In focusing on the need to support palliative care in the pandemic, our motion both acknowledges the impact of the COVID-19 pandemic on those providing end-of-life care and those who are terminally ill and their loved ones, and recognises the vital importance of high-quality palliative care and bereavement support services. 

Palliative and end-of-life care has never been as important as now. Whether dying of COVID-19 or other terminal and life-shortening conditions, people require expert palliative and end-of-life care. The acute rise in deaths related to the pandemic has increased the need for hospice and palliative care, on top of an already increasing need, with annual deaths under normal circumstances already projected to increase by 25 per cent over the next 20 years. As Marie Curie state, even before the pandemic one in four people didn't get the care or support they needed at the end of their lives. People are living longer with multiple conditions, and now our world contains a virus that could force any one of us to face our own mortality sooner than we expected. 

As Hospice UK state, during the pandemic Wales has seen a 10 per cent increase in deaths, and every person dying from COVID-19 could benefit from palliative and end-of-life care. Hospices and NHS palliative care services have provided continuity of care to people with terminal and life-limiting conditions throughout the pandemic. In some cases, front-line hospice staff have been amongst the only health and care professionals in contact with people as they approach the end of their lives. While many people want to die in their own homes, for some the hospice is their preferred place of care and, for many, it may not be possible or practical to be supported to die in their own home, highlighting the importance of hospice in-patient units also. Throughout the pandemic, hospices have been proactive in ensuring their communities have access to their in-patient services, providing specialist end-of-life care or crisis care should they need them. Nightingale House Hospice in Wrexham changed its referral process so that people or their families could self-refer into their care, as well as maintaining traditional routes of professional referral. Instead of closing, the hospice effectively opened up access to its care.

In April 2020, the Welsh Government announced up to £6.3 million to support continued core clinical hospice care, and develop hospice bereavement care, recognising the essential care provided by hospices when no alternative NHS provision is in place, care primarily funded through charitable donations. In 2019, hospices needed to fundraise £33.3 million to supplement the £5.7 million they received from statutory sources. Although the Welsh Government allocated £6.3 million to the hospice emergency fund, this is less generous than equivalent funds in all other UK nations, and falls significantly short of the total allocated to the Welsh Government in consequential funding from the UK Government's support for hospices in England. 

There has been no confirmed additional support for hospices in Wales to maintain their essential services during 2020-21, and they're facing a combined shortfall of £4.2 million by March, next month. However, hospice and community palliative care services are still providing vital face-to-face care to people. More people are being cared for at the end of life in their own homes, and this when extended families and friends aren't able to be with them, putting immediate families under huge pressure. In contrast, NHS England added up to £125 million for the five months from November 2020 to March 2021 to their original funding package, equating to up to £6 million extra in consequential funding to the Welsh Government. Again, the Welsh Government has not indicated that palliative care services in Wales will benefit from this. Further, there was no indication in the Welsh Government's draft budget for 2021-22 of continued support for hospices to maintain their essential services, despite their estimated combined shortfall of £6.1 million during 2021-22.

Before the pandemic, the Welsh Government agreed to review charitable hospice funding, recognising that the current arrangements neither accurately reflect population need for palliative care now, nor the projected increase into the future. As yet, this review has not been forthcoming. All hospice in-patient services providing specialist end-of-life care or crisis care have continued throughout the pandemic, as have hospice and bereavement counselling teams, many of which are also offering specialist mental health and bereavement care to local health and care staff through the pandemic. As the current Welsh Government end-of-life care delivery plan comes to an end, hospices in Wales are calling for a new national plan that both takes a whole-system approach and responds to the shift in home deaths through the pandemic. As the pandemic has demonstrated, every person should have access to expert and dignified end-of-life care no matter where they die. Diolch.