Prynhawn Da/ Good Afternoon and thank you to Hospice UK for inviting me to sponsor and speak at today’s Hospice Care Week Event as Chair of the Cross Party Group on Hospices and Palliative Care.
Hospice Care Week 2019 is being held from the 7-13 October 2019, with the theme ‘This Is What It Takes’ to provide hospice care.
Hospice Care Week rightly celebrates the amazing work that hospices undertake, and the ‘This is what it takes’ theme puts the dedicated staff, volunteers, and fundraising effort that keeps hospices running centre-stage.
Hospices care for more than 200,000 people across the UK every year.
Last year in Wales:
- 16 charitable hospices provided direct care to over 11,000 people and their families, whilst reaching thousands more through their community engagement and development.
- 290,000 hours were donated by hospice volunteers
- 2150 adults were seen in day hospice and outpatient care
- There were 22,500 overnight stays in inpatient care
- 3,500 people volunteered for local hospices
- 8600 adults seen by community care and hospice at home
- 800 children were helped directly by charitable hospice care
- There were 57,700 home visits by community care and hospice at home
- And 2300 families received bereavement care through hospices
A significant proportion of bereavement support is provided by our charitable hospices in Wales.
However, it's understood that families whose loved one dies in the acute setting after receiving intensive and critical care are missing out on the bereavement care they need through lack of signposting or availability.
Wales’ hospices had a combined revenue of £36 million in 2018, and fundraised around £28 million.
Statutory funding has flatlined for many years, with children’s hospices telling me that although they operate on a “buy one, get seven or eight free” basis, they’ve had flatline statutory funding for ten years.
Government funding of children’s hospices in Wales as a percentage of its charitable expenditure is lower than in England and Scotland.
In Wales, children’s hospices received 12% of their expenditure from government funding last year, compared with 21% in England and 53% in Scotland.
The UK government is doubling children’s hospice funding to £25 million annually by 2023/24 and the Scottish government is providing £30 million over five years to support children’s hospices there.
Government funding for adults’ hospices as a percentage of expenditure is lower in Wales than any other UK nation.
In Wales, adults’ hospices received 28% of government funding as a percentage of their expenditure in 2017, compared with 33% in England, 34% in Northern Ireland and 38% in Scotland.
Whilst most people express a preference to be cared for in their usual place of residence – at home or in their care home – (55%) of deaths in Wales occur in hospitals. However, many of these may receive some form of support from a hospice.
Last year, the Cross Party Group published its enquiry into Inequalities in access to hospice and palliative care.
It estimated that around 6,000 people with life-limiting conditions may be missing out on care provisions that they might need – and said a shortage of medical staff meant people can miss out on care at home or in the community.
The report said those with dementia, heart failure and neurological conditions in particular faced a range of barriers to appropriate care, and are less likely to be referred than cancer sufferers - when they should be entitled to care at home, in hospices and care homes as well as hospitals.
The report said people who are aged over 85 or live in a care home can struggle to get the right support - something the former Older People's Commissioner for Wales previously highlighted.
The traditional view of a hospice as an inpatient unit where someone might go for the last few weeks of their life is too narrow, when over 80% of hospice services in Wales are actually delivered out in the community or in people's homes.
The report made 11 recommendations for improvement, including:
- The Welsh government should develop a "robust action plan" to tackle the gaps in palliative care staffing, prioritising district nurses and community paediatric nurses
- Health boards need to ensure there is comprehensive out-of-hours coverage across the whole of Wales
- Hospice and palliative care providers should educate colleagues in health and social care about the range of services available
- And the Funding formula should be based on current population need – which will require clarification on which measurements will be used in determining need, noting that the End of Life Care Board no longer holds the levers and funding has been fully devolved to Health Boards.
Effective collaboration between the NHS and voluntary sector is essential if we are to radically improve access to hospice and palliative care for everyone across Wales – with Health Boards asking Hospices how they can help them deliver more.