The Fragility of Hospice Funding: But what does fair funding really look like?
By Niki Ellis, CEO, Tapping House
“Would 100% NHS funding solve the problem?
No – and it shouldn’t.”.
That might surprise some of you to hear.
There are elements of hospice care – our complementary therapies, our holistic wellbeing support, our bereavement services – that sit beautifully outside what the NHS is designed to provide. These are the touches of humanity and compassion that define hospice care, and they should remain community-funded.
But there’s a strong case for a far more balanced model.
Right now, less than 30% of our costs come from government funding. The rest – more than two-thirds – relies on charitable giving and the extraordinary generosity of our local community.
That’s not sustainable.
A fairer model would see 70 – 80% of hospice costs covered by the government, leaving 20 – 30% to be raised locally.
This shift would give hospices like ours the stability to plan, grow, and deliver high-quality, compassionate care – without the constant fear of financial crisis. It would also preserve that vital connection with our community, whose support is so deeply woven into who we are and what we do.
Why this matters now
For the first time, Tapping House will sit within a new “cluster” of Integrated Care Boards (ICBs) – bringing us together with other independent hospices in Norfolk, Waveney and Suffolk. Among them sits one fully NHS-funded hospice – a stark contrast that highlights the inequities in the current system.
This new structure presents a real opportunity to explore redistribution, fairness, and a more consistent approach to funding across our region. And that could be transformative – not just for us, but for the people and families we care for.
The real cost of imbalance
You may have heard about the government’s £100 million emergency funding for hospices.
It was welcome – and hard fought for by Hospice UK – but it came with restrictions. It could only be spent on capital projects, not the day-to-day running costs that keep beds open and staff in post.
At Tapping House, it enabled us to expand our inpatient unit. But we can’t yet afford to open those extra beds. Our revenue funding remains the same, already stretched to the limit. It’s not sustainable – and it’s a reality echoed by hospices up and down the country.
If hospice staff could access pay structures equivalent to NHS colleagues, recruitment and retention challenges would ease, allowing a stronger focus on patient care.
Meanwhile, our clinical and support teams continue to deliver exceptional care – often for less pay than their NHS counterparts. The quality is outstanding; the commitment, humbling. Yet it’s still hard for people to believe that so much of what we do relies almost entirely on charitable funding.
A shift in mindset
We’ve always been an innovative hospice. One that leads rather than follows. From introducing nurse-led inpatient care to pioneering rehabilitative day therapy long before it became mainstream, we’ve shown what’s possible when vision meets necessity.
Now, the next transformation is about sustainability – not just of services, but of the whole system.
The future lies in proactive, community-based care: supporting families earlier, equipping them to cope, preventing crises before they happen. That’s good for patients, good for hospitals, and good for the health system as a whole.
But to deliver that future, we need to invest in it.
Hospices are a vital part of the healthcare ecosystem. When funding falters, the ripple effects are seismic – hospital admissions rise, families lose vital support, and communities suffer.
If we want to protect compassionate, person-centred care for the future, the funding model must evolve with it.
It’s time to rethink what fair funding really means.
As we approach Christmas…
This season is often defined by generosity and goodwill – qualities that have always sustained hospice care. But as we’ve learned, goodwill alone is not enough.
If hospice care has touched your life, or the life of someone you love, there are simple yet powerful ways you can help shape its future:
– Donate or volunteer
– Lobby your local MP for hospice funding reform
– Leave a legacy in your will
– Become a sponsor or corporate partner
Together, we can ensure that compassion has a future – and that every person, in every community, has access to the dignity and care they deserve at the end of life.