The Adult Social Care and Health Overview and Scrutiny Committee met on Wednesday 24 June 2026 to discuss the critical financial challenges facing local hospices and palliative care services, and to review the year-end performance report for Adult Social Care. The committee heard impassioned pleas from hospice representatives detailing their struggles with funding and increasing demand, alongside a review of the council's performance in delivering social care services.

Palliative Care and Hospice Services Face Funding Crisis

A significant portion of the meeting was dedicated to understanding the precarious financial situation of Warwickshire's hospice and palliative care providers. Representatives from Shipston Home Nursing, The Shakespeare Hospice, Mary Ann Evans Hospice, and Myton Hospices presented a stark picture of their operational challenges.

Martin Sandler, a consultant physician and associate medical director, provided an overview of end-of-life and palliative care, highlighting the vital role hospices play in providing symptom alleviation, bereavement support, and holistic therapy, often complementing NHS services. He noted that while demand for these services is rising due to an ageing population, hospices are facing significant financial challenges driven by increasing costs and a heavy reliance on charitable income, which makes their financial planning unpredictable.

Andrew Revelle, Executive Director of Shipston Home Nursing, emphasised that hospices aim to reduce pressure on acute services by preventing unnecessary hospital admissions and supporting patients to remain at home. However, he stated that between 80% and 90% of their funding must be raised through community support, events, and grants, with only a small percentage coming from the NHS.

Tracey Sheridan, CEO of The Shakespeare Hospice, revealed that the hospice was facing a significant funding gap, requiring £100,000 per month to be drawn from reserves to cover salaries. This situation had led to the difficult decision to reduce clinical services by 25%, resulting in the redundancy of clinicians. She expressed concern that local communities would lose a CQC Outstanding rated service.

Liz Hancock, CEO of Mary Ann Evans Hospice, detailed how the hospice's reserves had been dramatically reduced due to consecutive years of significant financial deficits, leaving them with only one month of operating expenditure. This had necessitated cost reductions, including redundancies and the closure of their lymphoedema service. She highlighted that demand for their services had grown significantly, with their hospice-at-home team delivering over 5,000 hours of personal care in 2025-26, a substantial increase from the previous year.

Ruth Freeman, CEO of Myton Hospices, focused on the critical issue of inpatient bed availability. She stated that Myton Hospices, the only provider of hospice beds for Coventry and Warwickshire, had 11 beds decommissioned due to affordability issues, despite a significant waiting list. She argued that the cost of a hospice bed is less than an acute hospital bed and that opening these beds could eradicate waiting lists, saving the NHS an estimated £3.5 million annually.

Councillor Kate Rolfe, a trustee of The Shakespeare Hospice, expressed her shock at the financial crisis facing these organisations, particularly the inability to use 11 beds at Myton Hospices. She stressed that these services provide significant value for money and take pressure off the NHS, questioning why they were not receiving more substantial NHS funding.

Rachel Danter, Executive Director of Strategy and Strategic Commissioning for the Coventry and Warwickshire Integrated Care Board (ICB), acknowledged the national funding challenges for hospices and stated that the ICB was working to address these issues. She indicated that a new government document recognised the need for a review of hospice funding and that the ICB was committed to developing a longer-term strategy for commissioning hospice care. She offered to return to a future meeting with a more detailed plan.

The committee discussed various potential solutions, including exploring funding through continuing healthcare, seeking match-funding from private funders, and the possibility of councillors using their discretionary funds. There was a strong consensus that immediate action was needed to prevent hospice closures and service cuts.

Year-End Integrated Performance Report 2025/26

The committee also reviewed the Year-End Integrated Performance Report for Adult Social Care and Health for the period April 2025 to March 2026. Pete Sidgwick, Director of Adult Social Care and Support, presented the report, which indicated that 80% of Council Delivery Plan activities were on track, with 10% delayed and 10% challenging.

Key performance indicators (KBMs) showed that 58% of KBMs were achieved or delivering. However, two KBMs remained challenging: the percentage of older people supported in long-term services who remain in the community, and the number of carer assessments and reviews completed.

The report highlighted a projected overspend of £6.909 million for Adult Social Care and Health services, attributed largely to the increasing cost of care for older people and the gap between assessed contributions and actual care costs. Savings targets were forecast to be underachieved by £5.355 million.

Councillor Tracey Drew raised concerns about the HCRG contract for the 0-19 service, noting delays in mobilisation due to contract challenges, elections, and a subsequent cyber attack. While assurances were given that HCRG had addressed the cyber attack and had a good record elsewhere, the committee requested a detailed summary of the cyber security situation from the Council's Head of IT.

Councillor John Holland questioned why the council had two challenging and one underachieving KBM. Pete Sidgwick explained that the challenge with supporting older people in the community was due to demand exceeding targets, meaning more people were entering care homes, which was a necessity. The challenge with carer assessments and reviews was attributed to staffing gaps and ongoing service improvement work.

Councillor Drew also inquired about Warwickshire's older residents paying high levels of client contribution towards care costs. It was explained that this was due to the local population's ability to pay, as assessed under national regulations, and that individuals unable to afford contributions received them at no cost.

The committee noted the report and agreed to the future performance reporting arrangements for 2026/27.

Decisions Made:

• Councillor Jo Barker was elected as Chair.
• Councillor John Holland was elected as Vice-Chair.
• The committee agreed to note the draft Council Plan 2026-30 as part of the engagement process.
• The committee agreed to prioritise scrutiny of damp and mould in housing and a review of the Council's response to COVID-19 for its work programme.
• A briefing note from the Integrated Care Board (ICB) on preparations for winter pressures was requested.
• The committee agreed to schedule an in-depth review of hospices and palliative care for its next meeting.
• Detailed scrutiny of arrangements to support informal carers, including young carers, was added to the work programme.
• Briefing notes were requested on dementia diagnosis and support, menopause services, the CQC assessment of Adult Social Care, and the Home Environment Assessment and Response Team (HEART).
• The committee agreed to consider and comment on the year-end organisational performance, progress against the Council Delivery Plan, and management of finances and risk.
• The committee noted the future performance reporting arrangements for 2026/27.

Key Attendees:

• Councillor Jo Barker (Chair)
• Councillor John Holland (Vice-Chair)
• Councillor Kate Rolfe
• Councillor Tracey Drew
• Councillor John Holland (Deputy Leader of the Labour Group)
• Martin Sandler (Consultant Physician)
• Andrew Revelle (Executive Director of Shipston Home Nursing)
• Tracey Sheridan (CEO of The Shakespeare Hospice)
• Liz Hancock (CEO of Mary Ann Evans Hospice)
• Ruth Freeman (CEO of Myton Hospices)
• Rachel Danter (Executive Director of Strategy and Strategic Commissioning, ICB)
• Pete Sidgwick (Director of Adult Social Care and Support)
• Shade Agboola (Director of Public Health)
• Becky Hale (Executive Director for Social Care and Health)
• Zoe Mayhew (Director of Social Care and Health Commissioning)