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Hospitals are facing cuts to vital services for dying patients due to a multimillion-pound funding shortfall, a new report reveals.
Hospice leaders have described the sector as being in ‘crisis’, with a National Audit Office (NAO) review revealing that almost two-thirds of independent hospices in England are set to report losses in 2023/24.
The NAO found that the total expenditure of independent adult hospices exceeds income by £78 million. As a result, services have been cut and hospices have reduced beds for dying people or those with life-limiting conditions.
The report said that at the end of 2024, about 300 inpatient beds were “deregistered or removed from operation”, although some of this may be due to the preference for home care.
Hospices have also been forced to cut the number of staff caring for these people, the NAO report said.
This is despite the fact that the demand for palliative and end of life care There is going to be an increase in the coming years.
The NAO review also highlighted the “variation” in the location of hospices across England due to hospices having developed in an “unplanned manner” over the past few decades.
Experts said the report highlights “inconsistencies and inadequacies” in funding hospices.
Around 29 per cent of income for hospices in 2023/24 was through government funding.
According to the NAO report, the majority of independent adult hospices’ income is generated from charitable sources, such as charity shops and donations.
Meanwhile the NAO said that the Department of Health and Social Care (DHSC) and NHS England (NHSE) do not know “how dependent 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 provided by the independent adult hospice sector.
“It is not always clear which services are being introduced or whether local demand is being met,” the NAO report said.
Gareth Davies, head of the NAO, said: “It is vital that the sector is financially resilient.
“The DHSC and NHSE must assess how they will meet the increasing demand for palliative and end-of-life care if services provided by independent adult hospices remain inadequate.”
Commenting on the report, Sam Royston, executive director of research and policy at Marie Curie, says: “The NAO report reflects what we see 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 highlights the inconsistency and inadequacy in funding hospices.
“Palliative and end-of-life care is not prioritized across England.”
Hospice UK said it is calling for “full funding of specialist palliative care provided by hospitals” as well as other measures to “ensure that no one is deprived of specialist, compassionate care at the end of life.”
James Sanderson, chief executive of Sue Ryder, said: “This report shows the need for reform in how palliative care is provided across the UK.”
A DHSC spokesperson said: “Hospitals do incredible work to support people and families when they need it most, and we recognize the incredibly difficult pressures they are facing.
“The NAO report covers a period under the previous administration.
“Since then, we have made the largest investment in a generation – £100 million – in improving hospice facilities and have committed £80 million to children and young people’s hospices over three years.
“We recognize there is still much more to do, and we are exploring how we can improve access, quality and sustainability of palliative care and end-of-life care for all ages, in line with the 10-year health plan.”