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Hospice Alliance Northern Ireland, which includes Newry's Evora Hospice has launched a new report calling for an end to what it describes as a postcode lottery in access to hospice and palliative care. The alliance is urging government action to ensure people receive the care they need no matter where they live.
The report, 'With The End In Mind: Delivering equitable, quality and sustainable hospice care for Northern Ireland', was launched at Parliament Buildings, Stormont, and brought healthcare professionals, policymakers, palliative care patients and their families together with the four hospice charities that make up the alliance, Evora Hospice Care, Foyle Hospice, Marie Curie Northern Ireland, and Northern Ireland Hospice, including Northern Ireland Children's Hospice.
Liz Cuddy, Chief Executive of Evora Hospice Care in Newry, said hospice care was not an optional extra. "It is an essential part of the support people need when living with a life-limiting illness, while also supporting families and the wider health service," she said. "We need a sustainable partnership between hospices and the Health and Social Care system, one that reflects the complexity, quality and value of the care we provide. Hospices provide high-quality specialist care and represent excellent value for money. Even after taking current statutory funding into account, the additional cost could reach £27.2 million annually. That's why we need a sustainable, long-term partnership that secures hospice care for the future."
The report warns that maintaining the status quo is no longer an option, with access to care varying according to geography, diagnosis, service availability and how people enter the health and social care system. It calls on government, commissioners and the wider Health and Social Care system to act quickly to address these inequalities and ensure access is based on need, not postcode or circumstance.
Economic analysis commissioned by the alliance estimates that up to 19,000 people could benefit from palliative care each year by 2036, almost 17% more than in 2024. This comes against existing unmet need, with UK-wide research indicating that around one in three people who die have unmet palliative care needs.
The report argues that hospice care must be recognised as an essential part of Northern Ireland's Health and Social Care system, rather than viewed primarily as a charitable service. Hospices currently provide care to around 13,000 people each year, with 72% of that care delivered in people's own homes.
Trevor McCartney, Chief Executive of Northern Ireland Hospice and Chair of Hospice Alliance Northern Ireland, said nobody should have to live in one part of Northern Ireland rather than another to receive the hospice and palliative care they need. "Yet access can vary according to where people live, their diagnosis and how they enter the system," he said. He added that the report was about changing that, ensuring every person and family had the same opportunity to receive high-quality, compassionate care, building on examples of excellent practice already found throughout Northern Ireland, with equity to become the standard everywhere.
The report identifies five priorities for action under three connected pillars of equity, quality and sustainability. These are ensuring equitable access for all by reducing unwarranted variation and ensuring care is based on need; expanding care closer to home by increasing high-quality palliative care in people's homes and communities; developing workforce capacity and capability to meet growing demand; reforming funding and commissioning to create a fairer model that recognises hospice care as essential health and social care capacity; and strengthening leadership, partnership and innovation between hospices, government, commissioners and the wider Health and Social Care system.
Donall Henderson, Chief Executive of Foyle Hospice, said Northern Ireland was facing a growing palliative care challenge. "More people are living longer with complex, progressive and life-limiting conditions, while too many people are not getting the support they need, when they need it," he said. "We cannot allow the gap between need and provision to widen. Government must act quickly to address inequity and create a sustainable funding and commissioning model for hospice and palliative care." He said the report was not simply another call for more money but a shared vision for change. "Every person in Northern Ireland should have access to the right care, at the right time and in the right place. Where you live should not determine the care you receive."
Heather Monteverde, Managing Director of Marie Curie Northern Ireland, said people living with life-limiting illnesses should not have to reach crisis point before they received the care they need. She said recent research commissioned by Marie Curie into unscheduled care in Northern Ireland showed how gaps in community support could leave families with little option but to turn to ambulances and hospitals at their most difficult moments, adding that this too often led to additional distress for patients and their loved ones while placing avoidable pressure on already stretched emergency services. She said a neighbourhood model of care, combining hospice, primary care, community health services and social care around the person, offered a different future, and that expanding high-quality palliative care closer to home could help more people receive expert care where they wanted it most, reduce pressure on acute services, and ensure access to care was determined by need rather than postcode.
The report builds on recent policy developments, including the 2025 Committee for Health Inquiry into Palliative Care Services and the Department of Health's Health and Social Care Reset Plan.
The HANI report, With The End In Mind: Delivering equitable, quality and sustainable hospice care for Northern Ireland, is available at www.hospiceallianceni.org.
