Can social investment fill the end of life care funding gap?

by Maneesha Sharma
Project Manager, Social Investment in End of Life Care Initiative


With demand for end of life and palliative care services on the rise, a key question for UK healthcare is: where will the money come from to meet this demand?

Working in partnership with Sandwell and West Birmingham Clinical Commissioning Group, we at Marie Curie hope an innovative health pilot project, the Social Investment in End of Life Care Initiative, could provide an answer.

The pilot is being developed with NHS ConfederationNHS Clinical CommissionersSocial Investment BusinessBevan BrittanSocial Finance and Unipart. Its aim is to see whether social investment can be used to transform end of life care.

Social and financial return

Social investment is a funding model where finance is given to organisations with a clear charitable or social agenda, to generate both a social and financial return.

Currently, throughout the UK, community palliative and end of life care services are under-invested in and don’t have the capacity to meet current needs, much less the increased demand expected from 2015.

We need to start looking for new solutions, because the problem isn’t going to go away. Britain’s rapidly ageing population and increases in the number of people with multiple long-term conditions will mean that by 2030, the number of deaths each year will outnumber the number of births, rising by 17% to 590,000. NHS spending on end of life care is also expected to increase from £20 billion to £25 billion by 2030[1].

Service commissioner challenges

Establishing new funding routes will enable health providers to meet the needs of Britain’s rapidly ageing population – helping people to be cared for in the community, freeing up NHS beds (40% of those receiving end of life care in hospital have no clinical need to be there[2]) and reducing the burden on acute services.

Investing in community palliative care would enable more people to be cared for and die in the place of their choice. Most people (63%) would prefer to die at home; however, only 21%, across England and Wales, do so[3]. More than 60% currently die in hospital – the place where they are least likely to want to die.

Innovative funding model

While it’s cheaper for people to be cared for in the community, and it’s what they want, it’s challenging for commissioners to find the money needed to develop new services that are community based. Social  investment offers a way of funding that change.

This is the first social investment project for end of life care in the UK. If it works well, we want to use it as a blueprint model for services elsewhere. By March 2014, we aim to have a new integrated model for end of life care and social investment alternatives for funding.

We hope it will lead to improvement of services for end of life care patients and enable patient choice, ensuring that the right treatment and support is delivered at the right time, in the right place.

[1] Dying for Change, Demos 2010

[2] National Audit Office, 2008

[3] Dying Matters Coalition dated 2013