Terry O’Leary, Chair of St Catherine’s Hospice in Crawley, West Sussex, reflects on his learnings from attending his first Hospice Quality Partnership meeting. As a relatively new hospice chair, attending my first Hospice UK National Conference with a very full and complicated multi-stream programme, I found myself in a session I had not intended to join. Understandable, maybe, but fortuitous certainly. The session in question was the Hospice Quality Partnership (HQP) annual meeting. Even when I explained that St Catherine’s Hospice is not a member and I did not really know what HQP did, I was still made welcome, and I am very glad that I stayed. What I learnt during the session and from subsequent discussion with HQP MD, Tracey O’Keefe since, answered a question I have had for over a year. Coming from an unrelated environment (Global Banking on a very large scale) with no health or hospice background other than personal experience, I have frequently wondered why 200 medium size charities across the UK who essentially do the same thing for our respective communities, and who collaborate so effectively in so many ways clinically, do not always collaborate more cohesively in their acquisition of the third party goods and services they rely on to deliver care in their communities. Whenever I occasionally asked this question across our local network, the answer I received was seldom fully satisfactory. But what is clear is that scaling up from St Catherine’s Hospice numbers, UK hospices spend around £500 million annually – excluding salaries – on the goods and services needed to deliver care. I am sure we all believe we get the best possible deals but whether we like it or not, individually, we are small players with limited commercial leverage. However, collectively, we are potentially much more powerful, particularly with national suppliers. The scale of this opportunity is not life-changing, conservatively 10 to 15 per cent (I am estimating, hopefully more), but when you think of it in individual hospice terms it has a much bigger impact – think of how much fundraising effort or retail activity it would take to raise a net £250,000, or how that money could be used elsewhere. For example, to pay for nurses we cannot currently employ When we know there is this type of potential value for each of our individual hospices, I think we need to start exploring in more depth what is stopping us from working more collaboratively to acquire goods and services. But there are also three other reasons that we, at St Catherine’s, are joining HQP and why I would encourage other hospices to consider doing so too: At all times, we must be able to look our donors in the eye and say with conviction that every hard earned pound they give us is well spent. I believe we generally do, but I also believe we can do better. We do not currently reach everyone in our communities who need and deserve our care; to reach more of them we need more income which is always challenging – optimising third party costs can generate more income. We rely on the NHS for around one third of our income on average. Anecdotally, the NHS, while they respect what we do for terminally ill people, look at us as small, fragmented and possibly even inefficient local organisations. The NHS is a vast, leviathan-like £120 billion operation and they decide how much they will pay us. It is a decision that is important because it has a direct impact on the care we can give people in our communities. The more we can persuade them that we are not fragmented or inefficient, the stronger our argument for a greater share of their funds. The potential of gaining a greater share of funds is huge. Such is the scale of the NHS, if they increased their hospice funding by one tenth of one per cent (0.1 per cent) of the total NHS budget, that would raise total hospice funding by more than 5 per cent on average. Think how much effort it would take to increase your income by 5 per cent! But what about our identity as community-based charities relying largely on the generosity of the people we support? Is that compromised or confused if we are associated with national organisations, like HQP or Hospice UK?  I really do not think so. Our communities care that we are there for them locally when they need us, that we are human, approachable and accessible. Do they mind if we buy our electricity from X, or our insurance from Y? I very much doubt it. At St Catherine’s we are dipping our toe into the HQP water for all the reasons set out above. Time and experience will tell how beneficial this is but the more of us who participate; the greater the benefits are likely to be. I ask you to do no more than think about it. For more information visit St Catherine’s Hospice