Hospice Funding and the NHS Pay Award

Thelma Walker Excerpts

Wednesday 31st October 2018 Westminster Hall

[Liz McInnes]

Of course I agree with the hon. Gentleman, and I will go on to talk about recruitment and retention and the problems that this issue is causing to our hospices in Bolton, in Rochdale and, I am sure, up and down the country.

The chief executive raised three issues with me; I have outlined the first, but the second was whether the effect of the pay increase on voluntary sector hospices had been calculated. The third point was whether voluntary hospices would be able to access additional Government funding to be able to afford the NHS pay increase.

[Thelma Walker (Colne Valley) (Lab)]

Does my hon. Friend share my concern that these changes will only reinforce existing recruitment and retention pressures, and agree that the Government should ensure that they take steps to address staffing issues as well as pay changes?

[Liz McInnes]

There is a theme developing on recruitment and retention. We have shortages of particular groups of staff, and a two-tier pay arrangement for different NHS providers will only exacerbate those problems.

--- Later in debate ---

[Caroline Dinenage]

I can only applaud the hon. Lady’s tenacity in continuing to make that case, and we will certainly look into the matter. As I say, I have no knowledge of that individual case, but I share the desire of my right hon. Friend the Member for New Forest West to ensure that hospices such as Naomi House and Jacksplace have the funding that is necessary to do their incredible work. My mum got the whole family involved in all manner of quite humiliating fundraising exercises back in the 1990s to build Naomi House children’s hospice, and I was delighted that my role as Minister took me back to Naomi House and, indeed, Jacksplace, which caters for young adults. I went there over the summer, and Mark Smith, its director of care, was kind enough to give me a tour of the facilities. We discussed some of the issues that have been raised today, as well as others, and my team has been looking carefully at what more we can do about some of those issues.

Since I was appointed Minister for Care in January, I have met with a range of charitable stakeholders from the end of life and palliative care sector, as well as the national clinical director for end of life care, Professor Bee Wee, who is quite incredible. Having met both system representatives and representatives of charities, I have been impressed by not only their incredible passion and commitment to see Government aims for end of life care delivered, but the shared consensus on what changes are needed to drive through the improvements that we would all like to see. Hospices are an incredibly important feature of end of life care provision, but we have to see them in the wider context of our ambitions in that area. In 2016, the Government published our end of life care choice commitment, which encompasses the whole system approach to transforming end of life care, placing patients and their choices, needs and preferences at the heart of planning. The NHS gets it right when choice is meaningful, personalised, and matched by healthcare services that can respond in an effective way that places patients, families and carers at the centre of the decision-making process. I know that parts of the country are delivering excellent palliative and end of life care for both adults and children.

[Thelma Walker]

The Minister’s reference to “parts of the country” is of concern to me. Does she agree that the amount of funding, and the capacity for particular communities to raise that funding, is still a postcode lottery? In more deprived areas, accessing the knowledge, skills and ability to raise that funding is more of a challenge. How would the Minister suggest that we create more equity and parity?

[Caroline Dinenage]

The hon. Lady makes an excellent point. She is right: there are services up and down the country delivering first-class care, but there are also areas where we know we need to do more. NHS England is firmly focused on providing both the support and the challenge to achieve that, and the hon. Lady is right to mention the incredible efforts of the imaginative and resourceful volunteers who do incredible work to raise much-needed funds for those vital hospices.

A key objective in delivering our commitment to strengthening the provision of end of life services out of hospital and in the community is that people should have that level of choice, and a quality choice, up and down the country. Work is ongoing nationally to provide sustainability and transformation partnerships with tailored information to assess and enhance end of life care services in their areas. We talked earlier about commissioning; NHS England has commissioned Hospice UK to undertake an evaluation of the cost-effectiveness of hospice-led interventions in the community. Historically, hospices have struggled to demonstrate strong evidence of the services they provide and the fabulous care that we all know they offer.

The hon. Member for Burnley (Julie Cooper) mentioned currency. NHS England is working to support local use of the specialist palliative care currency, which can help local areas to plan and deliver services, including hospice services. The currency can help local services better understand the complexity of palliative care and the investment needed to deliver it properly. It is also essential that we can assess how effectively commissioners are working to improve end of life care services. My hon. Friend the Member for St Ives hit the nail on the head when he spoke about that. This year we have a new indicator in place designed to help measure how well patients needing end of life care are supported in the community. Going forward, we are planning to do more work to develop indicators that will enable NHS England to further scrutinise the effectiveness of local health economies in delivering choice in end of life care and securing the progress we all want to see.