Hospices will have to cut core services next year if they do not receive extra funding – after their income fell by £1.2 million during the pandemic.
Douglas Macmillan Hospice and Lichfield-based St Giles Hospice have warned NHS commissioners about the sustainability of their services in 2021/22 and beyond, due to Covid-19’s impact on charity retail.
Charity shops had to close during both national lockdowns, and even when they have been allowed to trade, footfall has been down.
While both hospices have carried out cost-cutting this year, they say they will not be able to make further efficiency savings without it affecting front-line services.
The chief executives of the hospices told Staffordshire’s health and well-being board that this would have cost implications for the local NHS, which would need to deliver services directly at a higher cost. They called for a long-term funding solution, either nationally or locally, as well as short-term support.
David Webster, CEO of Blurton-based Dougie Mac, said that his charity was also dealing with the takeover of the Donna Louise Children’s Hospice, which was ‘stretching leadership resources’.
He requested a ‘seat at the table’ so Dougie Mac could help shape future palliative and end-of-life provision in North Staffordshire.
Mr Webster said: “We can be more impactful in 2021/22, but we need some assurances of funding support in that time frame, otherwise not all of the clinical services will remain. I think the domino effect of that in the healthcare system would be significant.
“Hospice involvement in strategic plans for palliative and end-of-life care really can’t be left to the 11th hour. We do need a seat at the table at whatever planning discussions that are underway. The sooner we have involvement in that, the more impactful we can be. We have plenty of ideas that we would like to share.
“We have already shown during the Covid pandemic that we are resilient. Both our hospices have worked really hard to shrink our cost base, to make sure our efficiency numbers stack up, and yet still deliver the care to a couple of thousand people that we deliver every year. But that cost-cutting exercise is not repeatable in a second year.”
Mr Webster said hospices are very cost-effective, as they typically bring in £3 of voluntary income for every £1 of statutory funding they receive.
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Emma Hodges, CEO of St Giles, added: “The main concern to point out is that we are in incredibly uncertain times. Neither of our hospices are in a survival situation. However, we are flagging that there are future concerns if funding isn’t reshaped over the next few months, either nationally or locally.
“There have been some green shoots, with some conversations looking a little bit more positive. But I think it’s fair to say that if the funding situation doesn’t improve, we are concerned about the future stability of our services. Not our survival, but certainly whether the breadth of our services is sustainable.”
Craig Porter, managing director of South Staffordshire CCGs, agreed that the pandemic had demonstrated that a more sustainable funding arrangement was needed for the county’s hospices.
But he said any additional funding from the CCGS, which have their own financial issues, would be dependent on the hospices further lowering their costs.
He said: “The issue for the CCGs is that we will work with you on the redesign. Our funding is tied up in the providers we commission. Collectively, we all see the value in the hospices. But that will require us to move funding across the system to enable that sustainable end-of-life, end-to-end pathway that we’re all trying to achieve.
“But it will require all system partners to be able to respond to that positively, and be willing to reduce their cost base to allow the transfer of funding across the partnership, because the underlying position doesn’t allow the CCG to do that in isolation.”