The hospice funding crisis: could this be the end for hospices?

"This is the end
Beautiful friend
This is the end
My only friend, the end."

These lines from The Doors’ epic closing track on their debut album have been used in many films to add raw emotion.

Today, they feel particularly poignant for the hospice world, given reports and some of the things currently happening in the East Midlands and wider country.

The main headline is: could this be the end for many hospices?

There has certainly been a huge reduction in the provision of end of life care that is available currently is being reported. But what exactly is happening?

The hospice funding crisis

Primarily, there is a funding crisis. According to a report by the National Audit Offcie (NAO), less than a third of hospice funding is provided by the government. You read that right - 70% of the funding for end of life care is provided by donations.

I was recently involved in a publicity campaign for Rainbows Hospice for Children and Young People in Loughborough, who rely on public donations for around 87% of the income needed to provide their services.

Hospice UK figures released at the end of last year showed that nearly 400 beds had closed out of approximately 2,000 beds across England, simply because the organisations they belonged to were unable to keep them open any longer due to rising costs and funding not keeping pace with the increases.

This is a staggering fact.

In most areas of the UK, there are hospices reporting the same fact - beds are closing, costs are rising and the system is under strain.

Hospice UK has called on the government to fully fund specialist palliative care provided by hospices as part of its four-point plan. With such headlines, one would expect that hospices are going bust at an alarming rate right now, but according to Hospice UK, there has only been one adult hospice that has gone into administration in the last ten years.

So, how are they surviving?

Innovation in the hospice sector

I have previously written about Zoe’s place in Liverpool, which went from closed to very much open after a huge fundraising effort. Such efforts are likely the main reason many hospices are still operating.

Fundraising campaigns are becoming more focused, fundraising managers are becoming more business-minded and many hospices are becoming more innovative.

Over the last few years, I have often written about the need for charities to adopt a more business-focused approach. In many ways, the hospice sector is now a shining example of this.

One of the innovative ways hospices have responded has been to deliver more for less.

Hospice beds may be closing, but many hospices have moved to a ‘hospice at home’ model, allowing dedicated palliative care to be delivered in patients’ homes. This approach allows the same compassion and expertise to be delivered, but at significantly lower cost from cutting the overheads.

This truly is an example of understanding the core elements of cost and deliverables.

Some hospices, such as Nottinghamshire Hospice, have taken this to the next level by being able to move to a complete hospice in the home model, leaving surplus buildings available for other uses. In this case, a partnership with a local college has created an opportunity for additional funding, helping ensure continued care in people’s homes and dignity at the end of life.

Leadership and collaboration in the charity sector

The examples above demonstrate true leadership, supported by a business minded team.

Being able to provide an alternate support model and understand the impact of releasing now surplus assets does not happen by accident. Being able to spot a collaborative approach with a local partner and harness this to create a degree of synergy is a great example of the success of charities working together rather than competing for limited funding.

All of the business minded approaches I have long suggested charities should embrace are clearly being demonstrated across the hospice sector.

Is this really the end?

It’s clear that the funding crisis is unlikely to go away anytime soon. Employment costs are rising, there is wage pressure to compete with other areas of the healthcare sector, statutory funding isn’t keeping pace with these cost rises and the public can only donate so much and run so many marathons.

But if the sector can continue to deliver innovation and embrace change management, there is hope that this isn’t the end.