When Care Is at Risk: Hospice Funding, Workforce Pressures and What We Can Do

For many families, hospices are sanctuaries of compassionate, person-centred care at the end of life. St Wilfrid’s Hospice in Eastbourne has announced reductions to its community services due to severe financial pressures. These are not choices, but responses to a funding model that is becoming increasingly unsustainable.

Across England, the picture is similar. According to Hospice UK, around three-quarters of hospices are running deficits. Rising demand is colliding with flat charitable income and limited statutory funding. Beds have been taken out of use, community services reduced, and specialist posts cut.

Today’s announcement of a 3.5% Agenda for Change pay increase for NHS staff, while fully deserved, adds further strain. Most hospices align pay with NHS scales to recruit and retain skilled nurses, doctors and allied health professionals.

Unlike NHS trusts, however, hospices are not fully funded to absorb these increases. Without equivalent government uplift, they face growing difficulty retaining clinical staff, at a time when workforce stability is critical.

Why This Matters

Hospice care safeguards dignity, comfort and emotional wellbeing at the end of life. Yet on average, only 30–40% of hospice funding comes from the NHS or government; the rest relies on donations, legacies and fundraising. Inflation, rising employment costs and economic pressures are eroding sustainability, leading to fewer beds, reduced outreach and increasing postcode inequality in access to specialist palliative care.

What We Can Do

While systemic reform is needed, individuals and families can act:

Have open conversations about wishes for care, treatment preferences and priorities.
Document choices through advance care plans or advance decisions to ensure clarity for loved ones and clinicians.
Advocate for fair funding by engaging with MPs, Integrated Care Boards and campaigns led by Hospice UK.

Some families are also exploring support from end-of-life doulas — non-medical practitioners who provide emotional, practical and advocacy support. They do not replace clinical care but can complement overstretched services. Organisations such as End of Life Doula UK are helping strengthen standards and integration in this emerging field.

Final Thought

The challenges facing St Wilfrid’s Hospice reflect a national crisis — now intensified by rising staffing costs and the additional pressure of the 3.5% pay award. Protecting hospice care requires both personal action and collective advocacy, so that dignity, compassion and choice at the end of life remain accessible to all.