One in five hospice beds closed, report warns in end of life care cris | UK | News

Despite growing demand for end-of-life care, almost one in five hospice beds in England now sit closed or empty, according to a study by Oxford University researchers.

The analysis reveals a deepening funding crisis in the hospice sector; its authors describe it as a “national scandal”.
Professor Carl Heneghan, Director of the University of Oxford’s Center for Evidence-Based Medicine, and Dr. New research led by Tom Jefferson warns that deficiencies in end-of-life care mean increasing numbers of frail and elderly patients are dying “painfully, alone, often hungry and thirsty”, while others are being admitted to hospital in emergencies, increasing pressure on already strained NHS services.

The report, published in the Trust the Evidence blog post, estimates there are around 2,000 care home inpatient beds available across the country, but around 380 are currently unavailable because wards cannot afford the staff and day-to-day costs needed to keep them open safely.

The analysis warns that without additional funding, 40 percent of hospices could cut patient care in the coming months, while more than half of children’s hospices may be forced to reduce services, leaving more than 12,000 terminally ill patients unable to access end-of-life care.

Researchers say the closures are due to financial pressure rather than reduced need, and current funding arrangements are pushing nursing homes to breaking point.
The report reveals that despite providing care that would normally be provided by the NHS, hospices receive on average less than 36 per cent of their funding from government or NHS sources, with the remainder coming from donations, fundraising events and charity shops.
According to the analysis, the annual cost of hospice and palliative care across the UK is around £1.8 billion, which includes staff salaries, medicines, utilities, buildings and community services.

Less than £500 million of this total comes from government funding, with charities having to come up with more than £1.3 billion each year just to keep services going.

According to the report, the sector recorded a total deficit of £78 million in 2023-24; The deficit is now likely to be close to £100 million as inflation and staff pressures continue to rise.

It was revealed that almost two-thirds of independent care homes are operating at a loss, with a fifth facing a deficit of more than £1 million.

The report makes clear that beds were closed not because they were not needed, but because they had become too expensive for staff and operation.

Staffing accounts for the largest share of hospice costs, and providers face higher wage bills, hiring challenges and rising energy prices. The authors say government funding has not increased in line with costs, resulting in nursing homes receiving an increasingly larger share of expenses.

At the same time, the income of charities, which provide the bulk of hospice funding, has also been badly hit by Covid lockdowns, with charity shops forced to close and fundraising events cancelled. Although donations have partially recovered, the report notes that revenue has not recovered quickly enough to keep up with rising costs.

As a result, many nursing homes say they cannot safely staff every bed, leaving them with no choice but to close beds even as waiting lists grow.

The report highlights recent closures as evidence of rising tensions.

Last December, Richard House Children’s Hospice in east London closed after more than 25 years of supporting children with life-limiting conditions and their families. The report notes that less than a third of funding comes from the NHS, leaving it heavily reliant on charitable income.

Earlier this year, Marie Curie Hospice in Woolton, Liverpool, permanently closed its 26-bed inpatient unit due to ongoing staffing and financial pressures.

The report was published as part of a wider review of health spending by Professor Carl Heneghan and Dr. Compiled by Tom Jefferson.

In commentary accompanying the analysis, they described the situation as a “national scandal” and said care homes were carrying out “NHS work” without consistent NHS funding.

Dr Jefferson said: “This is unacceptable and appalling. This is nothing short of a national scandal. We live in a society where we cannot care for the weakest members of our society? Many will die alone, in pain, often left hungry and dehydrated due to the loss of services. We are effectively throwing these people away.”

Prof Heneghan, who also works as an out-of-hours GP, said: “I regularly see people failing to receive appropriate end-of-life care. It is heartbreaking. And it can leave loved ones scarred for life. “Every hour counts at this time.

The report states: “Care homes do the toughest job in the country – caring for people at the end of their lives. If you’re in an NHS hospital, the government foots the bill. But if you’re in a care home, doing NHS work, collecting money from the NHS, you’re expected to survive on income from cake sales and charity shops. How can one of the richest countries in the world rely on charities to fund a dignified death? If it’s NHS work, it should be NHS funded.”

The authors argue that nursing homes save health care money by keeping patients out of acute hospital beds, but they are still exposed to inflation, labor shortages, and fluctuations in public donations.

The report also examines the Government’s £100 million hospice funding package announced in December 2024.

Welcoming the investment, the authors note that it is largely capital financing for buildings, improvements and equipment, not day-to-day costs that force beds to close.

They warn that the fund cannot be used to pay nurses, heat buildings or buy medicines, and say more beds and services will be lost without long-term reforms.

A Department of Health and Social Care spokesman said: “Hospices do incredible work to support people and families when they need it most and when they face incredibly challenging pressures.

“This government has made the biggest investment in hospices in a generation (£125 million) to improve hospices facilities, committing £80 million to children and young people’s hospices over three years.

“We will soon unveil how we will transform palliative and end-of-life care across the country by ending the postcode lottery and ensuring every patient and family gets the quality care and support they deserve.”