Together for Short Lives
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Preventing family breakdown through short breaks for respite

Children with life-limiting conditions – and their families – rely on frequent short breaks for respite. The pressure on parents of having a child with a life-limiting condition is immense, so social care is vitally important to relieve this stress, spend time as a family and do the things that other families do. However, too few NHS organisations and local authorities in England plan and fund short breaks for children who need palliative care – and many argue about who is responsible. We call on the UK Government to fill the £434 million disabled children’s social care funding gap in England.

Why short breaks for respite is important for children with life-limiting conditions and their families

The pressure on parents of having a child with a life-limiting condition is immense. Most relationships will suffer, with 36% experiencing a breakdown of the family.

64% of mothers and 24% of fathers will need to give up work and this, combined with the extra costs of caring for a seriously ill child, means that many families may live in poverty.

Many brothers and sisters will miss school or experience educational difficulties; many will be bullied or feel isolated at school.

Children with life-limiting conditions – and their families – rely on frequent short breaks for respite to enable them to relieve this stress, spend time as a family and do the things that other families do. Every family’s needs are different: some need overnight, residential short breaks either with or without their child; some need short breaks for only a few hours at a time, provided at home or in hospital. Some will need a mix of both.

Overnight short breaks for children and young people with life-limiting conditions usually include some element of clinical care to meet their often complex health needs, even if it is just an initial clinical assessment. Therefore, NHS organisations have a specific role in jointly planning and funding these services with local authorities.

As Together for Short Lives own freedom of information (FOI) requests have found (see report linked on the right-hand side of this page), too many clinical commissioning groups (CCGs) and local authorities in England are failing to plan and fund short breaks. 84% of CCGs reported that they commission short breaks for children who need palliative care, which is an increase from our 2016 research, when just 77% commissioned these services. However, more than one in five (21%) local authorities do not commission short breaks for children with life-limiting and life-threatening conditions, despite having a legal duty to do so. This figure has declined since 2016, when one in seven (14%) reported that they do not commission these short breaks.

A new report from Together for Short Lives and Julia’s House Children’s Hospice ‘Give Me a Break’, includes new research by Pro Bono Economics, in association with volunteers from Compass Lexecon which sets out the positive impact that short breaks have. The research has estimated that:

  • 11 per cent of parents of children who need respite delivered by children’s palliative care providers would experience significantly less stress as a result of receiving breaks – moving them out of the ‘most stressed’ category of society.
  • Reduced stress leads to improved physical health among carer parents, which in turn leads to reduced number of GP visits and cost-savings to the health system. Demand for GP services declines by 8 per cent as a result of an individual moving out of the most stressed category.
  • Reduced stress leads to improved mental health among carer parents, which in turn reduces the use of mental health services and the associated costs. Demand for mental health services falls by 49 per cent as an individual moves out of the most stressed category.
  • For every working parent who experiences a reduction in stress, it is likely that this will reduce the number of days taken off work by around 2-3 days per year.

Together for Short Lives and Julia’s House Children’s Hospice are calling on the government to create a ringfenced £434 million grant for local councils to fill the funding gap in social care services for disabled children. Local authorities would be able to use this money fund short breaks for seriously ill and disabled children equitably and sustainably. Visit our campaign page and find out more here.

UK-wide research conducted by Julia’s House Children’s Hospice and Bournemouth University has examined the impact that caring for a child with a life-limiting or life-threatening condition has had on parental relationships. 17 children’s hospices from across England and Scotland took part. The research has found that:

  • 64% of divorced or separated parents cited having a child with complex needs as a reason for the breakdown of their relationship
  • of those couples, 75% had no access to short breaks at that time
  • most parents (74%) rated short breaks provided by children’s hospices as having a direct, positive effect on their relationship with a partner, giving them rare time together as a couple. Others used short breaks to spend time with their other children or just enjoyed time to themselves, regaining some balance in their lives, ultimately benefitting the whole family
  • couples whose relationships were identified as ‘non-distressed’ by the research were found to have received on average 43% more hours of short breaks from a children’s hospice compared to those who were in distressed relationships.

Evidence gathered by the Local Government Association (LGA) shows that, in 2015/16, local authorities in England overspent their children’s social care budgets by a total of £605 million. The LGA predicts that councils will face a £2billion children’s social care funding shortfall by 2020. As budgets come under increasing pressure, the demand for children’s social care is rising: the government’s own data shows that the number of children in need increased to 394,400 on 31 March 2016 compared to 391,000 on the same day in 2015. This represents an increase of 0.9%.

We are deeply concerned by this new evidence, which indicates that children’s social care in England is financial unsustainable. If it continues to be overlooked within Budget deliberations, the promised social care funding green paper and in the negotiation of local government finance, we are concerned that fewer and fewer children and families who need care and support will be able to access it. Ultimately, our children’s social care system it will become unsafe.

What are the UK’s governments doing to make sure children and families can access short breaks?

A government-commissioned review of funding arrangements for palliative care published in 2011 recognises that “short breaks which provide respite for the carers and families of children requiring palliative care should be funded by local authorities and the NHS under their respective legal short breaks duties”, including the short breaks duty on local authorities in England.

What would Together for Short Lives like to happen?

  1. HM Treasury to fill the £434 million disabled children’s social care funding gap in England by creating an annual ring-fenced disabled children’s grant. From this, local authorities would be able to make an equitable and sustainable funding contribution to short breaks for seriously ill children.
  2. The government to establish a £41 million Disabled Children’s Innovation Fund. This would provide financial backing to organisations delivering ground-breaking support and approaches in early intervention, such as short breaks for respite.

It is in no-one’s interests to wait for parents of seriously ill children to split up or to experience crises in their physical or mental health.

Policy and influencing