Palliative care organisations are urging the Government to match its promises with funding in the Budget, calling for a £200million-a-year transformation fund to help ensure more families receive high-quality end-of-life care and support. Marie Curie, Sue Ryder and Hospice UK are among the groups backing the proposal.
The appeal follows Prime Minister Andy Burnham’s warning that palliative care must be improved before Parliament can properly debate the legalisation of assisted dying. Many MPs and parliamentarians pointed to the severe underfunding of end-of-life services when explaining their opposition to the Terminally Ill Adults (End of Life) Bill.
Dr Sam Royston, Marie Curie’s director of policy and research, said: “Now is the absolute critical time for all of those words that have been shared about the state of palliative care to turn into action. The Prime Minister himself said that palliative care is not in a good enough state, it needs fixing.
“This has to be an urgent priority for the Government. We need it to be taken seriously. The Budget provides a great opportunity for them to do something about it.”
Marie Curie research indicates that almost one in three people die without receiving end-of-life care. That proportion is expected to increase by 24% by 2050 as the population continues to age rapidly.
Dr Royston described palliative care provision across the country as “a complete patchwork”, made up of “bits and pieces of care being provided in different ways in different places”.
Insufficient support in the community can leave patients spending days, weeks or even months in hospital, despite preferring to remain at home. Emergency hospital care accounts for 56% of all healthcare spending on people in the final year of life, compared with just 11% allocated to primary and community care.
The Government has set a target of cutting unplanned hospital bed days by 10% over the next three years. Ministers are also expected to publish a full Modern Service Framework (MSF) for Palliative and End-of-Life Care in England this autumn, outlining planned reforms and targets.
Dr Royston said those goals would be achievable only if the framework was supported by enough funding for local health leaders to commission services tailored to the needs of their communities.
He added: “Part of the purpose of this transformation fund is that it should be up to individual health commissioners to make the call on what works for their local area. There are so many examples of good practice to choose from across so many different settings.
“If what we end up with is just another plan that’s going to sit on a shelf and nobody will be able to act on it because there’s no money to actually deliver it, then it would be simply outrageous. Setting that up with the money to deliver it in the Budget would be a really big step forward.”
Marie Curie’s proposed £200million-a-year transformation fund has won support from several medical royal colleges, including the Royal College of Emergency Medicine, the Royal College of General Practitioners and the Royal College of Nursing. Age UK and the British Geriatrics Society are also backing the call.
James Sanderson, chief executive of palliative care and bereavement charity Sue Ryder, said the proposal “could be a once in a generation chance to make sure all dying people receive the right care”.
He added: “When someone with terminal illness is in pain and without support in the middle of the night, it is the loneliest and scariest place to be.
“When someone is dying in a busy hospital corridor and their loved ones don’t have the privacy to say goodbye, they feel helpless, fearful and even guilty.
“This isn’t the end of life that we would want for the people we love, but it is the reality for far too many people. Before the year is out, we need to see its plan, and in the Budget, we need to see the financial commitment to make that plan a reality. Otherwise, the people we love will continue to suffer needlessly.”
Hospice UK has also endorsed the wider investment proposal while making a separate call for an immediate £112.5million to support the struggling hospice sector. The sum would represent the first quarter of the £450million the charity says is required to fully fund specialist palliative care delivered by hospices.
Charlie King, Hospice UK’s director of external affairs, said: “Too many hospices are being pushed to breaking point, with vital services being cut and seriously ill patients and their families at risk of missing out on the care they desperately need.”
According to the charity, Government funding covers an average of only 40% of care provided by adult hospices and one-third of the costs incurred by children’s hospices. State support also varies significantly, ranging from as little as 3% of funding at some hospices to as much as 80% at others.
Research suggests that three-quarters of hospices in England were operating at a deficit in February, while almost six in 10 had either cut frontline services or were considering doing so.
Mr King added: “Hospices rely heavily on the generosity of local communities to keep essential services running, but charitable fundraising alone cannot sustain the care that patients and families depend on. We urgently need a fairer, more sustainable funding system.
“The Chancellor must use this Budget to act. We are calling for an immediate £112.5 million a year funding boost, alongside a long-term commitment to fully fund specialist palliative care, fair NHS contracts and support for staff pay.
“No one should face the end of their life worrying about whether the care they need will be there. The Government must stop leaving hospice care to chance.”
