Hospices across England are being forced to cut hundreds of beds and staff due to a deepening funding crisis, according to a new report by the National Audit Office (NAO). The findings reveal a growing strain on the nation’s palliative care network, just as demand for end-of-life care reaches record highs.
The NAO’s 52-page report showed that nearly two-thirds of independent hospices in England reported a financial deficit in 2023–2024, with total expenditure exceeding income by £78 million. This shortfall has pushed many hospices to reduce staff numbers and close inpatient beds. Around 300 beds were deregistered or withdrawn from service by the end of 2024, leaving many terminally ill patients with fewer care options.
Unequal Access and Lack of Government Oversight
The report warned that people in need of palliative care face a “postcode lottery” due to vast regional disparities in hospice access. It criticised the Department of Health and Social Care (DHSC) and NHS England (NHSE) for their lack of oversight, noting that neither agency fully understood how dependent they were on independent hospice providers.
Gareth Davies, head of the NAO, said independent hospices “play a key role in providing palliative and end-of-life care” but warned that “the sector must be financially resilient” to meet rising demand in the coming years.
Reliance on Charity Funding
The study highlighted that only 29% of hospice income came from government sources in 2023–2024, with the majority raised through donations, fundraising, and charity shops. This reliance on charitable funding has made hospices vulnerable to economic downturns and shifts in public giving trends.
Experts, including Marie Curie’s executive director for research and policy, Sam Royston, said the NAO findings “mirror the crisis we see daily,” while Sue Ryder’s CEO James Sanderson accused the government of lacking “a clear understanding of the value of hospices.”
Government Response and Recent Developments
The Department of Health and Social Care acknowledged the “incredibly tough” conditions facing hospices but defended its record, saying the findings covered a period under the previous government. The DHSC pointed to recent investments, including £100 million to upgrade hospice facilities and £80 million over three years for children’s and young people’s hospices.
Officials said they are now working to improve access, quality, and sustainability of palliative and end-of-life care under the NHS’s 10-year health plan. However, hospice leaders have warned that without stable, long-term funding, the crisis could deepen further as an ageing population drives demand even higher.
