Last week, the National Audit Office (NAO) published its report into the financial sustainability of England’s adult hospice sector. It’s not the first time the challenges facing hospices have been highlighted – Hospice UK and hospices themselves have long raised the alarm – but the NAO report reinforces, with independent analysis, what the sector has been saying for years: hospice care is essential, but it’s not being funded fairly or sustainably. 

The report highlights that nearly two-thirds of hospices in England recorded a deficit in 2023/24, and that demand for palliative and end of life care continues to rise. It also confirms that government funding currently makes up just 29% of the sector’s income, leaving hospices to raise the rest through fundraising, retail and charitable donations. 

Here in North Derbyshire, this paints a painfully familiar picture. The local NHS pays for around half of the specialist care we provide at Ashgate Hospice – and only about a third of the total cost of providing our care, which includes everything we do, from nursing and counselling to fundraising, retail, and community services. That means we must raise millions of pounds each year simply to keep our services running. The government funding we have received recently – £844,000 from the national hospice fund – can only be used for buildings and equipment, not to pay the nurses, doctors, counsellors and other specialists who deliver our care. 

So, while the report rightly calls for better oversight and consistency in how hospice care is commissioned, it stops short of addressing the most urgent issue: there just isn’t enough funding to meet the growing need for palliative and end of life care. 

This lack of sustainable funding is why many hospices, including Ashgate, are facing incredibly difficult decisions about the services we can afford to provide in the future. The proposed changes we’ve announced are not choices we want to make – they are the result of local and national funding systems that are simply no longer working. 

Despite these challenges, I’m proud of how our teams continue to deliver outstanding care, compassion and support to patients and those important to them every single day. We will keep doing everything we can to protect the services that matter most to our community. 

Hospice UK has said it clearly: palliative and end of life care must no longer be treated as the poor relation of the health system. We agree wholeheartedly. We stand with our colleagues across the country in calling for full funding of specialist hospice care, proper NHS contracts, funding that matches NHS pay rises, and national accountability to make sure everyone can access the care they deserve, wherever they live. 

At Ashgate, we’re calling on our community to Act Now for Ashgate. The National Audit Office’s findings make clear that hospices cannot continue to bridge the funding gap alone. We’ve launched this campaign to highlight the reality of the crisis we face here in North Derbyshire and to urge national leaders to act before more hospice services are lost.  

Because at the end of life, everyone should have access to expert, compassionate care – not just those who happen to live in an area where the hospice can afford to provide it.