Almost a fifth of UK children’s hospice charities are cutting services or employing fewer staff as a result of financial pressures, according to research published today.
The research, commissioned by national charity Together for Short Lives, found that while most hospices had managed to maintain service levels over the past year, nearly half had used reserves to do so.
A third had reduced short breaks or respite care, while a smaller proportion had cut hospice-at-home services and end-of-life care.
The findings came against the backdrop of an 18% sector-wide rise in charitable expenditure year on year, and a 21% increase in overall expenditure.
While national statutory funding had risen by 1% overall, this was only covering around 26% of charitable expenditure, with most of the rest sourced via hospices’ charitable income.
The report follows a recent letter to Downing Street from membership body Hospice UK urging an additional £112.5m in recurring revenue funding, among other measures, from the government.
‘Considerable strain’ of staffing costs
Almost all hospices responding to Together for Short Lives’ survey said the cost of recruiting and retaining skilled staff was a key factor – along with price rises and increased need – driving up spending.
The UK’s children’s hospices, which operate as charities, compete with the NHS for clinical staff and as such, the research found, a third align their pay scales.
This “places considerable strain [and rising] on hospice finances”, the report says, noting that the NHS 2026-27 pay award included funding for a 3.3% salary increase.
It warns that spending pressures “show no sign of easing” and that children’s hospices expect a further 7% rise during 2026-27 in the UK as a whole, and 8% in England.
The findings were based on survey responses from 27 of the UK’s 38 hospice organisations that provide care to seriously ill children.
Three-fifths of respondents ended the 2025-26 year facing an operating deficit, which extrapolated to include all children’s hospice charities would amount to an estimated £4.4m UK-wide shortfall.
Without action, the situation is expected to worsen with more than four in five hospices forecasting an operating deficit in 2026-27 and an estimated UK-wide shortfall of £34.3m, the report warns.
Local funding lottery
Researchers also found wide inequalities in levels of local NHS funding for hospices, which supplement the national children’s hospice grant.
Freedom of information requests sent to all 36 of the UK’s integrated care boards (ICBs) revealed that on average they spent £162 per child or young person with a life-shortening or life-threatening conditions, or severe medical complexity. But this varied from £407 in Shropshire, Telford and Wrekin to £32 in Northamptonshire.
Researchers found funding from local authorities – which have a statutory duty to fund respite care for family carers – had halved between 2024-25 and 2025-26. This left it covering 1.4% of children’s hospice charities’ expenditure.
Nick Carroll, chief executive of Together for Short Lives, said hospices “continue to be let down by a system that varies wildly according to where they live and, too often, overlooks them”.
“As demand for care grows and becomes more complex, unfair and unsustainable funding is pulling us further away from the government’s goal: that every person who needs palliative or end of life care in England will have equitable access to high quality support, shaped by what matters to them, their families and carers,” he added.
‘Ministers must act now’
A series of recommendations in the new report explicitly backed Hospice UK’s demands for a fairer funding model and urged the Department for Health and Social Care (DHSC) to work with ICBs to better understand local need, and to hold the regional bodies to account.
“I urge ministers to act now to fairly and sustainably support children’s hospices by fully funding children’s hospice’s clinical care year on year, filling the £310m children’s palliative care funding gap and better supporting NHS bodies,” Carroll said. “We cannot wait for a new government framework. If they do not, more demands will be loaded onto overstretched hospital services and too many families will be isolated and alone.”
A DHSC spokesperson acknowledged hospices face “incredibly tough pressures”.
“This government made the biggest [capital] investment in hospices in a generation – £125m – to improve hospice facilities, freeing other funding for patient care, and has committed £80m for children’s and young people’s hospices over three years,” they said.
“In autumn 2026, we will publish a new framework to modernise and improve the palliative and end-of-life care sector, as we shift more healthcare out of hospitals and into the community, with hospices playing a central role in delivering care closer to home.”
