Hospice Funding

Selaine Saxby Excerpts

Monday 22nd April 2024 Commons Chamber

[Selaine Saxby (North Devon) (Con)]

I want to take advantage of tonight’s debate to raise the specific issue of the North Devon hospice and its hospice to home service. When I last met its excellent chief executive, Stephen Roberts, last October, he flagged to me that the hospice was no longer in a position to continue its non-commissioned service after the end of this financial year. At the time, he wrote to the then Secretary of State, my right hon. Friend the Member for North East Cambridgeshire (Steve Barclay), detailing those concerns. I instantly phoned my hospital trust, because North Devon is home to the smallest hospital on the UK mainland and it already suffers with discharge issues and an overstretched A&E service.

In February when I met Dr Sarah Wollaston, the chair of the Devon integrated care board, I asked about the service and was assured that it was all fine and the money was being found. When this debate was announced —many thanks to my hon. Friends the Members for Hastings and Rye (Sally-Ann Hart) and for Darlington (Peter Gibson) for securing it—I contacted Stephen Roberts at the end of the recess and said that I would like to check that this was all okay. He told me that my email was timely because everything was not okay, despite having had endless meetings with the integrated care board. He asked me to share with the House tonight some of the email that he sent back to the integrated care board following a phone call with its new chief executive, in which he said:

“Thank you for your time yesterday. I thought it would be prudent to summarise in an email where we have got to as there is nothing on paper or email that corresponds to the discussions we had around your offer of £95k. As a summary as to where we stand today: North Devon Hospice’s Hospice to Home Service is dedicated to support palliative patients who are at the ‘end of life’ stage through: increasing care at home, reducing unplanned/avoidable hospital admissions, and expediting hospital discharges.”

He goes on to detail the 15 staff who deliver that vital service, which costs just £495,000 and which the North Devon Hospice charitable funds have covered for the last decade. He said:

“North Devon Hospice asked for funding support of £157,540 which represents the same level of commissioning support as our bedded unit and community nursing team receive. Devon ICB have stated that they are willing to provide £95k as a one off”

before the next commissioning review period. But he said that the hospice had to state in return:

“due to our year on year million-pound deficit, having funded the service for 10 years and propped up the cost of this service through cost management elsewhere in the organisation we are no longer able to support the service which is at its minimum establishment to be able to operate.”

The hospice has been advising the ICB of this for three years.

[Peter Gibson]

My hon. Friend illustrates one of the biggest single challenges for hospice at home. Hospice at home relies on transport, which in an urban community can be delivered at a relatively small cost, but in a deeply rural constituency like hers, those costs need to be addressed and met in order to deliver that care. Does she agree that the funding models need to address the cost of transport and travel in rural constituencies delivering a hospice at home service?

[Selaine Saxby]

I could not agree with my hon. Friend more. There are many elements of healthcare, but the rurality of constituencies like mine is not fully reflected in the funding settlements.

My hospice requested that the ICB find the additional £65,000 to get it through to the end of the year. The chief executive took this back to the board to see whether we could get that seven months of cover through. However, it has now been through a full board meeting and consultation, and this is where my email came in. He finished his email to the ICB by saying:

“I sincerely hope that the good faith you have asked of us extends to Devon ICB’s good faith in finding the extra £65k.”

The email that he sent to me at the end of the recess says that he met the ICB chief executive,

“and he asked for 8 more weeks to see if he can do something, no promises made. My Board met last night where we agreed to wait for his response before making any decisions on the service. Therefore, any pressure you can apply would be greatly appreciated. The headline is: ‘Has it really come to the point where we have to beg for £62k to stop 32 people dying in an Emergency Room?’”

That was four weeks ago, and the hospice has still heard nothing. Our ICB is also in special measures. I beg the Minister to intervene and see if we can help our much-loved hospice, as well as tackle the ever-growing issues we have with our integrated care board back home in Devon. The hospice to home service is hugely valued by families and ensures that their loved ones can spend their final days at home, not in hospital. It also helps by taking the pressure off North Devon’s much loved, very small hospital. As it says across the shops back home in North Devon for our hospice, “Your life is a story, and the ending matters.” I very much hope that there is a way to secure the future of this hospice to home service to ensure that we have many other happy endings.