Gov’t must assess the 'damaging' impact of the NHS pay award on charitable hospice providers
4 min read
Ahead of her Westminster Hall debate today on hospice funding and the NHS pay award, Liz McInnes MP writes about the topic for PoliticsHome.
The 3 year NHS Pay award negotiated earlier this year between NHS Employers and the Trade Unions was welcomed for finally lifting our much valued NHS Staff out of the constraints of the 1% Public Sector pay cap. However, one unintended consequence of this pay deal is the adverse impact upon the charitable sector which is commissioned to provide NHS services.
Our Hospices do an amazing job providing end of life care to those suffering from terminal illnesses, and providing support for their families, and are an integral part of NHS care from cradle to grave. Yet the majority of Hospices are funded mainly by charitable donations and fundraising with on average only around 30% of their funding coming from the NHS.
The Department of Health and Social Care has announced that the NHS pay award will not be funded for the charitable sector unless they employ staff on Agenda for Change terms and conditions, the nationally agreed deal for NHS staff. The Department has acknowledged that most charitable hospices do not employ staff on NHS terms and conditions, as these staff are not NHS employees. However, as hospices recruit their staff from the same local pool as the NHS, they have little option but to mirror the pay award made to NHS staff in order to recruit and retain the staff that they need.
In terms of the potential impact on charitable hospices, Hospice UK have estimated that over the course of the three year NHS pay deal, charitable hospices will be faced with an additional bill of somewhere between £60m and £100m. In the absence of any additional government support, hospices are faced with a difficult choice– they must either ask their local communities to donate more to fund the pay award, or they must look at options to reduce services proportionately to cover the cost. Neither of these are palatable options either for the hospices or for the communities they serve.
The Department of Health & Social Care also maintains that hospices should look to their Clinical Commissioning Groups for additional support. Research by Hospice UK has shown that in recent years, two-thirds of hospices in England have had their NHS funding cut or frozen, in many instances for several consecutive years. In the absence of tariffs that reflect the costs of care, the NHS currently makes a contribution towards the costs of providing hospice care (on average just 30% of the costs of providing adult hospice care services, and just 15% for children’s hospice services), although there is wide variation in that funding around the country.
The pay deal that has been agreed is a pay deal for NHS staff, and it is welcomed. However, there is real concern is that it will have an unforeseen, but damaging, impact on charitable hospices who are already at a significant disadvantage compared to other non-NHS providers in not receiving reimbursement for the costs of the care that they provide to NHS patients.
A sustainable hospice movement is an essential component of delivering the improvements in end of life care that the Government has rightly sought. The Government must look again at the conditions imposed upon non-NHS providers and consider how funding may be made available in order to prevent a diminution of the end of life care service.
The patient should be at the heart of everything the NHS does and the Government must now turn its focus to the impact upon patients and their families should they allow their good intentions around the NHS Pay Award to adversely affect the quality and provision of end of life care.
Liz McInnes is Labour MP for Heywood and Middleton
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