS uplift.
• Disappointingly, 9 ICBs were yet to agree 2023-4 uplifts for hospice contracts by July 2023.

Hospices provide care and support to 300,000 people a year across the UK. They are an integral part of our health system but remain largely funded by charity. On average, only one third of adult hospice income comes from the state, leaving hospices to rely on charitable donations to pay for the majority of their vital work. With the cost of living crisis affecting everyone, many hospices are increasingly concerned that their local communities will not be able to continue to give as generously.

“This state of affairs is unfair and short-sighted. Hospices care for some of the most vulnerable people in society, those at the end of their lives or grieving. But they are increasingly worried about the future of their services, with nearly every hospice in the UK spending more than it brings in. Hospice UK tracks hospice finances closely, and we estimate that hospices are currently on track to spend almost £200m more on delivering their care than they will receive in income. This is highly alarming and clearly not sustainable.

“While hospices are mostly funded by charitable donations, NHS contracts represent around a third of the income of a typical adults' hospice. But with the cost of caring for dying patients and their families spiralling, for Government support to fall short by £47 million means hospice care services are under threat.

“Hospices are a vital part of our wider healthcare system. It is unfair and unrealistic for the Government to allow their funding to hospices to fall short and expect local communities that support hospices so generously to make up the shortfall.

“ICBs have a duty to ensure palliative and end of life care in their area is well funded. But our data shows that nowhere is that funding anywhere near keeping pace with inflation. Our data shows that some hospices are still being paid the same in 2023 as they were 2 years ago to deliver services that now cost significantly more to provide, due to increases in things like salaries and energy bills.

“We’ve been warning for over a year about the impact that insufficient Government funding will have on essential hospice services. It’s getting critical.”

“Surely we all want to see end of life care and bereavement services properly funded, and available to anyone that needs it. We need ICBs to properly plan to meet the demand for palliative care in their area and provide fair funding to do so. And we need those ICBs to be properly funded by central Government. End of life care should not be determined by a postcode lottery.”