The Fragility of Hospice Funding: We can’t survive on goodwill alone

 By Niki Ellis, CEO, Tapping House

“We’re holding our heads above the water – albeit on tiptoe!”

Across the UK, more than half of hospices are now operating at a deficit, and one in five face losses of over £1 million. At Tapping House, we’ve managed to avoid that fate – but only through foresight, teamwork, and the extraordinary generosity of our community… but we’re by no means stable.

We recognised early on that tough times were ahead. As enormously supportive as our local community has been, we knew we had to strengthen our income base. Fortunately, we still had some untapped reserves and fundraising opportunities that hadn’t been fully explored. Many other hospices weren’t in that position – they’d already maximised every possible source of income, and their communities had given everything they could. That’s why some have had no choice but to reduce their services, which is desperately sad.

At Tapping House, we decided to act decisively. We invested in our fundraising team – from leadership through to delivery – giving each member a clear focus and a sense of purpose. We opened up new income streams and made the most of existing ones. And it’s thankfully paid off.

Once again, our community rallied. Their support has helped move us from two years of significant deficit into a position of fragile stability. As we stand on tiptoe, we’re just about hanging in there. But as we are about to enter a phase of history in which we’ll see the highest number of deaths and we’re faced with the possibility of having to reduce the amount of services to support death and dying. We need to be investing in proactive Hospice care to support people rather than a reactive mopping up in crisis.

We’re working hard at both a local and national level – engaging with government and NHS commissioners – to increase the funding hospices receive. But we know change takes time. So, while that process continues, we’ve turned once more to our community, and it was absolutely the right thing to do.

The shocking funding truth

Many people are surprised to learn that hospice care is not fully funded by the NHS. At Tapping House, less than 30% of our costs come from government sources. The rest – around 70% – must be raised through fundraising, donations, legacies[1] , and community support.

When those funding streams dry up, it isn’t just a number on a spreadsheet. Beds close. Services shrink. Families miss out on vital support when they need it most. If we were no longer able to operate our services, that care would have to be picked up by existing NHS services almost entirely in fact by the local acute hospital and not only is that the wrong place for the patient to go, that’s not cost effective.The recent downsizing at Arthur Rank Hospice in Addenbrookes Cambridge is a sobering reminder of how fragile this system really is.

It’s a wake-up call for all of us: supporting your local hospice isn’t simply charity – it’s about safeguarding care for our friends, neighbours, and loved ones.

When capital funding isn’t the solution

The Government’s recent £100 million hospice funding announcement was gratefully received and hard-fought by Hospice UK. However, that funding was limited to capital projects – not the day-to-day operational costs that hospices urgently need to cover.

For Tapping House, that money allowed us to expand our inpatient unit. But here’s the catch: we can’t afford to open the three new beds because our ongoing revenue funding remains the same, and is already woefully inadequate and will not support the increased capacity – which is already stretched far too thin.

So it’s not particularly sustainable, is it?

Creativity for survival – and for the future

When funding is unpredictable, we have to be creative and imaginative. We have to look at both the short-term and the long-term.

For example, our work around legacies and gifts in wills[2]  won’t yield immediate results – it may take five to seven years to make an impact. But that’s how we have to think now: ensuring we can care for people not only this year, but in the next decade too.

It’s about resilience and responsibility – making sure the hospice of the future can thrive, not just survive.

What truly motivates me on finding creative ways to survive, are the incredibly moving and extraordinary stories I hear day in, day out, about how the Hospice Care our local community experiences. One recent patient shared[3]  that the Hospice at Home care his father received, “… felt a bit like magic.” He went on to say that, “At three in the morning, when we didn’t know what to do, we could phone and in five minutes the cavalry would arrive. Just knowing help was on the way was an absolute gift.”

It’s stories like these that compel me to keep fighting for fairer funding for Hospices.

“Goodwill alone won’t sustain hospice care. But with the right balance of funding, creativity, and compassion – we can thrive as we can’t stand on tiptoes forever.”

Turn goodwill into lasting impact

This Christmas, goodwill is everywhere – in the cards we send, the gifts we give, the time we share. If hospice care has touched your life, this festive season is the perfect time to turn that spirit of kindness into real, lasting impact. Even the simplest acts – a donation, a phone call to your MP, or including Tapping House in your will – help ensure that families receive the care, comfort, and dignity they deserve when it matters most.

Find out how you can help:
– Donate or volunteer
– Lobby your local MP for hospice funding reform
– Leave a legacy in your will
– Become a sponsor or corporate partner