Committee publication · Correspondence · 26 January 2026
Letter from the Chief Executive Officer of Hospice UK relating to the Committee’s evidence session on 12 January 2026 on Financial Sustainability of Adult Hospices, 15 January 2025
From: Public Accounts Committee
Inquiry: Financial sustainability of adult hospices in England
Summary
Toby Porter, CEO of Hospice UK, writes to the Public Accounts Committee following their 12 January 2026 evidence session on hospice financial sustainability. He clarifies that while hospice insolvencies are rare, the sector faces accelerating service cuts—380 inpatient beds lost in the past year, specialist home visits down from 610,000 to 460,000. He details hospices' forced retrenchment to preserve reserves and presents Hospice UK's Four Point Plan, calling for £112.5m initial NHS funding from 2026-27, rising to £450m annually by 2030 to fully fund specialist palliative care and stabilise services.
Key findings
- Three small hospices entered administration since 2018 (two in past six months: Shalom House in Wales, Richard House Children's Hospice in England), but closure is rare; service erosion is the dominant crisis.
- Hospice sector lost 380 inpatient beds over past year; specialist home visits fell 24% year-on-year (610,000 in 2023-24 to 460,000 in 2024-25).
- April 2025 Hospice UK assessment found 30% of hospices planning patient-facing service cuts; nationally 220 inpatient beds out of use in England 2024-25 due to funding and staffing shortages.
- Hospices cannot run structural deficits without reserves, unlike NHS trusts; charities must cut services to remain viable when income falls short.
- Hospice UK's Four Point Plan: £112.5m recurring revenue from 2026-27 to fully fund specialist palliative care (escalating to £450m by 2030); multi-year NHS contracts based on agreed costings; funding to match NHS pay rises; national accountability for equitable provision.
Tone
FactualTopics
Key actors
Toby Porter, Hospice UK, Baroness Finlay of Llandaff, Professor Fliss Murtagh, Public Accounts Committee, Department of Health and Social Care, NHS England
Notable line
“To remain financially viable, hospice charities are now cutting services significantly. The attached appendix illustrates the extent of this, and we expect to see far more in the run-up to the next financial year in April, where the sector faces a cliff-edge …”
Key Quotes
“The very much more serious issue for communities and local health systems is the accelerating erosion of hospice care services, including in some of the country's largest and most specialist hospices …”
“Nobody forgives a charity's debt as the health system would forgive a NHS hospital trust or ICB that had overspent their budget.”
“This is why the hospice sector has lost 380 IPU beds over the past year, and why the number of specialist home visits conducted by hospices has reduced precipitously from 610,000 in 2023-24 to 460,000 in 2024-25.”
“Hospice UK's estimate of the additional cost of full funding of hospice specialist palliative care services per annum is around £450m. Recognising the tough fiscal environment we all operate in, our proposal to government has been to move toward this figure incrementally over the next four years, starting with £112.5m from financial year 26-27.”
“By targeting statutory NHS funding to specialist services in this way, this approach would reduce inequity, incentivise scale, standardise commissioning, and allow charitable income to fund enhanced services and facilities.”
Source · parliament.uk record ↗