Looking ahead to a strong financial future for health and social care organisations
It’s well-known that parts of the health and social care sector in the UK - covering care homes, domiciliary care and hospice services - are experiencing financial hardship.
A study from BBC Radio 4 in November 2020 found that care homes had combined debts in excess of £100m, with a quarter facing closure.
Elsewhere in the health and social care sector, some hospices were already struggling to balance the books even before the pandemic struck. This is clearly worrying given that a report from Sue Ryder in February 2021 estimates that demand for palliative care alone is projected to rise from 245,000 in 2021/22 to 379,000 in 2030/31.
Keeping cash flowing
To ensure they could continue delivering care to patients, finance teams in hospices have to work even harder to maintain financial stability, as Maria Holmes who is the finance director for Nottinghamshire Hospice, explains:
“We really had to ensure our income levels were stable enough. It was crucial that we were able to continue to support those we were helping and keep the charity and its staff going.
“We were able to achieve this during lockdown by adapting our fundraising activity to maximise digital opportunities. Alongside this, many of our supporters devised their own virtual challenges to raise funds for us.”
Although shop closures led to a digital transformation in the industry, accelerating the use of virtual donation tools, not every organisation had the facilities to pivot quickly and the effects are still felt. A 2020 survey by charity Hospice UK revealed 44% of hospice leaders estimated they could be forced to reduce the end-of-life services they deliver due to Covid-19.
Weathering the storm and reaching stable ground
With a projected deficit of £150,000, Nottinghamshire Hospice knew it had to take action to mitigate the impact of the pandemic.
To boost income sources while shops were closed, the charity applied for funding through grants and trusts, as more organisations opened up to support charities during the Covid-19 pandemic. New fundraising campaigns were also launched, including the Forever Fund appeal. This aimed to recruit regular givers, which can typically donate more than 42% over the course of one year than a one-time giver does. It also used the Big Give match-funding platform in December which, together with other fundraising activities, raised more than £80,000 for its Christmas appeal – more than ever before.
“With so much uncertainty, the finance team had to work hard to ensure stability,” said Maria. “We did this by maximising use of government support including the furlough scheme and Local Authority business grants to support our shops. We have also ensured the careful management of our expenses wherever possible.
“We have been fortunate to see a real increase in support as a result of Covid-19. Our supporters have been especially conscious of the challenges we faced...we plan to build on this momentum.”
In May 2020, as a direct response to the pandemic, Nottinghamshire Hospice launched the Hospice Outreach and Discharge Support service (HODS), to fast track people out of hospital and receive end of life care in their own homes. An anonymous windfall of £110,000 ensured it could be funded for three months.
Maria continued: “We’ve learnt a lot about how our supporters enjoy engaging with us. Moving forward we will continue to provide poignant, meaningful ways for people to remember their loved ones. This includes fun and creative ways for people to take part in sponsorship events and challenges. We will also continue to communicate with our hospice family, sharing stories and future plans through our direct mail and social media platforms.”
Post-pandemic financial future
Finance teams for hospices and charities can breathe a sigh of relief with restrictions now lifted. Charity shops are now open again and filled with stock to sell. survey in summer 2020 found that over half of householders had items to donate, after clearing out their homes over lockdown, while 56% felt comfortable to purchase from a charity shop when they reopened (just marginally less than new clothes stores, which was at 60%).
Still, the wider health and social care sector is recovering from a period of intense pressure, as it worked to keep its service users and staff safe amid the pandemic. New challenges are appearing too - a call for mandatory vaccinations for staff is leading to predictions of staff shortages. A survey of care home managers by the Institute of Health and Social Care Management found that 58% of operators estimate that they’ll need to lay off workers who chose not to have the vaccine by November 2021.
For much of the country, life is returning ‘back to normal’ after Covid-19. For health and social care, the pre-pandemic norm was still one that relied on careful budgeting and reforecasting to keep businesses agile, and ensure continued service delivery. But as Nottinghamshire Hospice has shown, even during the toughest times, it’s possible to steer a stable ship with a clever use of resources.
