Hundreds of hospice beds and staff cut in England amid funding crisis | Hospices

England’s hospices are cutting hundreds of beds and staff due to a funding crisis, despite a sharp rise in demand for palliative care, a damning report warns.

People needing end-of-life care were finding themselves facing a postal lottery because access to services was highly unequal, the National Audit Office (NAO) reported.

The lack of government oversight meant ministers were unaware of the extent to which they relied on independent hospices, his 52-page report said.

The NAO said almost two thirds of independent hospices in England reported a deficit in 2023-24. Overall expenditure was £78m higher than revenue generated.

As a result, services were cut and hospices were forced to reduce the number of beds available for dying people and those with life-threatening illnesses. By the end of 2024, about 300 inpatient beds were “written off or removed from service,” the report said, although some could be due to a preference for home care.

Hospices have been forced to reduce staff numbers, the NAO added, despite increasing demand for palliative care.

The NAO highlighted the “variation” in the location of hospices across England, due to the “unplanned way” in which they have developed over recent decades.

Experts said the report showed “inconsistency and inadequacy” in the way hospices were funded. In 2023-24, approximately 29% of hospice revenue came from the government. Most of their income came from charitable sources, such as charity shops and donations, the NAO reported.

The Department of Health and Social Care (DHSC) and NHS England had no idea “of their dependence on the sector” because they did not know what proportion of palliative care in England was provided by the independent palliative care sector.

Gareth Davies, director of the NAO, said: “Independent hospices play a key role in providing palliative and end-of-life care and offering choice to people at the end of their lives.

“As many more people are expected to want palliative care in the future, it is crucial that the sector is financially resilient. The DHSC and NHSE should assess how they could meet the increased demand for palliative and end-of-life care if the services provided by independent adult hospices prove insufficient.”

Sam Royston, executive director of research and policy at Marie Curie, said the NAO’s findings echoed the “crisis” he was witnessing daily in the sector.

Sue Ryder chief executive James Sanderson said the report called out the government for failing to have “a clear picture of the value of palliative care”.

The DHSC said hospices were doing an “incredible job” supporting people, and it acknowledged the “incredibly difficult” pressures they were facing.

The NAO report covered a period under the previous government, a spokesperson added. “Since then we have made the biggest investment in a generation – £100m – to improve hospice settings and committed £80m to children and young people’s hospices over three years.

“We recognize that there is still much to do and we are exploring how we can improve access, quality and sustainability of palliative and end-of-life care for all ages, in line with the 10-year health plan. »