The DHSC and NHSE do not know how funding is used by hospices for palliative and end-of-life care due to a lack of central oversight, according to the National Audit Office (NAO).

A report found the DHSC and NHSE do not know how reliant they are on hospices for palliative and end-of-life care because the way they provide funding makes it determine to level of the activity delivered.

Nearly two-thirds of hospices reported a deficit in 2023-24 with expenditure £78m more than income, resulting in reduced services and cuts to beds and staff.

ICBs funded spending, equating to over £400m, but the NAO said a lack of central oversight meant it was unclear what this was used for, or whether it was sufficient to maintain the sector's future without more services having to be delivered by the NHS to meet increasing demand.

Gareth Davies, head of the NAO, said: ‘With many more people expected to want hospice care in the future, 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.'

Reaction

Liberal Democrat care and carers spokesperson, Alison Bennett, said: ‘For too long, the vital role played by hospices in our health and care system has been overlooked, and its patients are paying the price. This must change, patients and their families deserve so much better.'

Sue Ryder, James Sanderson, said: ‘We can help the Government to understand how palliative care can sit at the heart of its neighbourhood health model – a role they've already acknowledged we must play if they are to achieve the shift towards community-based care. This shift will require the sector to think bigger than the four walls of hospices and meet more patients where they need us. Without modernising hospice care for future generations, it is hard to conceive how the Government will achieve the ambition of its 10-Year Health Plan.'

A Department of Health and Social Care spokesperson said: ‘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 - £100m – to improve hospice facilities and have committed to £80m 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.'

Lee Peart is editor of Hemming Group’s Healthcare Management magazine.