The Committee was reminded that the Council, at its meeting on 7th December, had passed the following motion on Funding for Palliative and End-of-Life Care, which had been
proposed by Councillor Whyte and seconded by Councillor Lyons:
“This Council recognises that hospice care is a vitally important part of our care system; considers it necessary that people approaching the end of life, their families and carers get the right care and support where and when they need it; notes that hospice staff deserve recognition for the world-class medical care and emotional support they provide, not just to patients but also to their families; and looks forward to the hospice movement going from strength to strength in years to come.
Accordingly, the Council agrees to write to the Minister of Health, Robin Swann MLA, calling upon him to ensure fair and transparent funding in line with demand, and continued high quality palliative and end-of-life care.”
The City Solicitor drew the Committee’s attention to a response which had been received from the Minister of Health.
The Minister had highlighted the valued service which hospices in Northern Ireland provided in caring for and supporting people living with palliative and end-of-life care and those who were important to them. Department of Health officials and their colleagues in the Health and Social Care Board worked closely with hospices and were aware of the both the contribution which they made and the challenges they faced.
The Minister, in recognising the financial pressures which hospices were facing, had pointed out that Covid-19 had had an impact across the community and voluntary sector and referred to similar issues across other areas and organisations, where there were also increasing demands for services and associated financial pressures.
He explained that the Health and Social Care Board had Service Level Agreements in place with each of the hospice providers in Northern Ireland for both inpatient and community based services. Separate arrangements were also in place with Health and Social Care Trusts for hospice night services, as required. The Marie Curie charity also provided a regional out-of-hours service.
In terms of funding, the Minister stated that guidance which had been put in place by the Department of Health in 2004 had introduced 50/50 funding for agreed adult inpatient hospice services, with effect from 2004/05, and 50% funding for agreed adult community services, with effect from 2005/06. Those arrangements provided for the funding of agreed commissioned services, not a hospice’s total running costs.
He pointed out that children’s hospice services were funded differently to adult services, with separate commissioning and funding arrangements in place for children’s palliative care and hospice services. In addition to core funding for children’s services, the Department of Health had agreed, following the closure of the Horizon West children’s hospice, to fund on a 50/50 basis an additional bed in the NI Children’s Hospice at Horizon House for three years from 2018/19.
Since 2018, a Paediatric and Life Limited Service had also been commissioned from the NI Children’s Hospice. That service had provided a specialist nursing role to support children, families and clinicians in recognising and managing end-of-life needs, as well as access to a dedicated bed in the NI Children’s Hospice or in the child’s home. Funding of £186,000 for the service had been made initially through Confidence and Supply transformation funding. The Department of Health had extended that funding for a further year to ensure the continued delivery of the service by the NI Children’s Hospice.
The Minister had gone on to state that, in recognition of the challenges being faced by hospices during the current pandemic, the Health and Social Care Board, with the agreement of his Department, had put in place arrangements to support hospices’ cash flow. Those arrangements had applied also to contracts between hospices and Health and Social Care Trusts. The Health and Social Care Board worked closely also with hospices around the availability of Personal Protection Equipment, fit testing and access to sanitising equipment and to keep them informed of the broader system approach to responding to Covid-19.
The Minister welcomed the additional funding which had been made available to hospices, in recognition of the restrictions on fundraising opportunities and retail, as a result of Covid-19, and had referred to £6.75m and £7.3m which had been allocated to local hospices and the Cancer Fund for Children in May and October, 2020 respectively.
He explained that the Health and Social Care Board had recently completed a review of adult hospice funding, which had identified a total funding shortfall of £867,360 between the 2019/20 funding provided to hospices, when compared against benchmarked costs assessed as part of the review process. That additional funding had been made available to hospices and had been backdated to April, 2019. In October, 2020, the Health and Social Care Board had also approved a 4% uplift for 2020/21 to the value of its core contract Service Level Agreements held with hospices in Northern Ireland. The Minister believed that, given that the current funding arrangements date back to 2004, it would be appropriate to review those arrangements in light of the changing context and demographics for palliative care and trusted that hospices would engage in that process.
The Minister had concluded by stating that the New Decade New Approach deal included a commitment to increase investment on palliative and end-of-life care to fully implement service improvements, including enhancing the contribution of hospices, and to increase support for palliative perinatal care. Investment to meet the New Decade New Approach commitment had been captured within his Department’s bids for additional funding in the Department of Finance Budget 2021-22 exercise.
The Committee noted the information which had been provided.