Hospices work in partnership with, and supplement, existing NHS services within local areas. Last year in Wales, 16 charitable hospices provided direct care to over 11,000 people and their families, whilst reaching thousands more through their community engagement and development; 290,000 hours were donated by hospice volunteers; 2,150 adults were seen in day hospice and out-patient care; there were 22,500 overnight stays in in-patient care; 3,500 people volunteered for their local hospices; 8,600 adults were seen by community care and hospice at home; 800 children were helped directly by charitable hospice care; there were 57,700 home visits by community care and hospice at home; and 2,300 families received bereavement care through hospices.

As the cross-party group report found, despite some progress in widening access to hospice and palliative care in Wales, there remains significant unmet need and under-met need. A significant proportion of bereavement support is provided by our charitable hospices in Wales. However, families whose loved one dies in the acute setting after receiving intensive and critical care often miss out on the bereavement care they need through lack of signposting or availability.

The Welsh Government is working with Cardiff University, Marie Curie and the end-of-life care board to review bereavement services. Cruse Cymru hopes that the final report will include a robust and detailed commitment to a strategic commissioning approach to bereavement services across Wales. In welcoming the review, Marie Curie tells me that ensuring adequate support for families experiencing bereavement is an important part of the process of death and dying and is a priority for many in the end-of-life sector. 

The charity 2 Wish Upon a Star also welcomes this review and emphasises the correlation between those organisations funded by the Welsh Government, local authorities or health boards, who predominantly signpost or refer into organisations, and those who provide bereavement services but receive little or no funding. The cross-party group report calls for bereavement to be made a key feature of all relevant policies.

In July 2018, the Minister announced his ambition for Wales to become the first compassionate country—a country where we ensure that the well-being needs of an entire community are a priority. Our motion calls on the Welsh Government to outline how it will achieve this. Marie Curie identifies many examples of best practice in cities, towns and states, utilising the compassionate community model to ensure a better end-of-life experience, ranging from Good Life, Good Death, Good Grief and the Scottish Partnership for Palliative Care toolkit, encouraging local communities to create support networks, to projects in India and Australia.

Hospices and the voluntary sector are well positioned to mobilise volunteers and support communities to help deliver compassionate communities, with many already delivering programmes that focus on widening participation within end-of-life care. Marie Curie runs a helper scheme, in which specially trained volunteers help to provide regular support to those receiving palliative care and their families. Wrexham-based Nightingale House established compassionate communities groups, and, although they cannot manage the liability further down the line, they state that hospices can contribute if their role is focused on people with palliative care needs and that compassionate communities could, therefore, develop with them on this basis. They're, for example, taking their day services out to Chirk in Denbighshire and Mold in Flintshire. 

Hospices also provide additional services to those provided by the NHS, such as support for carers and complementary therapies. However, despite their importance within wider care service provision, hospices are experiencing a number of challenges, which impact on their ability to provide sufficient support services. These include, they state, a lack of statutory Welsh Government funding, resulting in financial pressures that are restricting the ability of hospices to provide services; an out-of-date funding formula leading to a postcode lottery of services; and unmet need caused by a lack of specialist palliative care staff.