Select Committee on Health Written Evidence


Memorandum by New Opportunities Fund (PC 23)


  1.  The Community Fund distributes money from the National Lottery to projects across the United Kingdom to help meet the needs of those at greatest disadvantage in society and to improve the quality of life in communities. To date, the Community Fund has distributed £2.6 billion to 56,000 charities and community groups across the United Kingdom. Funding is restricted to the voluntary and community sector.

  2.  The Community Fund has funded a significant number of projects concerned with palliative care, particularly hospices. While the Fund does not support work which is the responsibility of the NHS, we have consistently funded other aspects of hospice work, including capital projects, education, hospice volunteers, bereavement counselling and respite care, provided by the voluntary sector. These projects have built on the central role of the voluntary sector and volunteers in the provision of palliative care, both in terms of day-to-day hospice management and in wider outreach work.

  3.  Since 1995, the Community Fund has made 119 grants totalling more than £29 million to hospices and related programmes. Examples of some of the projects funded are given in Annex A.


  4.  The New Opportunities Fund delivers programmes to support education, health and environment initiatives across the UK. Since the Fund's inception in 1999, we have committed over £3.5 billion to these areas.

  5.  The Fund's health programmes are very diverse and cover prevention, detection, treatment and care services across a range of areas including palliative care. Details of the Fund's palliative care programmes are set out below, including an explanation of how they are targeted and what findings our evaluations have made. Also included are two case studies at Annex B.

The adult programme

  6.  The £22 million adults programme was targeted at areas of the country with the highest palliative care need. Awards have been made to 55 multi professional teams to enable them to care for people in their homes. These teams offer therapeutic, nursing and emotional support and some also make use of complementary therapies. A number of these projects will also be extending the availability of care for longer periods of the day.

The children's programme

  7.  Seventy awards have been made to home based care teams to enable them to provide a range of services to allow children to be cared for at home. Thirty-nine bereavement teams are helping families who have experienced or will go through the death of a child. Twenty-five children's hospices have benefited from grants that will enable them to sustain or develop their provision. Four-eight million pounds was made available for this programme.

Timetable for the adult and children programmes

  8.   Both programmes were launched in March 2002. The maximum grant length was 36 months with an optional four months lead-in time, so most schemes are expected to be in operation until 2006-07.

Aims and evaluation

  9.  The evaluation of the Fund's palliative care programme began in April 2003, so it is too early to report interim findings. However, the evaluation of the NOF cancer programme is further ahead and, since 95% of adult palliative care services are used by people with cancer and there is some cross-over in home-based service delivery between cancer and palliative care, we consider the early cancer findings to be of relevance to the palliative care programme. Both programmes are aimed at improving access for groups whose uptake of services has hitherto been limited. In line with the Fund's overall mission, the programmes aim to target disadvantaged regions and groups, with particular regard to BME communities' access to cancer services and children's access to palliative care services.

  10.  The cancer and palliative care programmes will be evaluated by the same partnership from City and Warwick Universities, ensuring that learning is shared between them. The cancer evaluation recently produced its first annual report, which identifies some emerging themes arising from initial case studies. The evaluation includes projects across England, Scotland, Wales and Northern Ireland (projects that were wholly for equipment or capital building were not included in the evaluation). With an overall aim of improving cancer prevention, detection, treatment and care, projects focus on homecare, carer support, information provision and improved access to and awareness of cancer services.

  11.  Early findings indicate that the Fund's cancer projects are generally located in areas where there is high cancer mortality, high mortality from other causes and high levels of deprivation. New partnerships and collaborations have developed to deliver cancer services to hard-to-reach groups. Such new partnerships have encountered some start-up difficulties and cultural challenges, particularly when they involve voluntary and statutory organisations working together, but they have also led to new ways of working, innovative approaches and delivery of services to marginalised groups. Other projects have been affected by NHS restructuring and have had some difficulty recruiting and retaining staff on short contracts. We expect this problem also to be faced by palliative care teams. Projects are gradually becoming aware of the wide range of organisations involved in the cancer field, and NOF is working with them to encourage greater awareness of cancer networks, particularly as considerations of sustainability and future funding start to arise.

  12.  These emerging themes provide NOF with an assessment of the success of its cancer initiative in meeting the programme aims and individual project aims and contributing to NOF's wider mission and values. They will be fed into the development of the palliative care programme, encouraging linkage between different organisations and the sharing of good practice.

Sustainability issues

  13.   The Fund expects schemes to have considered arrangements to sustain the gains made by projects once their funding from NOF is complete, and to have begun to develop continuation funding or exit strategies. The Fund is encouraging all projects to carry out a self-evaluation; in addition to improving performance management this will help projects to reflect on their progress and provide evidence of success to potential funders.


  14.  The proposal to create a new distributor is a central part of the Secretary of State's review of the National Lottery. The National Lottery Funding Decision Document in July 2003 sets out the case for a new distribution body which will take on the functions of the Community Fund and the New Opportunities Fund and assume the Millennium Commission's ability to support large scale regenerative projects, as well as taking a wider responsibility for leading on a range of Lottery issues on behalf of all Lottery distributors.

  15.  The intention is that the two organisations will merge administratively in May 2004, in preparation for legislation which defines the powers of the new distributor and establishes it as a legal entity.

February 2004

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