The hospice that paused its day room

The Shakespeare Hospice sits in Shottery, on the edge of Stratford-upon-Avon, and the Care Quality Commission rates it outstanding. This month it told people who use its day services that those sessions are pausing. Occupational therapy ends in September. From October the day room — the drop-ins, the Living Well programme for people living with a life-limiting illness — is being set down so that hospice at home and bereavement support can keep running.

Tracey Sheridan, the chief executive, told the BBC the decision had not been taken lightly. Without the pause, she said, the future of the hospice itself would be at risk. NHS funding covers about 12 per cent of its income. The Stratford Herald puts the annual cost at about £3 million, and last year’s deficit at £804,000, some £500,000 larger than the year before. Around forty people will feel the day-service change directly. The announcement came seven months after a £35,338 grant for facilities.

That is one Warwickshire charity, rated outstanding, pausing the part of its work that looks most like ordinary life.

This week Channel 4 News published exclusive figures from Hospice UK that describe the same arrangement across England and Wales. In 2024 the government gave those hospices more than £450 million. Delivering the care cost around £1.2 billion. The difference, £745 million, is money they had to find themselves. In 2012 the gap was £414 million. By 2023 it had reached £650 million. Extra Covid grants are the only dip in a line that otherwise climbs.

Toby Porter, Hospice UK’s chief executive, told Channel 4 that hospices “cherish the generosity of their local communities” and are “all too often dependent on these communities giving more and more to bridge the gap.” The gap, he said, “has become untenable”, and “it is ultimately the patients who pay the price.”

A Department of Health and Social Care spokesperson pointed to £125 million for facilities and a further £80 million for children’s and young people’s hospices, calling it the biggest investment in a generation. The buildings money is real. It is also a different kind of money from a nurse’s shift. The Public Accounts Committee said so in March: the capital is welcome, it is one-off, and it does not cover the cost of running the care. Independent adult hospices, the committee noted, save the NHS more than £800 million a year by helping around 20,000 people die outside hospital. Integrated Care Boards put in around £420 million toward a £1.2 billion bill.

Hospice UK’s latest benchmarking, drawn from the last financial year, found English hospices more than £70 million in the red — more than double the year before. Almost six in ten have made changes to services or are considering them. There are now 380 hospice beds unused.

In Southport, Queenscourt Hospice halved its inpatient ward, ten beds to five. NHS money covers about 24 per cent of its costs. Victoria Bassett, whose husband Richard spent his last weeks there, told the BBC they had their daughter’s fourth birthday party on the ward. She believed the care gave them an extra month. That is what a bed is.

Charlie King, at Hospice UK, said the quiet part when Queenscourt announced the cut: pain relief, medicines and nurses’ pay should not have to rely on bake sales, fun runs and the sale of second-hand clothes.

Echoleft can host a memorial that raises money for a hospice, if a family wants that. Plenty of families will not. Neither choice fills a hole this size. People give in memory because a hospice made a last month possible. A charity-shop till, or a page that collects donations after a funeral, is currently doing the work of a health contract. The giving is real. The contract is still missing.

A gift in memory cannot close a £745 million gap. It was never supposed to be asked to. If you want to give to a hospice because someone you love was in that day room, or because there is no longer a day room, that is yours to decide, in your own time. What the NHS pays for the care itself remains a public question, and it is still unanswered.