New restaurant opens in Yorkshire hospice as funding crisis forces creativity

“I decided to join Saint Catherine’s because I was ready for a new challenge and it’s not often as a chef you get the chance to do what you love but also find a way to give something back to a local community and a fabulous cause,” he says of the new venture.

At first it appears to be a strange idea, but Margaret Middlebrook MBE, chair of the trustees for the hospice, explains the logic behind opening a restaurant there to The Yorkshire Post as being important in removing taboos around the sector.

“Yes it’s an income stream for us, but it’s also somewhere the community can come and be on a hospice site, and realise hospices are not places where you have lots of dead and dying people lying around in corridors,” she says.

“Actually, a hospice is a very joyful place, because the whole purpose is to enable people to live as well as they can for as long as they can. The great thing is the day we opened the bistro we had an outpatient and his wife come in to have some lunch, and the lady said to me, ‘That’s the most I’ve seen him eat for months’. That’s why we do it.”

Saint Catherine’s, officially opened in 1985 by Princess Margaret, has also put solar panels on its roof, and is installing electric vehicle charging stations on-site. “We’ll be able to offer to people in the community to charge their cars at a reasonable rate – so it benefits the community, and it benefits us as well,” says Margaret.

The reality is that Saint Catherine’s is having to diversify its revenue streams because hospice funding in the UK is in crisis.

“Our services cost £5.9m a year to run, which is £11,000 a day,” says Margaret. “To me, that £11,000 a day is scary money. This year, we’re expecting our deficit will be a million, which isn’t sustainable. Nobody can sustain that.”

Ruth Driscoll, associate director for policy & public affairs for hospice charity Marie Curie, describes the situation as “a perfect storm”.

Last month, she gave evidence to MPs in Parliament to highlight the crisis. She says there’s a need for greater integration between the NHS and the hospice sector.

“When you look forward, the crisis starts to feel even larger. Demand for these services is rising really fast because our population is ageing,” she says. “By 2045 the number of people aged 85 or over will double. There’ll be 136,000 more deaths each year, compared to this year.”

One of the issues contributing to the “perfect storm” is the role of Integrated Care Boards (ICBs). They were set up as part of the reforms of the Health and Care Act 2022, as local bodies commissioning services to support the NHS. However, according to research by Marie Curie, they’re not prioritising palliative and end-of-life care, despite having a statutory obligation to commission these services.

“50 per cent of the ICBs who responded to our survey told us they had not made or do not plan to make significant capital investment in palliative and end-of-life care,” says Ms Driscoll. “Over 40 per cent told us their current investment in these services isn’t sufficient to meet the needs of their local community, or that they didn’t know if it was sufficient. By their own account, they’re not investing in these services.

“There is a real problem in the way the funding is given, really what we need is a new funding model, one that doesn’t rely so heavily on charitable fundraising.”

Saint Catherine’s relies on charitable donations to cover 70 per cent of its annual costs of £5m. For Marie Curie, 40 per cent of its £3.2m costs for community services operating from its Bradford hospice is funded by donors.

Meanwhile, St Gemma’s in Leeds, the biggest hospice in Yorkshire, also relies on donations and fundraising to cover just less than 70 per cent of its costs.

It faces a shortfall of more than £500,000 this year. Its chief executive, Kerry Jackson OBE, argues in favour of a new framework for distributing money to the hospice sector.

“I think the solution is a proper needs assessment for the population,” she says. “The need for palliative and end-of-life care is due to grow about 25 per cent by 2048, so we absolutely need that assessment of what we’re providing currently, and what that future need is likely to be.

“It needs to be fair, it needs to be sustainable. At the moment it isn’t.

“We need to assess the needs of the population and then set out a plan to meet the needs of that population, we absolutely need a new commissioning framework.”

Margaret Middlebrook agrees: “There has to be some way for quantifying the worth of hospice services, and for those to be funded at their true cost.

In an ideal world, if we had a system where our basic services were fully funded, the volunteering and donations we get could be used to fund things that are not essential. But I think we’re a long way away from that.”

Around 30 per cent of St Gemma’s annual costs of £15m are covered by money from the NHS. But while the charity’s expenses rise, funding is failing to keep up with inflation.

Kerry Jackson adds: “The whole sector is facing threats to long-term financial sustainability. Partly, that’s because the amount of NHS funding we get has remained fairly static, and in some cases it’s even been reduced, and yet hospices are facing significant cost pressures.

“We’re trying to absorb all of that non-pay inflation, things like utilities, over the recent years. The NHS is being really squeezed at the same time. In some cases donors are finding it harder to donate, so hospices are being hit from multiple different angles.”

Asked if ICBs are failing in their statutory duty to commission palliative and end-of-life care from hospices, Kerry is sympathetic.

“I think from an ICB perspective, to be fair to them, they’ve been given a responsibility to fund services, but they haven’t been given additional funding by NHS England, by central government, to fund those services. So they’re in a bit of a bind as well. They’ve got massive cost savings to make this year as well.

“I think they’re struggling to find their feet as organisations,” she adds.