The Government’s recent announcement of £80 million in additional support for children’s hospices over the next three years is a welcome step forward. It follows sustained calls from the children’s hospice sector and from my Liberal Democrat colleagues for greater security and stability in funding.
This three-year settlement will provide some breathing space. It will allow hospices to plan and deliver care with greater confidence, and it will ensure that seriously ill children and their families can continue to access vital support.
The reality, however, is that this announcement will not end the financial crisis facing children’s hospices. It will, at best, slow the rate at which services are being cut. Without further action, many of these essential providers will remain on a precarious footing.
Across England, children’s hospices support thousands of babies, children and young people with life-limiting conditions, as well as their families. They offer expert medical care, respite, and emotional and psychological support. For many families, hospices are a lifeline.
Yet the pressures on the sector are intensifying. Since 2019, the number of children and young people needing end-of-life care has doubled, and demand for symptom management has risen by 108%. Inflation and workforce costs have increased expenditure by around 15% in just the past year. Local NHS funding from Integrated Care Boards (ICBs) remains 18% lower than three years ago, even as demand continues to rise.
As a result, hospices are dipping into their reserves simply to stay open. In 2024/25, 59% of children’s hospices ended the year in deficit; next year, that figure is expected to rise to 91%. This is clearly unsustainable.
At the same time, a postcode lottery in funding continues. Research by the charity Together for Short Lives found that some ICBs in London spent over £400 per child needing palliative care, while others spent less than £25. In the South East, one ICB spent more than £260 per child, while another spent just over £100. Only a third of ICBs could even say how many children in their region accessed hospice care.
This lack of consistency and transparency must be addressed. If funding continues to be distributed through ICBs, we must ensure that it is done fairly and equitably across the country. NHS England and the Department of Health and Social Care should set clear expectations and hold local systems accountable for delivery.
The hospice workforce crisis also demands urgent attention. There are currently only 24 full-time equivalent paediatric palliative medicine specialists serving the entire UK – when we know that at least 40 to 60 are needed. Following Royal College of Nursing guidance, England should have nearly 5,000 community children’s nurses; in reality, there are fewer than 1,000.
If we want to secure the future of children’s hospice care, three actions are essential.
First, the Government must commit to longer-term NHS funding to close the £310 million gap in children’s palliative care across hospitals, communities and hospices.
Second, we need a more coherent commissioning system. NHS England and DHSC should model what each ICB should be spending on palliative care, hold them accountable, and commission regionally where appropriate to achieve economies of scale and consistency.
Third, we must invest in the workforce – including £2.4 million per year in GRID and SPIN training for paediatric palliative medicine, and proper funding for safe staffing ratios for nurses.
Children’s hospices provide exceptional value – delivering £3.32 of care for every £1 invested by the state. But beyond the numbers, this is about ensuring that every child and family receives the compassion, dignity and care they deserve.
The Government’s latest announcement is a positive start, but a short-term injection of funds cannot substitute for a sustainable, long-term settlement. If ministers truly wish to deliver on the vision set out in the NHS Long Term Plan – one in which hospitals, hospices and community services work together to provide high-quality end-of-life care – then now is the time to act.
No child should be left without care. No family should face this journey alone. And no hospice that provides such vital support should have to fight for its survival year after year.
Three year financial settlements for children’s hospices will not resolve the funding crisis, but are a step in the right direction
