Survey reveals underfunded hospices are struggling to cope

12.00.00am BST (GMT +0100) Tue 16th May 2006

A new survey of hospices in England, published today by Liberal Democrat Shadow Health Minister Sandra Gidley MP, has exposed a crisis in care for the dying.

It was found that hospices are being forced to rely on lottery handouts and donations to provide care for the chronically ill. Hospices contribute an average of £1.80 pounds for every £1 of Government funding.

Shortages of funding from local authorities are forcing one in ten hospices to turn away the seriously ill, whilst one third of hospices have waiting lists.

Ninety-five per cent of hospice beds are used by terminally ill cancer sufferers, although only one in four people die from cancer.

The number of people dying in hospices in England and Wales increased in 2004 by 4,093 to 25,625.

Main Findings:

-The survey found that hospices receive on average 35.5% of their funding from the NHS

• The survey identified inconsistent funding from Primary Care Trusts across England. One hospice receives up to 80% of its funding from the NHS, whilst others receive just 17% of their funding from the NHS.

• 55% of hospices surveyed suffer from staff shortages and recruitment problems.

• One third of hospices have a waiting list

• One third of hospices relied on funding from the National Lottery over the past year

• 60% of those hospices receiving funding from the Lottery found the application procedure too complicated

• 10 % of hospices have had to close their hospice to new admissions over the past year

The following comments were received:

• "As I approach the beginning of a new financial year, in spite of all my efforts, I still have no commitment from our local PCT as to the level of funding I will receive," Business Director Hospice A

• "Our PCTs always under-fund inflation…discussions with them [PCT] show that they really don't care about palliative care," Chief Executive of Hospice B.

• "We have had difficulty recruiting our Consultants- it has taken nearly three years to successfully recruit two Consultants." Chief Executive of Hospice C

• "We are told that Payment by Results will be introduced from 2008/09 but this looks increasingly unlikely according to the PCT commissioners," Business Director of Hospice D

Commenting on the results, Sandra said:

"It's a scandal that National Lottery funds are being used to subsidise core services that should be provided by the Government.

"We hear a lot about the 'choice' agenda in the NHS, but for those who are chronically ill or in need of palliative care services, choice is clearly not being realised, with inconsistencies apparent across England.

"Up to 300,000 die every year from chronic diseases other than cancer. More must be done to develop palliative services for those who require them."

The Liberal Democrats undertook a survey of 144 adult hospices in England during March and April 2006, with one third of hospices responding.

Failure to meet overhead costs

In 2002 the Treasury stated that Government departments must, by April 2006[1][1], pay the full overhead costs of voluntary organisations which carry out public services, which would include hospices.

This would ease the financial burden placed on hospices, whose fundraisers are clearly stretched to the limit.

"13. Funders should recognise that it is legitimate for providers to include the relevant element of overheads in their cost estimates for providing a given service under service agreement or contract.

All departments will incorporate the review's funding recommendations fully into their procurement policies by ensuring that the price for contracts reflects the full cost of the service, including the legitimate portion of overhead costs by April 2006"

The charity Help the Hospices have said: "The Treasury's requirement is not yet being met in relation to hospices and feedback from hospices suggests that PCTs do not consider that it applies to their commissioning relationship with hospices.