Social investment in end of life care

Why do we do what we do? What motivates us? What drives us to be our best selves? When we think about fulfilling roles, roles that have a direct impact for good, we probably think about nurses, doctors and volunteers (and rightly so!).

Even though my role as a finance director isn’t ‘on the front line’, my motivation for joining Macmillan and what keeps me going is a personal connection.

I lost my mum in my 20s. She died after a brave fight with stomach cancer and I spent three days and nights by her side in a hospice.

So I’ve seen first-hand how important good end of life care is. But through Macmillan’s work talking to people with cancer, we know many people aren’t getting the end of life care they want and deserve. The healthcare system is struggling to address that due to cost pressures and capacity.

That's where finance and social investment comes in.

Macmillan is using social impact bonds to improve end of life care. This is in partnership with UK healthcare organisations and Social Finance.

Firstly, we agreed some outcomes based on the things that matter most to some people. For instance, like being cared for or dying at home instead of in hospital.

We work to address system pressures like hospital capacity, spend on agencies or workforce challenges.

As part of the process, we consider the impact of what matters most to people on system pressures like:

• hospital capacity
• workforce challenges
• financial challenges.

The agreement involves Macmillan funding the entire cost of the new service. The partner organisation starts paying back about halfway through the contract. But only if they’ve achieved the agreed system level and patient outcomes.

Repayments are capped up to the value of the original investment. If the new service doesn’t achieve the outcomes, Macmillan as the investor absorbs the cost. This helps to reduce the risks associated with innovation.

We’re acutely aware of the financial challenges the public sector is facing. Asking for an investment to be repaid can sometimes be a challenge. That’s why we work with finance teams to build the business case and model the cost efficiencies a project will create.

Although financial successes with the system are important, ultimately whatever we do is about people with cancer and at the end of life. And through our social investments we have supported more than 10,000 people as they approach the end of their lives.

That’s why Macmillan has launched a £36m fund. Over a 4-year period will invest in end-of-life care services. Using social investment we want to improve the outcomes of people who are in the final stages of their life.

For our loved ones, like my mum, when they’re near to the end of their lives, we want the experience to be as good as it can be.

If we know that social investment is a way of giving that to more people that’s also financially sustainable for the system, why wouldn’t we?

To find out more about the Macmillan Fund, take a look at our social investment resources page.