Hospice Cuts Raise Alarm Across England Amid Funding Crisis

Published: 29 October 2025. The English Chronicle Desk. The English Chronicle Online.

Hospices across England are facing a growing funding crisis that is forcing hundreds of cuts to beds and staff, even as demand for palliative and end-of-life care continues to rise sharply. A recent report by the National Audit Office (NAO) has revealed a worrying postcode lottery in access to hospice services, highlighting how uneven provision has left patients vulnerable and families struggling to find adequate care.

The NAO report, spanning 52 pages, paints a stark picture of a sector grappling with financial instability. Ministers were found to be largely unaware of the scale of the NHS’s reliance on independent hospices, leaving gaps in oversight and planning. According to the report, nearly two-thirds of independent hospices in England reported a deficit in 2023-24, with overall expenditure exceeding income by £78 million. This shortfall has prompted institutions to cut back on inpatient beds and staff at a time when demand for services is increasing due to an ageing population and rising numbers of patients with life-limiting conditions.

By the end of 2024, approximately 300 inpatient beds had been deregistered or withdrawn from operation. While some closures may reflect patient preference for home-based care, the scale of these reductions underscores the pressures facing the sector. Hospice staff, often providing essential end-of-life care, are also being affected, with many facing job insecurity as organisations strive to balance budgets against surging demand.

Gareth Davies, head of the NAO, stressed the vital role played by independent hospices. “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,” he said. “With many more people expected to want hospice care in the future, it is crucial that the sector is financially resilient. DHSC and NHS England 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 NAO also highlighted “variation” in where hospices are situated across England, noting that the sector’s unplanned growth over decades has led to a patchwork system of provision. Some regions are better served than others, creating inconsistencies that leave many families without timely access to specialist care. Experts argue that this underlines the “inconsistency and insufficiency” of how hospices are funded. In 2023-24, government funding accounted for just 29% of income for hospices, with most of the sector’s revenue coming from charitable sources, such as donations, fundraising events, and charity shops.

Sam Royston, executive director for research and policy at Marie Curie, said the NAO findings mirror the daily reality he witnesses in the sector. “This report confirms the crisis we see on the ground,” he said. “Hospices are under immense pressure to provide high-quality care with limited and unpredictable funding. Without urgent support, more beds will close and staff will be lost, leaving vulnerable patients and families without crucial care at the most difficult times.”

James Sanderson, chief executive of Sue Ryder, echoed these concerns. “The NAO report exposes the government for not having a clear picture of the value of hospices and their essential role in end-of-life care,” he said. “The lack of strategic oversight has created a fragile system that struggles to meet demand and risks leaving patients without adequate support.”

The Department of Health and Social Care (DHSC) acknowledged the challenges facing hospices but highlighted the sector’s vital contribution. “Hospices do incredible work supporting patients and their families,” a spokesperson said. “We recognise the incredibly tough pressures they face and are committed to ensuring services remain available and sustainable.”

The spokesperson also pointed out that the NAO report primarily covers a period under the previous government. Since then, the current administration has pledged significant investment, including £100 million to improve adult hospice facilities and £80 million over three years to support children’s and young people’s hospices. In addition, work is underway to enhance access, quality, and sustainability of palliative care in line with the NHS’s ten-year plan.

Despite these investments, advocates warn that urgent action is still required. The NAO report highlights that without long-term funding stability, the sector will continue to face uncertainty. “We cannot rely on charitable donations alone to sustain end-of-life care,” said Royston. “The government must ensure that independent hospices have the resources needed to meet rising demand and provide consistent, high-quality care across England.”

The human impact of these cuts is stark. Families seeking hospice care often face delays or travel long distances to access services, adding stress during already challenging times. Patients with terminal illnesses may receive reduced support, while hospices struggle to provide comprehensive care with fewer staff and beds. Many hospice staff, including nurses, carers, and volunteers, report that rising workloads and resource shortages are affecting the quality of care, leading to burnout and staff attrition.

The report also highlights a broader issue: the lack of clear data on how much palliative care is delivered by the independent sector. DHSC and NHS England reportedly have limited information on the proportion of end-of-life care provided by hospices, making it difficult to plan for future demand and allocate resources effectively. Without better oversight and planning, experts fear that gaps in care will widen, particularly in underserved regions.

As the UK population ages and more people require palliative care, the NAO warns that the current trajectory is unsustainable. “Independent hospices are essential to the health and wellbeing of thousands of people every year,” said Davies. “It is vital that government and healthcare bodies work together to ensure the sector is financially secure and capable of meeting increasing demand.”

The report has sparked renewed calls for government action. Advocates are urging policymakers to develop a long-term funding strategy, improve oversight, and ensure equitable access to hospice care nationwide. “This is not just a financial issue; it’s a question of dignity and choice for people at the end of their lives,” said Sanderson. “We must act now before more services are lost and more families are left without vital support.”

The NAO findings underline the urgent need for strategic investment and stronger government oversight to protect hospice services and the patients who rely on them. Without immediate and sustained action, the report warns, the independent hospice sector risks further instability, placing additional pressure on the NHS and leaving vulnerable individuals without the care they deserve.