Health leaders criticised over hospice funding ‘crisis’
MPs warn of funding 'cliff edge' for hospices in England
MPs say too many people are dying in hospitals instead of at home or in a hospice.
They have criticised health leaders for not taking financial “crisis” in the hospice sector seriously enough.
The Public Accounts Committee said the hospice sector in England is facing a “serious financial situation” which is already affecting patient care, including cuts to services.
Hospice UK warn that nearly six in 10 English hospices have made or are considering cuts to frontline services.
Hospices face a funding “cliff edge” from April
MPs on the committee highlighted how “too many” people are spending their final days in hospitals, which “does not always achieve the best outcomes for patients nor represent value for money”.
They said the Department of Health and Social Care and NHS England are “not responding to the growing financial crisis in the adult hospice sector with the seriousness and urgency needed”.
MPs were told that hospices face a funding “cliff edge” from April and were warned that if no new funding is given to the sector before the new financial year, hospices would be forced to reduce services further.
A new report from MPs on the committee says there is an “urgent need” for reform to address the financial challenges that the independent adult hospice sector faces.
The authors highlight how the Government’s solution is in the “early stages of development” but say the details are “sketchy” and that it is at least a year from being introduced.
“This is not good enough when so many hospices are announcing service cuts,” they add.
Sir Geoffrey Clifton-Brown, chairman of the Public Accounts Committee, warned that “by the time any help arrives, invaluable services may already have been cut.”
Overall hospices in England spend around £1.2 billion on care each year, with £420 million provided by local health bodies.
This means hospices rely on charitable donations to fund much of the care they provide, the authors add.
But it comes as a separate report from the Charities Aid Foundation highlighted how charity donations by the public fell by £1.4 billion last year.
MPs on the committee said that the department and NHS England “do not have effective oversight of the independent hospice sector” as they called for the reform – known as the modern service framework – to outline the core hospice services that local health bodies have a duty to commission.
They also called on health leaders to set out in detail how end of life and palliative care will be moved out of hospitals and into the community.
Health officials have also been told to work with local health bodies to determine the impact of hospice cuts.
“The current way in which hospices are funded is not fit for purpose."
Sir Geoffrey said: “The institutions whose job it is to help ease our final days deserve to have recognition of the central role they play in our health system.
“And yet Government’s actions, despite all reassurances to the contrary, are communicating a certain blithe certainty that the sector’s challenges will be resolved at the local level.
“We acknowledge the Government’s insistence that it lacks complacency but the autumn timelines of the arrival of its current reforms risk ignoring the reality.
“A funding cliff-edge is approaching in only a month.
“Details of what these reforms might look like are thin on the ground, but regardless, by the time any help arrives, invaluable services may already have been cut.”
Commenting on the report, Toby Porter, chief executive of Hospice UK said: “Hospices are facing a genuine cliff-edge as funding fails to keep pace with rapidly rising costs and growing demand.
“The current way in which hospices are funded is not fit for purpose. It is patients who will pay the prices for this unfair model.
“The Government’s plan for a Modern Service Framework to overhaul palliative and end-of-life care is welcome and the hospice sector will work with them at pace to deliver this.
“But with nearly six in 10 English hospices having made or considering cuts to frontline services, the truth is many can’t wait, they need support right now to avoid further reductions in their care.”
James Sanderson, chief executive at the palliative care charity Sue Ryder, said: “The palliative care sector is crying out for reform.
“The Government’s plan for palliative care, its modern service framework, must deliver later this year. It has the potential to be transformative but without the right balance of funding and structural reform, it will be insufficient to deliver the changes required and it will be terminally ill people who pay the price.”
Sam Royston, executive director of research and policy, at end-of-life charity Marie Curie, added: “The committee has laid bare what Marie Curie has warned for years; end-of-life care is in crisis, and the UK government’s response does not reflect the scale or urgency of the issue.
“Almost one in three people lack the end-of-life care they need, with many dying in pain or alone due to overstretched, underfunded services.
“A modern service framework is vital but must be backed by clear delivery and funding to bring real change.
“Shifting care from costly emergency hospital settings to the community is not just the right thing to do for people, it makes financial sense.
“Dying well should not depend on where you live or what you can give to a charity. It is a basic expectation that government has a duty to meet.”
The Department of Health and Social Care and NHS England have been approached for comment.