End of life care to be ‘stripped back’ if NHS can’t fund hospices hit by tax hike

Hospices providing end of life care have warned they will be forced to strip back their vital services if the NHS is not able to support them with funding.

Rachel Reeves’ plans to increase national insurance (NI) on employers in the Autumn Budget will exacerbate the “urgent funding crisis” already faced by hospices, charities have told i.

Public sector organisations are set to receive additional funding to cover the extra costs from the NI hike for employers, but the private and voluntary sectors are expected to use their own funds, with concerns that the largest burden will be felt by smaller charities.

James Sanderson, Chief Executive at the palliative care and bereavement charity, Sue Ryder, said the hospice care sector needed more sustainable funding and urged the government to consider using funds created by NI rises to support it more fully.

He said: “End-of-life care is a vital part of our healthcare system, not a ‘nice to have’. Sue Ryder relieves pressure on the NHS every day by providing expert care for people who are dying.

“Demand for end-of-life care grows each year, how we approach it is more important now than ever before. We must, as a society be able to ensure that people have access to the right care at the end of their lives.”

John Vickers, Director of Finance at St Christopher’s Hospice, said the Government should be increasing hospice funding rather than making cuts.

The suggested increase of 2 per cent rise in Employer’s National Insurance would cost St Christopher’s approximately £250,000 extra each year, the cost of funding around five specialist community nurses.

Mr Vickers said: “This proposed rise in Employer’s National Insurance will be worrying hospices across the country at a time when we are already facing an urgent funding crisis, with government funding falling far short of inflation and a growing demand for support.”

“Services and jobs are already being cut at hospices across the country. Now is the time to be providing extra funding for hospices and not increasing our burden.

“We urge the Chancellor to rethink this move and are still hoping that extra funding will be made available for hospices and palliative care in tomorrow’s Budget.”

Paul Farthing, Chief Executive at Shooting Star Children’s Hospices, told i the plans created uncertainty over finances: “Adult and children’s hospices work closely alongside the NHS, delivering the same quality of clinical care and facing the same cost pressures and workforce shortages.

“Announcements like the plans for employer national insurance do not recognise this, and the extra costs to hospices are not being offset by increases to the fees being paid by the NHS.

“This creates greater uncertainty over hospice finances and leaves us with two choices – either raise more money if we can or hold back on plans to develop services to help more families that need the support we provide.”

According to Toby Porter, CEO of Hospice UK, which represents the UK’s 200 hospices, hospices receive only a third of their funding from the NHS with the rest coming through charitable donations.

The Government should recognise the particular pressures faced by charitable providers of NHS services, he said.

“The cost of paying brilliant hospice staff a fair wage represents the majority of the costs of running those services,” Mr Porter added.

Read Next

“Already, the cost of keeping pace with NHS salaries, for which hospices receive no additional state funding, is stretching hospice finances significantly and we are seeing hospices across the country make service reductions and redundancies.

“Further increases to staffing costs will worsen this situation.”

It comes after Matthew Reed, the chief executive of palliative care charity Marie Curie, told i on Monday that it would also need to find new sources of income or face having to scale back its services.

He said: “Increasing the national insurance on a charity already dependent on donations from the public will have a detrimental impact on the amount of care we are able to provide.

“We will now need to ask for more funding from our NHS partners or rely further on kind donations from the public to continue to provide our services.”

The Prince and Princess of Wales Hospice chief executive Rhona Baillie OBE said they had already been “severely affected” by challenges in recent years, including rising costs from the cost-of-living crisis, increasing staff salaries, and reduced income from fundraising, and that further dents in the funding gap may threaten the ongoing viablity of their services.

Ms Baillie said: “We have been campaigning for a fair and sustainable funding agreement with Governments for many years, however this has not been forthcoming.

“Our hospice is predicting a £500,000 deficit for the financial year 2024/25 and any increase in the employer’s National Insurance contributions will only worsen this financial position.

“We have managed to maintain our staffing levels and services, only because of income generating initiatives including our fundraising and retail operations and extremely generous donations from our supporting communities, which have bridged the funding gap.

“However, should this gap continue to widen and in the absence of fair and sustainable Government funding, our services may be under threat in the future.”

i has approached NHS England and the Department for Health for comment.

A No 10 spokesman said: “I can’t get into possible Budget measures, which the Chancellor will present tomorrow. More broadly, the UK is a world leader in the charitable sector. Our tax regime for charities, including an exemption from paying business rates, is among the most generous anywhere in the world, and tax reliefs for charities and their donors were worth over £6bn for the tax year to April 2024.”