Written evidence submitted by Mary Ann Evans Hospice (AHE0005)

Executive Summary

Mary Ann Evans Hospice is facing a critical financial challenge that threatens its continued operation within the next two years. Despite delivering high-quality, essential palliative and end-of-life care to nearly 3,000 patients annually, the hospice is experiencing a monthly deficit of £65,000. This is unsustainable and places vital services at risk. Commissioners (currently Coventry & Warwickshire ICB) are urged to consider strategic funding interventions to safeguard the future of hospice care in North Warwickshire.

Financial Overview

• Monthly Expenditure: £240,000
• Monthly Income: £175,000
• Monthly Deficit: £65,000
• Annual Expenditure: £2.8 million
• NHS Contribution: £725,000 (24% of total costs)
• Reserves: Projected to fall below 3 months in 2025, breaching policy thresholds

The hospice has historically maintained reserves at 4–5 months, but consecutive deficits in 2024 and 2025 have eroded financial resilience.

Statutory Funding Trends

• NHS funding has declined from 43% to 24% of total income over the past decade.
• Additional services (e.g., Rapid Response) have increased operational costs without proportionate funding uplift.
• Temporary COVID-19 support masked underlying funding shortfalls.
• National average statutory contribution to hospices is 33%—for Mary Ann, this would equate to £950,000, requiring an uplift of £225,000.

The graph below clearly shows the steady increase in expenditure alongside the minimal, or no, increase in statutory funding.

Impact on Local Healthcare System

Mary Ann Evans Hospice plays a critical role in supporting NHS services through:

• Admission avoidance and hospital discharge facilitation
• Reduction in 999/111 calls and Emergency Department attendances
• Support for carers and families, reducing breakdown and crisis interventions

Example: 638 patients received personal care with an average stay of 24 days, directly reducing hospital burden.

If the hospice ceases operations, the system will face:

• Increased demand on urgent and primary care
• Deterioration in patient and carer experience
• Loss of specialised palliative & end of life care capacity in the community

Clinical Services Delivered (2025–26 NHS Contract)

• Family Support & Bereavement
• Hospice Palliative Day Services (Wellbeing Centre)
• Hospice at Home
• Rapid Response (Day & Night)
• Motor Neurone Disease Service
• Complementary Therapy
• Lymphoedema Service (currently unfunded by the NHS)

Strategic Actions & Requests

1. Contractual Funding

• Only provide clinical services that are backed by secured commissioning arrangements.
• Limit Lymphoedema provision to Oncology referrals from UHCW and palliative patients registered with a Warwickshire North GP.

2. Increase Statutory Contribution

• Adjust statutory funding to match the national average 33% to ensure long-term sustainability.
• Incorporate inflationary uplifts, NHS Pension contributions, National Insurance and Agenda for Change pay structures.

3. Support for Income Diversification

• Endorse expansion of retail operations and digital fundraising initiatives.
• Promote Fasttrack referral pathways to enhance care quality and align funding with service delivery.

Conclusion

Mary Ann Evans Hospice is at a tipping point. Without urgent and recurrent funding support, the hospice will be forced to reduce or cease operations, with significant consequences for patients, families, and the wider health system. Mary Ann is seeking a sustainable funding model that preserves this vital community asset.

November 2025

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