Ministers urged to match funding for cash-strapped hospices sector
Hospice staff providing palliative care across Scotland are at risk of being perceived as “less important” than their counterparts in the NHS unless the Scottish Government provides pay parity, according to a senior figure at Scotland’s largest independent provider of end of life care.
Amy Dalrymple, associate director of policy and public affairs for Marie Curie Scotland, called on Scottish ministers to take action in order to recognise that independent and charitable providers are an important part of Scotland’s health and social care workforce, and stressed there was a “fundamental question” over why palliative care should be so reliant on the goodwill of donors.
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Hide AdAt a time when the hospice sector is coming under unprecedented financial pressure, another leading charity, Hospices UK, also warned that with government funding failing to keep pace with rising costs, many hospices in Scotland were at risk of having to make “difficult cuts.”
Earlier this month, Scottish ministers tabled a 5.5 per cent pay increase for NHS nurses and healthcare staff across Scotland to ensure they have the best pay package in the UK. That offer, if accepted by trade unions, will see an investment of more than £448 million in 2024/25. But with hospices recruiting from the same pool of staff as the NHS, there are concerns about the knock-on effect.
Ms Dalrymple said: “The Scottish Government’s workforce plan says independent and charitable providers are an important part of its health and social care workforce, but it says nothing whatsoever about what they’re going to do about recognising that.
“When you give a very well deserved pay award to NHS staff, but don’t provide funds for an equivalent uplift for contracts with providers like ourselves, you’re effectively saying those staff are less important to the effort to retain a wider health and social care workforce. That’s not a choice we agree with.”
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Hide AdMs Dalrymple pointed out that there were widespread disparities around the funding received by hospices from health and social care partnerships (HSCPs) across Scotland, and stressed there were broader structural problems that meant the skills of hospice care teams were not being utilised as best as possible.


“We can be budgeting for one health and social care partnership paying 29 per cent of the service they are commissioning, whilst some pay over or around 50 per cent - there’s an average of about 40 per cent across Scotland,” she explained.
Ms Dalrymple stressed the long-term solution was “not necessarily about more money,” but better partnership working and recognising the role played by palliative care. “It’s about having a service level agreement, a three year plan, and working it out in a way that isn’t just about an HSCP paying Marie Curie or another hospice for service provision for 12 months, where you’re really working hand-to-mouth, and can’t do any workforce planning,” she added.
“Our big campaign at the moment is about the right to palliative care, and recognising that so much of the resource use in our health and care services is on people in the last year of their lives. But most of those people are receiving that care from GPs, district nurses, and care homes. If we can do end-of-life care better and recognise the role of palliative care, it goes a long way to solving a lot of problems.”
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Hide AdLast week saw the publication of a major study funded by Marie Curie which revealed that across England and Wales, one in three dying people were severely or overwhelmingly affected by pain in the last week of life, with bereaved people reporting difficulty in obtaining joined-up support from health and care professionals at home. While there has been interest in the situation in Scotland’s devolved healthcare system, Ms Dalrymple said it was not possible to produce a similar analysis given the limitations of the data currently available to researchers and policy makers.
“While we do have some decent health data in Scotland, it’s very hard to access and there are massive gaps in it,” she said. “The reason that report didn’t cover Scotland as well as England and Wales is because there’s no way to carry out that survey apart from what academics call a convenience sample, which basically involves going on social media and engaging whoever wants to reply.”


It emerged this month that Marie Curie has made almost 100 of its staff redundant, a decision its chief financial officer said was “tough but necessary” in order to ensure its long-term financial sustainability. At least five hospices across England have planned job cuts in recent months due to financial strain, and Hospices UK said Scotland was not immune from such pressures.
Helen Malo, the charity’s senior policy and public affairs manager for Scotland, said: “Hospices in Scotland, like those across the UK, are facing significant financial pressures. With government funding failing to keep pace with rising costs, many Scottish hospices are at risk of having to make difficult cuts. We urgently need increased government support to safeguard the future of these critical services.”
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Hide AdA Scottish Government spokeswoman said: “The Scottish Government understands the pressures hospices are currently facing and strive to support independent hospices where possible. The Cabinet secretary for health has visited a number of hospices over the last few months and has held open and honest discussions with hospice leaders.
“We will continue to work with chief officers and independent hospices to support longer term sustainable planning and commissioning for the sector. The minister for public health is meeting the chair of the Scottish Hospice Leadership Group and Hospice UK later this month to discuss these matters. Independent hospices are highly valued and provide vital support to people and their families, as well as other health and social care services and teams delivering palliative care.”
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