Written evidence submitted by East Cheshire Hospice, Cheshire & Merseyside Hospice Provider Collaborative (AHE0010)

 

This submission is on behalf of the Cheshire & Merseyside Hospice Provider Collaborative, which is a collaboration between 11 Adult Hospices and 1 Children’s Hospice within Cheshire & Merseyside Integrated Care Board boundaries, who are working together to support one another and to raise the profile of Specialist and Enhanced Palliative and End of Life Care Services with the Cheshire and Merseyside Integrated Care Board and within the 9 Places in Cheshire & Merseyside – serving a total population of 2.7M. 

 

Hospices Key Issues:

 

  1. We have identified a funding shortfall of at least £6M to sustain Specialist Core Inpatient Unit provision only, which is set out as a statutory NHS responsibility in the “NHS Commissioning and Investment Framework for Palliative and End of Life Care”
  2. We have lost services; in 24/25 the region has permanently lost 18 SPC Beds from Marie Curie Liverpool, the Hospice of the Good Shepherd Out of Hours Specialist Palliative Care Advice Line ended, Queenscourt Virtual Ward with Rapid Response also ended. 
  3. All our hospices have risks around funding, workforce and digital/cyber security.  Hospice costs are consistenly escalating adding more risk and pressure. Hospices’ workforce are naturally relatively small and therefore workforce gaps impact on service resiliance quickly, agency staff is expensive and adds to the worsening financial situation but are often needed to maintain provision.  This can result in the need to temporarily reduce activity, impacting on patient flow in the system and individual patients do not get the good end of life care they would want.  For Cyber, the sector incurs a disproportionate rise in insurance premiums year on year. 
  4. Cheshire & Merseyside have delivered a Palliative and End of Life Care Population Based Needs Assessment which shows the current demand for Palliative and End of Life Care services against current limited provision putting pressure on the whole healthcare system and showing the expected growth demand over the next 5 years for which we are unprepared.
  5. We have a Hospice Review Programme underway with Cheshire & Merseyside ICB anticipated to run over 3 years to look at sustainability of our hospices.  The work is slow, with risk that the work will not deliver before some are forced to make service cuts.  Impacted also by the backdrop of significant efficiencies having to be made in the NHS, there is a risk that the ICB see this Hospice review as a cost cutting exercise.
  6. A request to the ICB in 2023/24 for a phased 6 year investment plan of £7M was rejected. This would have stabilised all the hospices in the collaborative, significantly reducing the risk of closure.
  7. Our Hospices generally all receive less NHS funding than the national average of 34%, one as low as 8% with hospice investment from the NHS standing at only £5.44 per head of population against the national average of £7.35 – this is a widening gap which confirms the funding gap at between £6M - £7M just for specialist Inpatient care.
  8. Specialist palliative care bed capacity is low at 126 beds available against the recommended number of 179 beds (53 bed shortage) this includes the loss of Marie Curie Liverpool 18 beds with our near hospices responding to the need in Liverpool as best they can, many SPC patients are diverted to Acute trusts, some receiving corridor care with many losing the dignity of dying in their preferred place of death without the specialist holistic care and support hospices offer for them and their loved ones.
  9. We have little confidence as a sector of being robustly engaged by the ICB and Place leaders in developing the Neighbourhood Model of care being developed from the NHS 10 year plan, despite our best efforts we have had limited response from the ICB on this engagement in the planning stage, although there are 2 Places who are pilot areas being St Helens and Sefton Places.  We will be keen to see how the local hospices are engaged.

 

November 2025