Thank you. Despite hospices putting emergency fundraising activities in place and reducing non-essential provision, there was still a very high and growing risk that hospice and end-of-life care services could slip into insolvency. That is why the Welsh Government stepped in and allocated almost £14 million of emergency funding to support Welsh hospices throughout the pandemic. This funding was provided specifically to reimburse hospices for their loss of income through their charitable activities, to protect their core services and to strengthen bereavement support.

Turning specifically to our programme for government commitment to review voluntary hospice funding, the Welsh Government has made significant steps to review the specialist palliative care funding formula, implemented back in 2010-11 following the palliative care planning review undertaken by Vivienne Sugar. Following the Sugar review, an annual budget of £6.3 million was put in place to help take forward the recommendations of her report—£3 million of which was allocated to voluntary hospices. In 2014, that funding was repatriated to health board budgets and ring-fenced until 2017.

While individual hospices have secured additional funding as part of service level agreements with health boards, there has been no recognised uplift of actual core costs since the original allocation back in 2010-11. Recognising this, in July 2021, I asked the end-of-life care implementation board to undertake a voluntary hospices funding review as part of a wider end-of-life care services review, which would include all statutory and voluntary sector provision. The preferred approach would have been to undertake the wider end-of-life care service review first, followed by the review of voluntary hospice funding. However, the urgent need to make recommendations for future hospice funding in time for the 2022-23 draft budget led to a prioritisation of the hospice funding review.

The original funding formula centred on an evidence-based model of care, simply quantifying care delivery around numbers of beds and the largely clinical teams of consultants in palliative medicine and clinical nurse specialists. Hospice at home was excluded from the formula, and has since become a vital part of care closer to home, allowing patients to exercise their choice to die at home. The formula also did not take account of the vital role of children's hospices in supporting children with life-limiting conditions and their families through the availability of respite care. A number of significant considerations were also acknowledged at the outset of the review, including that children’s hospices are inherently different from adult hospices, and a comprehensive assessment for people with palliative and end-of-life care needs had not been undertaken.