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Hospices have been forced to cut back on provision for terminally ill patients because of multimillion-pound funding shortfalls, a report has revealed. Leaders within the hospice sector described the situation as a "crisis" following a newly published National Audit Office (NAO) review, which shows that nearly two-thirds of independent hospices in England recorded a deficit in 2023/2024. The NAO report reveals that overall expenditure for independent adult hospices exceeded income generated by £78 million. Consequently, services have been reduced and hospices have reduced the number of beds available for dying patients or those living with life-limiting conditions. READ MORE: The report states that by the end of 2024, approximately 300 inpatient beds had been "deregistered or withdrawn from operation," although some of these closures may have reflected patients' preference for home-based care. Hospices have also had to reduce staffing levels for these individuals, according to the NAO report. This comes despite projections showing demand for palliative and end-of-life care is set to increase in the coming years. The NAO review also highlights "variation" in hospice locations across England resulting from the "unplanned way" in which hospices have evolved over recent decades. Experts stated the report underlines the "inconsistency and insufficiency" of hospice funding arrangements. During 2023/2024, approximately 29 per cent of hospice income came from Government funding. The majority of income for independent adult hospices is derived from charitable sources, such as charity shops and donations, according to a report by the National Audit Office (NAO). The NAO has stated that the Department of Health and Social Care (DHSC) and NHS England (NHSE) are unaware of "how reliant they are on the sector" due to their lack of knowledge regarding what percentage of total palliative and end-of-life care provided in England is delivered by the independent adult hospice sector. The NAO report indicates that it's not always evident what services are being commissioned or if local demand is being met. Gareth Davies, head of the NAO, commented: "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." Reacting to the report, Sam Royston, executive director for research and policy at Marie Curie, said: "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, remarked: "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 has issued calls for "full funding of specialist palliative care provided by hospices" alongside additional measures to "ensure that no one misses out on the expert, compassionate care they deserve at the end of life." Sue Ryder's chief executive, James Sanderson, remarked: "This report demonstrates the need to reform how palliative care is delivered across the UK." A spokesperson from the DHSC responded: "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."
