Hospices are cutting vital services for dying patients due to multimillion-pound funding deficits, a new report reveals.
Hospice leaders describe the sector as being in ‘crisis’, with a National Audit Office (NAO) review showing nearly two-thirds of independent hospices in England reported a deficit in 2023/24.
The NAO found that overall expenditure for independent adult hospices exceeded income by £78 million. Consequently, services have been cut and hospices have reduced beds for dying people or those with life-limiting conditions.
At the end of 2024, around 300 inpatient beds were “deregistered or withdrawn from operation”, the report states, though some of these could have been due to a preference for being cared for at home.
Hospices have also been forced to cut back on staff caring for these people, the NAO report said.
This is despite the fact that demand for palliative and end-of-life care is due to rise in coming years.
The NAO review also highlights “variation” in where hospices are situated across England due to the “unplanned way” hospices have developed over the last few decades.
Experts said the report highlights the “inconsistency and insufficiency” in how hospices are funded.
In 2023/24 around 29 per cent of income for hospices was through Government funding.
Most income for independent adult hospices is generated from charitable sources, such as charity shops and donations, according to the NAO report.
Meanwhile the NAO said that the Department of Health and Social Care (DHSC) and NHS England (NHSE) do not know “how reliant they are on the sector” because they do not know what proportion of the total amount of palliative and end-of-life care provided in England is delivered by the independent adult hospice sector.
“It is not always clear what services are being commissioned or whether local demand is being met,” the NAO report states.
Gareth Davies, head of the NAO, said: “It is crucial that the sector is financially resilient.
“DHSC and NHSE should assess how they would meet increased demand for palliative and end-of-life care should services delivered by independent adult hospices be insufficient.”
Commenting on the report, Sam Royston, executive director for research and policy at Marie Curie, says: “The NAO report echoes what we witness every day: palliative and end-of-life care is in crisis.”
Toby Porter, chief executive of Hospice UK, said: “We welcome this important report, which lays bare the inconsistency and insufficiency in how hospices are funded.
“Palliative and end-of-life care is not prioritised across England.”
Hospice UK said it is calling for “full funding of specialist palliative care provided by hospices” along with other measures to “ensure that no-one misses out on the expert, compassionate care they deserve at the end of life”.
James Sanderson, chief executive of Sue Ryder, said: “This report demonstrates the need to reform how palliative care is delivered across the UK.”
A DHSC spokesperson said: “Hospices do incredible work to support people and families when they need it most, and we recognise the incredibly tough pressures they are facing.
“The NAO report covers a period under the previous administration.
“Since then, we’ve made the biggest investment in a generation – £100 million – to improve hospice facilities and have committed to £80 million for children’s and young people’s hospices over three years.
“We recognise there is more to do, and we are exploring how we can improve the access, quality and sustainability of all-age palliative care and end-of-life care in line with the 10-Year Health Plan.”
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