Consultation on Children's Hospice Grant

The Children's Hospice Grant

The Department of Health defines children’s palliative care as an active and total approach to care, from the point of diagnosis or recognition, throughout the child’s life, death and beyond. It embraces physical, emotional, social and spiritual elements and focuses on the enhancement of quality of life for the child or young person and support for the family. It includes the management of distressing symptoms, provision of short breaks and care through death and bereavement.

Through the Children’s Hospice Grant, NHS England makes a financial contribution to children’s hospices for the health-related elements of children’s palliative care which they provide. It is in addition to any funding allocated to children’s hospices by clinical commissioning groups (CCGs) and local authorities. It is currently worth a total of £11million per year and is distributed annually among 36 children's hospice charities in England. 

Changing the way in which the grant is allocated

NHS England wrote to children’s hospice services on 6 April 2016 to advise that they would be consulting in 2016 on the future allocation formula for the children’s hospice grant. It is proposed that the new allocation formula be implemented for April 2017 and will cover the financial years 2017/18, 2018/19 and 2019/20, subject to the NHS England approved budget for each financial year.

NHS England is only seeking to review the formula for allocating the grants budget between hospices and not the mechanism by which which the grant is paid, which is via a national grants programme paid centrally by NHS England. A further fundamental review of the grants programme will be undertaken in 2019.

Together for Short Lives was approached by NHS England to help with the consultation and to engage children’s hospice services to advise on the future formula. In July, we held a pre-consultation event with our wider membership (hospice services and the wider sector) which concluded that:

  • the consultation on the formula is long overdue
  • funding should be simple and fair
  • distribution should remain through NHS England rather than through clinical commissioning groups in order to protect and ring fence that funding; and
  • current funding levels are inadequate in meeting the growing number of children’s hospice services; the number of children and young people requiring care at both ends of the age spectrum is increasing, with more neonates and more young people now living longer; overall, the needs of children of all ages are becoming more complex

It was clear that any consultation would need to be appraised and informed by the significant changes that have taken place since the original grant programme was conceived in 2006 - in terms of:

  • the increased demand for children’s palliative care services
  • the growth in the number of children’s hospice services and other charitable providers to meet that demand
  • the increased complexity and diversity of care required and delivered. 

The significant savings children’s hospice services and other providers bring to the NHS was also to be a key consideration.

The eligibility criteria for the NHS England Children’s Hospice Grant Programme is determined by the grant making powers of the NHS Act. The funding is a grants programme under the grant making powers to Voluntary Organisations under Section 13X NHS Act 2006 (as amended). A grant is defined as a contribution to the costs of an organisation with similar objectives to the NHS. The definition for voluntary organisations under the NHS Act specifically excludes public and local authority which include NHS trusts, foundation trusts as well as commercial organisations. The grants programme is also limited to voluntary organisation who operate as children’s hospices and deliver palliative care clinical services to children and young people as their core or main service.

The consultation

To consult children's hospices on how the Children's Hospice Grant should be allocated, NHS England and Together for Short Lives asked children's hospices in England to complete an online survey. The survey sought information from children's hospices about the services they provide now and how they have changed since the grant was first introduced in 2007. The consultation closed at 9am on Friday 20 January 2017.

Next steps

NHS England is currently considering the feedback provided by children's hospices.