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<p>No specific assessment has been made of provision or patient population in Wirral
or the north west. As with the vast majority of NHS services, the funding and commissioning
of palliative and end of life care, is a local matter, over which individual National
Health Service commissioners have responsibility. Local commissioners are best placed
to understand the needs of local populations and commission services to meet those
needs accordingly. The only exception to this are a small number specialist paediatric
palliative care inpatient services, commissioned nationally by NHS England from <ins
class="ministerial">ten centres </ins><del class="ministerial">eight centres</del>
across England as part of its remit to deliver specialised services.</p><p> </p><p>Much
of the routine palliative care patients receive will be provided either in outpatient
or community settings, by nurses, community teams or general practitioners as part
of general NHS services provision, rather than as an identified palliative care service.
In such services, data are either not available or does not identify palliative treatment.
In addition, social and voluntary sector organisations can provide additional support
to patients at the end of life. Therefore, figures for the total cost of palliative
care service for children nationally, or across local areas, is not available. Decisions
regarding referral to local palliative care services will be made on the basis of
clinical need.</p><p><br /> The following table shows information regarding funding
provided via the Children’s Hospice Grant to hospices in the North and in Wirral over
the last eight years. Nationally, children’s hospices are receiving £11 million in
2018/19 through the Children’s Hospice Grant, which is awarded annually and administered
by NHS England.</p><p> </p><table><tbody><tr><td><p> </p></td><td><p>North west</p></td><td><p>Wirral</p></td></tr><tr><td><p>2011/12</p></td><td><p>£1,522,944</p></td><td><p>£353,306</p></td></tr><tr><td><p>2012/13</p></td><td><p>£1,522,944</p></td><td><p>£353,306</p></td></tr><tr><td><p>2013/14</p></td><td><p>£1,562,576</p></td><td><p>£353,306</p></td></tr><tr><td><p>2014/15</p></td><td><p>£1,562,576</p></td><td><p>£362,500</p></td></tr><tr><td><p>2015/16</p></td><td><p>£1,562,576</p></td><td><p>£362,500</p></td></tr><tr><td><p>2016/17</p></td><td><p>£1,562,576</p></td><td><p>£362,500</p></td></tr><tr><td><p>2017/18</p></td><td><p>£1,562,576</p></td><td><p>£362,500</p></td></tr><tr><td><p>2018/19</p></td><td><p>£1,562,576</p></td><td><p>£362,500</p></td></tr></tbody></table><p>
</p><p>Notes:</p><p> </p><p>- The children’s hospice grant programme provides a general
contribution to the operating costs for hospices. It does not pay for actual services
for patients in specified areas. Therefore, it is not possible to reconcile the grant
payment to actual activity delivered within any geographical area. Neither does the
grant pay specifically for specialised or non-specialised services as it is a general
contribution.</p><p>- For this analysis for the grant figure for the North West includes
Cheshire, Merseyside, Greater Manchester, Lancashire and Cumbria based hospices.</p><p>-
The Wirral figure is for a single hospice.</p><p>- Local NHS commissioners also provide
funding to children’s hospices which is a mixture of grant funding and activity based
payments. Due to the low value of this funding this is not routinely recorded and
so is not readily available.</p><p>- Local authorities also provide some funding to
some hospices, but this information is not held by NHS England.</p><p> </p>
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