Callum Murphy is an aide to a Shadow Minister, a school governor and Community Champion for Acorns Hospice.
On Wednesday, the Chancellor will deliver his Budget. Amid the arguments over tax, borrowing and public spending, the financial pressures facing Britain’s hospices must not be overlooked.
I have written before about what hospices mean to families. They provide specialist care, short breaks and support when it is needed most. They also show what communities can achieve through volunteering and charitable giving. Yet rising costs and inconsistent NHS funding are putting these services under increasing strain.
In August, Hospice UK reported that 87 hospices in its financial survey had recorded a combined deficit of more than £70 million in 2025-26, more than double the previous year. Nearly six in ten had made, or were considering, changes to frontline care. Across England, 380 hospice beds were out of use.
These pressures are not confined to smaller charities. Marie Curie reported that NHS funding met just 34 per cent of its hospice costs and 47 per cent of its Hospice Care at Home costs in 2024-25. Sue Ryder said its palliative care staffing costs in 2024 were 170 per cent of the income it received from local NHS commissioners.
Hospices must recruit experienced nurses and specialist staff from the same workforce as the NHS, often without funding that reflects the full cost of providing NHS-commissioned care.
Children’s hospices face particular pressures. Research from Together for Short Lives found that 60 per cent of children’s hospices surveyed ended 2025-26 with an operating deficit, while 84 per cent expected one in 2026-27. In England, 38 per cent had reduced their provision of short breaks and respite care.
These services offer children with complex conditions specialist support, give parents a much-needed break and allow children and their siblings to enjoy experiences other families may take for granted. They make an enormous difference to family life.
As a Community Champion for Acorns Children’s Hospice, I see the importance of this work across the West Midlands and Gloucestershire. Acorns supports seriously ill children and their families through its three hospices and in the community.
But Acorns faces the same financial challenges. Its latest published audited accounts, for 2024-25, recorded a £934,000 deficit, compared with a £781,000 surplus the previous year. Available reserves fell from £7.85 million to £6.29 million.
Its shops, fundraisers and supporters make an extraordinary contribution. Yet charitable giving cannot be expected to absorb ever-rising costs for essential clinical care.
Acorns’ Chief Executive, Trevor Johnson, made that point last year. Capital grants can improve buildings and equipment, but they cannot pay for the specialist nurses needed to care for children each day. Improved facilities matter, but without the staff to deliver care, they are of limited use.
The Government has provided £125 million in capital support for hospices and committed nearly £80 million in revenue funding for children’s hospices over three years. That is welcome, particularly the greater certainty of multi-year funding. But it does not resolve the underlying questions about day-to-day costs and NHS commissioning.
Hospice UK has proposed an initial £112.5 million in recurring support towards an estimated £450 million gap in specialist hospice care. The Treasury should examine the evidence, affordability and scope to reprioritise existing health spending. Any commitment must be properly costed. Another short-term grant alone will not fix the problem.
There are practical reforms ministers should pursue.
First, when the NHS commissions clinical care from a hospice, contracts should reflect the real cost of delivering it. That means fairer, multi-year agreements, clear expectations and proper recognition of staffing and other unavoidable costs.
Second, local NHS bodies should be held to account for what families can actually access. Together for Short Lives found that local NHS spending on children’s hospices ranged from around £407 per eligible child or young person in Shropshire, Telford and Wrekin to just £32 in Northamptonshire. Local needs differ, but a gap of that scale demands an explanation. Commissioners should publish what they spend, what services are available and where gaps remain.
The Government’s planned Modern Service Framework for Palliative and End-of-Life Care should help deliver that accountability, rather than become another document that makes promises without changing provision.
None of this should undermine the independence of hospices. Their volunteers, fundraising networks and deep local roots are among their greatest strengths. Conservatives understand the importance of institutions that exist beyond the state. NHS commissioners should pay fairly for the clinical care they commission, while charitable generosity continues to enrich the support available to families.
This Friday, 30 October, would have been my late brother’s 28th birthday, always a reflective time for me. It is a reminder of why families need confidence that the right support will be there when they need it.
The Government says it wants more care delivered closer to home. It cannot keep making that promise while failing to address the financial pressures facing hospices already providing so much of that care.
The Chancellor must explain why essential NHS-commissioned services remain so dependent on charitable fundraising, and what steps the Government will take to put hospice funding on a more sustainable footing.
Ministers have seen the deficits and heard the warnings. This Budget is their opportunity to show they are taking them seriously. Britain’s hospices, and the families who depend on them, deserve more than warm words and short-term fixes.
Callum Murphy is an aide to a Shadow Minister, a school governor and Community Champion for Acorns Hospice.
On Wednesday, the Chancellor will deliver his Budget. Amid the arguments over tax, borrowing and public spending, the financial pressures facing Britain’s hospices must not be overlooked.
I have written before about what hospices mean to families. They provide specialist care, short breaks and support when it is needed most. They also show what communities can achieve through volunteering and charitable giving. Yet rising costs and inconsistent NHS funding are putting these services under increasing strain.
In August, Hospice UK reported that 87 hospices in its financial survey had recorded a combined deficit of more than £70 million in 2025-26, more than double the previous year. Nearly six in ten had made, or were considering, changes to frontline care. Across England, 380 hospice beds were out of use.
These pressures are not confined to smaller charities. Marie Curie reported that NHS funding met just 34 per cent of its hospice costs and 47 per cent of its Hospice Care at Home costs in 2024-25. Sue Ryder said its palliative care staffing costs in 2024 were 170 per cent of the income it received from local NHS commissioners.
Hospices must recruit experienced nurses and specialist staff from the same workforce as the NHS, often without funding that reflects the full cost of providing NHS-commissioned care.
Children’s hospices face particular pressures. Research from Together for Short Lives found that 60 per cent of children’s hospices surveyed ended 2025-26 with an operating deficit, while 84 per cent expected one in 2026-27. In England, 38 per cent had reduced their provision of short breaks and respite care.
These services offer children with complex conditions specialist support, give parents a much-needed break and allow children and their siblings to enjoy experiences other families may take for granted. They make an enormous difference to family life.
As a Community Champion for Acorns Children’s Hospice, I see the importance of this work across the West Midlands and Gloucestershire. Acorns supports seriously ill children and their families through its three hospices and in the community.
But Acorns faces the same financial challenges. Its latest published audited accounts, for 2024-25, recorded a £934,000 deficit, compared with a £781,000 surplus the previous year. Available reserves fell from £7.85 million to £6.29 million.
Its shops, fundraisers and supporters make an extraordinary contribution. Yet charitable giving cannot be expected to absorb ever-rising costs for essential clinical care.
Acorns’ Chief Executive, Trevor Johnson, made that point last year. Capital grants can improve buildings and equipment, but they cannot pay for the specialist nurses needed to care for children each day. Improved facilities matter, but without the staff to deliver care, they are of limited use.
The Government has provided £125 million in capital support for hospices and committed nearly £80 million in revenue funding for children’s hospices over three years. That is welcome, particularly the greater certainty of multi-year funding. But it does not resolve the underlying questions about day-to-day costs and NHS commissioning.
Hospice UK has proposed an initial £112.5 million in recurring support towards an estimated £450 million gap in specialist hospice care. The Treasury should examine the evidence, affordability and scope to reprioritise existing health spending. Any commitment must be properly costed. Another short-term grant alone will not fix the problem.
There are practical reforms ministers should pursue.
First, when the NHS commissions clinical care from a hospice, contracts should reflect the real cost of delivering it. That means fairer, multi-year agreements, clear expectations and proper recognition of staffing and other unavoidable costs.
Second, local NHS bodies should be held to account for what families can actually access. Together for Short Lives found that local NHS spending on children’s hospices ranged from around £407 per eligible child or young person in Shropshire, Telford and Wrekin to just £32 in Northamptonshire. Local needs differ, but a gap of that scale demands an explanation. Commissioners should publish what they spend, what services are available and where gaps remain.
The Government’s planned Modern Service Framework for Palliative and End-of-Life Care should help deliver that accountability, rather than become another document that makes promises without changing provision.
None of this should undermine the independence of hospices. Their volunteers, fundraising networks and deep local roots are among their greatest strengths. Conservatives understand the importance of institutions that exist beyond the state. NHS commissioners should pay fairly for the clinical care they commission, while charitable generosity continues to enrich the support available to families.
This Friday, 30 October, would have been my late brother’s 28th birthday, always a reflective time for me. It is a reminder of why families need confidence that the right support will be there when they need it.
The Government says it wants more care delivered closer to home. It cannot keep making that promise while failing to address the financial pressures facing hospices already providing so much of that care.
The Chancellor must explain why essential NHS-commissioned services remain so dependent on charitable fundraising, and what steps the Government will take to put hospice funding on a more sustainable footing.
Ministers have seen the deficits and heard the warnings. This Budget is their opportunity to show they are taking them seriously. Britain’s hospices, and the families who depend on them, deserve more than warm words and short-term fixes.