Back in 2006, I hosted an event here highlighting the essential role played by Hospices in providing palliative care services in Wales, and calling on the Welsh Government to address the growing funding crisis they were facing, attended by every Hospice in Wales.
I Chaired the 2018 Cross Party Group on Hospice and Palliative Care’s enquiry into ‘Inequalities in Access to Hospice and Palliative Care’ in Wales, which found:
- that ‘there is significant unmet need and under-met need’;
- that Statutory Hospice funding had flatlined for a decade and therefore fallen in real terms each year;
- that Statutory funding of children’s Hospices in Wales was significantly lower than in England and Scotland;
- and that statutory funding for adult hospices in Wales as a percentage of expenditure was lower than in other UK Nation.
I also Chaired the Cross Party Group on Hospice and Palliative Care’s Inquiry into “Experiences of palliative and end of life care in the community during the COVID-19 pandemic”.
Our report, published last January, found that the number of people requiring palliative care is forecast to grow by over 40% by 2040, with much of this growth in community settings.
Every hospice in Wales is projecting a deficit for this financial year, drawing on their very limited reserves to make up the short fall and protect services.
The harsh reality is that Welsh hospices are already making cuts to services, with 80% of Hospices Cymru members telling us that pressures are highly likely to result in them having to further reduce the volume of certain services delivered.
This will result in reduced support being available to the wider system, such as hospitals and care homes, placing greater end of life pressure on an already overstretched NHS.
Over 80% of hospices with in-patient units believe cost of living pressures are highly likely to result in one or more in-patient bed(s) being temporarily or permanently unavailable.
The majority of their care is delivered in the community through their own charitable fundraising efforts, significantly reducing numbers of hospital admissions and enabling patients to stay at home.
However, rising staff and energy costs, workforce pressures, and increasing demand for complex care, pose a serious threat to Welsh hospices continuing to be able to do this, and to their ability to be key partners in helping transform palliative care services for the future.
NHS pay increases over the last two years have pushed total hospice staffing costs up by approximately £5.4m.
Both Adult and Children’s hospices in Wales are committed to paying a fair and competitive wage to their brilliant staff, but cannot keep pace with either NHS pay rises or significant inflation on all areas of their provision.
At the Cross Party Group, Children’s Hospices Ty Hafan and Ty Gobaith described the serious challenges they face delivering services to meet local need across large areas of Wales, where hospices are often the only source of support for children and their families.
Cost of travel continues to be a real issue for families, alongside out of hours support and partnership work with increasingly overstretched children’s community nursing teams.
St David’s Hospice in Llandudno described how Betsi Cadwaladr University Health Board is cutting their funding at a time when the Health Board has closed its own specialist palliative care beds.
The hospice currently delivers three quarters of its services through its own charitable fundraising efforts. They said the funding review should address these immediate pressures and the postcode lottery of hospice funding in Wales, alongside building a more sustainable model for the future.
Hospices bring expertise, innovation and capacity in improving person centred care, addressing equity of access, enhancing advance and future care planning, and developing national outcomes and experience measures.
Cuts to their services means there is shrinking hospice partnership capacity to work with Welsh Government and Health Boards to transform services and address increasing demand for palliative and end of life care.
Hospices save NHS Wales millions, and can help them save millions more with smart funding and services that are jointly designed and delivered.
Alternatively, the negative impact on patients and their families when Hospices have to cut services means people in Wales with a palliative care diagnosis not receiving the care and support they need to live their best life and to have a good death.
The Welsh Government would be failing in their duty if they did not work with the Hospice sector to address the immediate funding challenges and develop a long-term sustainable funding solution.