Financial sustainability of adult hospices in England

Status / emerging findings

• Hospices raise £1.2bn annually but receive only £420m statutory funding from ICBs—effectively subsidising the NHS by £800m per year
• Two in five hospices are making service cuts despite specialist palliative care saving £6,500–£8,000 per death versus acute hospital care
• Care quality is deteriorating: one in five families now report poor GP care in final months (up from 12% in 2015); one in three people needing palliative care receive none
• Current system delivers 42% of deaths in hospitals (expensive, often unwanted) versus 5% in hospices; most people prefer to die at home (28% do)
• Department's Modern Service Framework remains underdeveloped with no clear timeline; ICBs themselves are understaffed and undergoing reorganisation

Why it matters

The independent hospice sector is quietly collapsing while the NHS avoids spending money on the most cost-effective end-of-life care, leaving dying people with worse outcomes and forcing families to fund care through private charity.

Tone arc

Opened procedural; shifted to crisis-framing after January 2026 evidence session revealed scale of financial subsidy and care quality decline; committee response letters (March–April 2026) show hardened critical tone toward Department inaction.

Key witnesses

Baroness Ilora Finlay of Llandaff (palliative care expert), Toby Porter (CEO, Hospice UK), Sir Jim Mackey (NHS England leadership), Dr Amanda Doyle OBE, Samantha Jones (Department of Health and Social Care), Sue Ryder (national hospice chain), Marie Curie (national hospice chain)