Three leading London hospices are today calling on central government to step in after their urgent and repeated requests for more NHS funding from the South West London Integrated Care Board (SWL ICB) have not been successful.

Following last week’s announcement from Hospice UK that one in five UK hospices have either cut specialist palliative and end of life services in the last year or plan to do so, three south west London hospices, St Raphael’s Hospice, Princess Alice Hospice and Royal Trinity Hospice, are warning that only a change in approach from central government can address the funding crisis.

St Raphael’s Hospice, which provides end of life and palliative care to people living in Merton and Sutton, announced last week that it is proposing cuts to its community, medical and psychosocial services of £1M after seeing their annual costs rise by £1.1M in the last few years but with only £140k uplift in its NHS funding over the same period.

Last year, the three south west London hospices collectively spent £14.9M to deliver core and specialist services. Only £4M of that was funded by the NHS*. Each hospice is an independent charity, but together they are commissioned by SWL ICB to deliver specialist palliative care, free of charge, to people living in the region.

The three hospices providing care in the SWL ICB area have consistently warned local commissioners that the 23-30% contribution towards their combined core costs is insufficient. Despite warning of the impending need to reduce services at St Raphael’s Hospice, the local NHS commissioners have still taken no action.

Last week’s news of reductions in services and proposed redundancies at St Raphael’s Hospice sadly means that fewer people with a life-limiting illness will receive the timely, specialist care they need to live and die with dignity in south west London.

Hospices exist to give people at the end of life the comfort, dignity and independence they deserve for as long as possible, and the care and support they need to die well. Many people are unaware that hospice care is not fully funded by the NHS and that they instead rely on donations, charity shops and community support to fund their care.

Nick Stevens, CEO at St Raphael’s Hospice said:

“To be forced to make such substantial cuts is devastating for St Raphael’s and the community we are proud to support. We know that the palliative and end of life care we provide to people at the end of their lives is desperately needed but we simply cannot sustain a £1.1M deficit if we want our incredible hospice to have a future.

“Our proposed cuts include reducing our Community Clinical Services by 33% which will put immediate additional pressure on the already stretched local services including hospitals, GPs, district nurses, ambulances and other healthcare teams. As a result, NHS patients are likely to reach crisis point sooner, resulting in more A&E attendances and hospital admissions to avoid patients deteriorating at home with their symptoms unmanaged.

“Making some of our specialist, loyal and dedicated clinical staff redundant is our absolute last resort but we see no other way forward. We are urging the SWL ICB to reconsider its funding immediately so that we can stop as many of these devastating cuts as possible becoming a reality.”

Lesley Munro, Deputy CEO & Director of Patient Care and Communities at Princess Alice Hospice said:

“Princess Alice Hospice works primarily to support local patients and families, as well as our health and care colleagues in other organisations. 

“We believe the SWL ICB’s short-term decision not to increase funding adequately for St Raphael’s Hospice, Royal Trinity Hospice and ourselves now will cost them more in the long run. 

“Patients will still need specialist care, and people will continue to die. Reduced hospice services will lead to more hospital admissions, costing the wider local healthcare system more money. Patients discharged from hospital for specialist palliative care at home or another setting will experience delays, causing longer hospital stays. 

“Our population is aging, living longer, and with more complex, multiple conditions, creating increased demand on services such as primary care, NHS community nursing and therapy services. Reducing hospice funding will simply mean costs being met elsewhere in the system. It will also mean that there is a widening gap of inequitable access to specialist end of life care, which is unacceptable. 

“We urge the Government to discuss and plan hospice funding as a priority, before we see vital services continue to be cut, impacting patients, families, communities and the wider health and care system.“ 

Emily Carter, Chief Executive Officer at Royal Trinity Hospice said: 

“Having a good, dignified death and dying well in a compassionate society should be fundamental for everyone. At Royal Trinity Hospice, we are extremely fortunate that our generous local community raises millions of pounds every year to help make a good death possible for our patients.

“However, our costs have increased significantly over the past two years. We need to make sure we pay our skilled staff a fair wage and have had to absorb the impact of the increased costs of food, fuel and electricity, which of course also increases the cost of raising funds, all while responding to the significant increase in people dying who need our support.

“We have been running a deficit for the past three years because NHS funding has not responded to our growing costs. We have been raising serious concerns to our NHS commissioners about the level of funding we receive which needs to increase for us to be here in the future. We warned SWL ICB in January 2024 that services were at risk if this was not addressed and very sadly their inaction has now indeed seen St Raphael’s forced to cut vital services. We need a national funding package from the government to sort this out because local NHS commissioners are clearly not solving this problem.”

*Royal Trinity Hospice and Princess Alice Hospice provide services in other ICB areas and this figure relates to the contracts relating to provision of care in South West London only.