Hospices in England forced to cut beds and staff amid funding crisis
Hospices in England have cut around 300 beds and reduced staff as nearly two-thirds reported deficits, despite rising demand for end-of-life care, a new report has revealed.
Services have been reduced across the country, creating what campaigners describe as a postcode lottery in access to palliative care — specialist support for people with life-limiting conditions.
The cuts come as demand for such care continues to rise.
The National Audit Office (NAO) found that independent hospices spent £78m more than they earned in 2023–24, with nearly two-thirds running at a deficit.
Ministers were unaware of how reliant they were on independent hospices because of limited oversight, the 52-page report found.
The Department of Health and Social Care (DHSC) and NHS England did not know what proportion of palliative care in England was provided by the independent sector.
By the end of 2024, about 300 inpatient beds had been “deregistered or withdrawn from operation”, though the NAO noted that some closures may reflect patient preferences for home-based care. Staffing levels have also been reduced.
Only 29 per cent of hospice income came from government funding in 2023–24, with most revenue raised through charitable sources such as donations and hospice shops.
The NAO highlighted uneven access to care, pointing to “variation” in hospice provision across England caused by the “unplanned way” the sector developed over the past few decades.
Gareth Davies, head of the NAO, said: “Independent hospices play a key role in providing palliative and end of life care and provide choice for people at the end of their lives.
“With many more people expected to want hospice care in the future, it is crucial that the sector is financially resilient.
“DHSC and NHSE should assess how they would meet increased demand for palliative and end of life care should services delivered by independent adult hospices be insufficient.”
The DHSC said hospices did “incredible work” to support people and recognised the “incredibly tough” pressures they faced.
A spokesperson noted that the NAO report covered a period under the previous government.
“Since then, we’ve made the biggest investment in a generation – £100m – to improve hospice facilities and have committed to £80m for children’s and young people’s hospices over three years,” the spokesperson said.
“We recognise there is more to do, and we are exploring how we can improve the access, quality and sustainability of all-age palliative and end of life care in line with the 10-year health plan.”
The funding crisis comes as England’s ageing population drives growing demand for end-of-life services.
Hospices provide specialist care such as pain management, emotional support and respite for patients and families facing terminal illness.
