Hospice Lotteries Association Annual Conference Funding Hospice Care

Hospice Lotteries Association Annual Conference Funding Hospice Care : What does the future look like? Sarah Brocklebank Chief Executive 12 th September 2012

Overview • • Hospice services NHS funding Hospice lottery funding Total funding & its implications My “ideal” characteristics of income streams Looking forward The future?

Hospice services • Independent hospices provide over 80% all palliative care services in the UK • 220 adult in patient units & 42 children IPUs • Not just a building – community services of increasing importance • £ 1. 4 m spent on hospice services in UK each day • Total income for hospices range £ 1 m - £ 10 m

NHS current funding structure • NHS average contribution (England) – Adult hospices = 34% – Children’s hospices = 15% • Average NHS funding in Wales 24%, N Ireland 30%, Scotland 39% • NHS funding largely historical and predominantly grants although contracts emerging • “Joe Public” is funding hospices c £ 1 m per day

What about hospice lottery income? • Average net profit per hospice £ 228 k (based on 114 lotteries) • Average profitability 51% (compared to retail income at c 30%) • Huge amount of support from public – and hard work from lottery teams • Trends show lottery income has withstood the recession better than most income streams • Much broader benefits of lottery players than “just” lottery income – “getting to know your customers”

PTH income

What does a funding structure like this mean? • • Extremely difficult to plan with any confidence Unreliable Volatile – esp legacy income Potentially adversely affected by external events – e. g. the weather • Disproportionate management time & effort for relatively small NHS income • “Interesting” relationship with the NHS, from whom we receive all our referrals • Unfair

My ideal characteristics of income streams • Reliable • Regular • Resilient

Testing current funding streams Reliable? Regular? Resilient?

Looking forward (1) • NHS reorganisation – 2013/14 onwards – Clinical Commissioning Groups replacing PCTs – Focus on “end of life care” services – broader than most hospice services • Palliative Care Funding Review – – 2015/16 onwards Tariff for all end of life providers not just hospices State responsibility / society responsibility Pilot sites being set up to test different models / tariffs

Looking forward (2) • Economic challenges – – Current & ongoing issue CFDG, Io. F & PWC report “Managing in a Downturn” (04/12) “Managing in the new normal – a perfect storm” 93% say things have got tougher in the last year – and the future doesn’t look any brighter

Looking forwards – so what? • NHS reorganisation – Increasingly fragmented commissioners – Partnership working key - many hospices will find themselves in a “subcontractor role” – Huge opportunities as hospices have many of the solutions to NHS problems – e. g. keeping people out of hospital • Palliative Care Funding Review – Increased competition for funds / new competitors – State funding being directed towards community services rather than IP services – Increased confusion by Joe Public as to who funds what • Economic challenges – Not looking great for the foreseeable future

Testing future funding streams Reliable? Regular? Resilient?

Concluding remarks • Thank you • It’s tough out there – for all areas of income • Some are more resilient to external factors than other • New opportunities emerging – esp with social media, digital • Don’t forget the added benefits of lottery membership – “supporter journey” • Keep close to & knowledgeable about the work of your hospice

Thank you Any questions?