Hospice UK Conference 2025

This week’s Hospice UK conference sees the sector in greater peril than ever before. The last 18 months or so have seen many hospices announce job cuts and service closures. And nearly 20% of beds in hospices lie empty due to funding shortfalls. 

The Government points to the funding it announced a year ago. But this was not even a sticking plaster. Results from the regular survey db associates runs with Hospice UK shows that in the 1st quarter of 2025/26, the average loss amongst participating hospices was £273k, up from £213k last year. 

It’s easy and convenient to blame the present administration. In truth, the current crisis is a result of decades of under-investment in end of life care. No government of any colour has provided a national solution. 

In the late 1990s there was vague talk of 50/50 funding, but nothing really happened. In 2011, the coalition government promised to introduce a new funding mechanism. 

A few years and several hundreds of thousands of pounds later, nothing resulted. The postcode lottery pattern of state support continued; wide variations in the levels of funding, in the types of agreement and in what services were included.  

Legislation in 2022 placed duties on ICBs in commissioning end of life care. But this only requires the ICB to commission services ‘to such extent as it considers necessary to meet the reasonable requirements of the people for whom it has responsibility’. 

So, there is legal discretion for local variation and no prescriptive package that every ICB must provide. And, no specific process to hold commissioners accountable for delivering services. Not surprisingly, it seems to have had limited impact in practice.

This year has witnessed both good and bad examples of NHS and hospice relationships. Over the summer, the NHS NW London Board announced a major investment in EOL care. 

More recently, St Catherine’s Hospice in Crawley announced a trial pilot initiative with East Surrey Hospital, which will enable them to open three more beds on a 6 month trial basis. Regional alliances of hospices in West Yorkshire and Kent have also had success in their negotiations with commissioners.

On the down side, Mountbatten was hit with a threat of a massive reduction in its funding in a cack handed attempt to ‘level up’ the system. And Arthur Rank Hospice and Cambridge University Hospitals NHS Foundation Trust became embroiled in a dispute over the latter’s decision to reduce their funding of beds at the former. 

A recent article by Tracey Bleakley, formerly CEO of Hospice UK who has more recently served in senior NHS roles, neatly outlines some of the misconceptions that exist on both sides and makes practical suggestions on how improvements could be made.

But in the long-term, end of life care needs national strategy and direction. Without that, we will see more of both the positive but also negative examples outlined above.

Whatever your views on assisted dying, as Toby Porter said at last year’s Hospice UK conference, can we really have a system where those who want to end their life receive fully statutory funded services, whilst others with life ending conditions rely  on services heavily dependent on fundraising? 

Hospices UK’s proposed model provides the template for such an approach.  Will we hear any kind of commitment to moving towards from the Minister speaking in Liverpool? Let's hope so.