Nearly two-thirds of independent adult hospices have recorded a deficit, with £78m more spent than earned, according to a National Audit Office report.
The report, which examines the financial sustainability of England’s adult hospice sector, found the proportion of hospices recording a deficit in 2023-24 was “by far” the highest over the preceding 10 years.
It reported that in 2023/24 the independent adult hospice sector, including Marie Curie and Sue Ryder, overall spent about £78m more than it generated in income.
The report examined financial data provided by Hospice UK, which collects annual accounts from all 135 independent adult hospices in England, covering the period from 2014/15 to 2023/24.
Over the past decade, 2023/24 was the first year when total spend exceeded total income by more than £10m, in real terms.
The proportion of hospices reporting a deficit in 2023/24 stood at 64 per cent, the highest proportion across the period examined.
The NAO also found that the the Department of Health & Social Care and NHS England do not know how much of the palliative and end-of-life care provided in England is delivered by the independent adult hospice sector, and therefore how reliant they are on the sector.
“DHSC and NHS England do not know the total amount the NHS spends on palliative and end-of-life care, nor the proportion provided by the independent adult hospice sector,” the report states.
The report found that the way DHSC and NHS England provide funding to hospices makes it difficult to determine the level of activity delivered, adding that limited financial and activity data are available.
“Independent hospices play a key role in providing palliative and end-of-life care and provide choice for people at the end of their lives,” the report said.
Gareth Davies, comptroller and auditor general, head of the NAO, said: “With many more people expected to want hospice care in the future, it is crucial that the sector is financially resilient.
“DHSC and NHSE should assess how they would meet increased demand for palliative and end-of-life care should services delivered by independent adult hospices be insufficient.”