How Can Hospices Transform Your End-of-Life Experience?

The challenges facing hospice services in Wales are becoming increasingly critical, with the current funding model deemed unsustainable. As highlighted by patients like Paul Thomas, who found solace and improved care at St Kentigern Hospice, the need for adequate financial support is urgent. With nine out of fourteen hospices in Wales anticipating financial deficits by 2025-26, the future of end-of-life care hangs in the balance, prompting calls for immediate reform in funding and support.

Last updated: 25 October 2023 (BST)

What’s happening now

The current landscape for hospice care in Wales is characterised by a looming financial crisis. Despite previous assurances from the Welsh government regarding increased investment, many hospices are struggling to cope with rising operational costs. The financial strain has led to the closure of Shalom House Hospice in Pembrokeshire and the temporary shutdown of a unit at St David's Hospice in Holyhead. The urgency for a new funding model is underscored by the experiences of patients like Paul Thomas, who rely heavily on these services for comfort and dignity in their final days.

Key takeaways

Nine out of 14 hospices in Wales face financial deficits by 2025-26.
Recent government investment has not alleviated financial pressures significantly.
Hospice UK warns that community and inpatient services could decline without urgent funding reform.

Timeline: how we got here

The financial challenges facing Welsh hospices have developed over several years, with increasing operational costs and insufficient funding. Key milestones include:

2024: Rowena Owen was diagnosed with cancer, highlighting the need for compassionate hospice care.
2025: Predictions show that 25% more people will require palliative and end-of-life care over the next 25 years.
2023: The Welsh government announced an additional £5.2 million annually for hospice funding, though this has not fully addressed the needs.
October 2023: Reports indicate that nine hospices will face deficits, with critical closures impacting service delivery.

What’s new vs what’s known

New today/this week

Recent discussions among political parties in Wales have centred around improving the financial sustainability of hospice services. The Liberal Democrats and Plaid Cymru have proposed various measures, including reversing National Insurance increases for hospices and ensuring pay parity with NHS staff.

What was already established

It has been previously established that hospice services are predominantly funded through charitable donations, with only about 30% of their funding coming from the Welsh government and NHS. This reliance on charity has made hospices vulnerable to financial instability.

Impact for the UK

Consumers and households

For families facing terminal illness, the availability of hospice care can significantly ease the emotional and financial burden of end-of-life care. The current funding crises may lead to increased pressure on families who might have to seek alternative care options, potentially in less supportive or more clinical environments.

Businesses and jobs

The financial instability of hospices may affect local employment opportunities, particularly for healthcare professionals who may seek more secure positions elsewhere. Reduced funding can lead to staff shortages, impacting the quality of care provided to patients.

Policy and regulation

The Welsh government is in discussions to create a new commissioning approach for hospice services, aiming for a more sustainable funding model. However, the effectiveness of these proposed changes remains to be seen, and immediate action is necessary to prevent further service reductions.

Numbers that matter

20,000: The number of adults and children supported by hospices each year in Wales.
95: The total inpatient beds available across Welsh hospices, although not all may be in use due to funding issues.
30%: The proportion of hospice funding derived from the Welsh government and NHS, with the remaining 70% reliant on charitable donations.

Definitions and jargon buster

Palliative Care: A type of medical care focused on providing relief from symptoms and stress of a serious illness.
End-of-Life Care: Support and medical care given during the time surrounding death.
Senedd: The Welsh Parliament located in Cardiff, responsible for making Welsh laws.

How to think about the next steps

Near term (0–4 weeks)

Hospices will be assessing their immediate financial situations and may announce service reductions or closures if funding does not improve. Stakeholders should monitor communications from local hospices regarding service availability.

Medium term (1–6 months)

Expect developments in the Welsh government's approach to hospice funding. Advocacy efforts from charities and political parties may lead to proposed legislative changes aimed at improving financial sustainability.

Signals to watch

Reports on the financial health of individual hospices.
Announcements regarding government funding initiatives for hospices.
Community fundraising efforts and their impact on local hospice services.

Practical guidance

Do

Stay informed about local hospice services and their funding needs.
Consider contributing to hospice charities to support their work.
Advocate for policy changes that promote sustainable funding for hospice care.

Don’t

Don’t assume that current funding levels will remain sufficient to meet future needs.
Don’t overlook the emotional and practical support that hospices provide to families.
Don’t hesitate to engage with local representatives to voice concerns about hospice care funding.

Checklist

Identify local hospices and their current funding campaigns.
Understand the types of services your local hospice offers.
Explore volunteer opportunities at nearby hospices to provide support.
Review potential legislative changes regarding hospice funding on the Welsh Parliament's agenda.

Risks, caveats, and uncertainties

The situation regarding hospice funding is fluid, with many factors potentially influencing future service availability. Political negotiations, public response, and individual hospice financial health can all change rapidly. These uncertainties make it difficult to predict the long-term sustainability of these vital services.

Bottom line

The current crisis in hospice funding in Wales poses significant risks to the availability and quality of end-of-life care. Urgent action and reform are needed to secure the future of these essential services, ensuring that patients and their families receive the comfort and support they deserve during difficult times.

FAQs

What is the current state of hospice funding in Wales?

Hospice funding in Wales is under significant strain, with many hospices facing financial deficits and some already closing. A new funding model is urgently needed to ensure the sustainability of these services.

How do hospices differ from hospitals in terms of care?

Hospices focus on palliative and end-of-life care, providing a more comforting and less clinical environment compared to hospitals, which are primarily oriented towards treatment and recovery.

What can individuals do to support hospice services?

Individuals can support hospice services by donating, volunteering, or advocating for better funding and policies that protect these vital services.